Courage in a crisis
The mysterious and deadly disease that struck Singapore in 2003 brought out great courage from the healthcare workers at the frontlines.

For about two months in 2003, a mystery virus raged in Singapore. It first appeared on Saturday, March 1, at Tan Tock Seng Hospital, when a young woman was admitted to Ward 5A. She was Miss Esther Mok, Patient Number 1.

Other patients, their visitors and healthcare workers who had had contact with the young woman began to fall ill. No one knew anything about this disease. Only that it appeared highly infectious and that normally healthy people were reduced to weak, gasping shadows of themselves in days.

On March 15, the mystery illness it had been puzzled by for two weeks had a name. An alert from the Geneva-based World Health Organisation (WHO) called it severe acute respiratory syndrome or Sars.

Tan Tock Seng Hospital became Sars’ Ground Zero. This is where Singapore began an intensive war against a silent killer that, unchecked, could have wiped out hundreds. It was a war that tested the courage and resolve of a nation and of individuals.

As the number of Sars patients climbed, there was a shortage of ICU-trained doctors and nurses. In TTSH, nurses from other specialties stepped forward to help, under the guidance of trained ICU staff. An appeal was sent out to the other hospitals.

Seven nurses from Singapore General Hospital and two nurses and a doctor from Alexandra Hospital came over to help. From National University Hospital came two doctors and four nurses from the Children’s Medical Institute to help care for young Sars patients in TTSH.

Said Dr Loo Shi, the ICU committee chairman: “These were very appreciated. Their presence speaks more than any encouragement. These people are willing to risk their lives alongside us.”

No one really knew what would work against Sars. This was a new disease, so there was no standard treatment. Sars patients typically came in with a high fever that did not subside for days. Their bodies ached and they felt weak and unwell. Many also developed coughs. But eight in 10 would recover after a bad spell. Two in 10 would need intensive care, usually from Day 7 to 10 of the onset of symptoms.

Sars is a pneumonia-like disease affecting the lungs, where the lungs get flooded with fluid and find it difficult to get oxygen. When this happens, patients are gasping for air and need mechanical ventilation. That is when they are sent to the ICU wards.

Some patients become so ill that other organs malfunction and they may experience renal or heart failure. Some suffer strokes or get blood clots in their veins. ICU doctors used all the weapons in their arsenal of treatments.

Apart from their concern for patients, Sars ICU staff also worried for themselves and their loved ones. Many faced pressure from their families to resign. Dr Dessmon Tai’s wife wanted him to quit.

He told her: "It’s like a soldier going to war. If a war broke out, you cannot just take off the uniform and say, ‘I don’t want to be a soldier’. Or just like at the World Trade Center, when terrorists attacked, the fireman cannot say, ‘I refuse to go in and fight the fire’."

Miss Widarni Khanip, 22, an assistant nurse, felt the same way when she heard that the newly opened Sars ward at Ward 13D needed staff.

“They asked if anybody wanted to volunteer for this job. So I raised my hand and said yes,” said Nurse Widarni, whose petite frame belies her monumental courage.

Throughout the Sars period, she fed and washed patients, changed their diapers if they were bed-bound and took them to the toilet. “Everything they cannot do, we do for them,” she said.

Far from deterring her, the experience strengthened her calling to be a nurse. “I learnt to appreciate the people around me more.

“Now, I’m more mentally prepared and stronger and I think if anything happens in the future, we will be ready for it. It’s made me want to stay in nursing,” she said.

Would she volunteer again if Sars cropped up again? As she had months before, she did not hesitate when she said: “Yes.”

This story is adapted from the book A Defining Moment: How Singapore Beat SARS by Chua Mui Hoong (Institute of Policy Studies, 2004). Text copyright: Ministry of Information, Communication and the Arts. Used with permission of MICA.