Singapore epidemics over the years

In the 95 years of the school’s history, Tanglin Trust School Singapore has gone through at least four other epidemic hiatuses, civil unrest and a world war! FIONA RITSON talks us through the community resilience these experiences have built.

Tanglin’s experiences of polio in the 1940s, SARS in 2003 and H1N1 in 2009, all serve as reminders that the novel coronavirus is not as unprecedented as it might seem. This in itself might bring some comfort, but when we are all in need of some good news stories, the positives that came out of these past challenges might also give (comfort) food for thought…

#1 Poliomyelitis (polio)

While the world was teetering on the edge of World War II, another grave threat was gathering force across Singapore and Malaya. Sporadic cases of polio that were reported in the 1930s spiralled into two larger outbreaks in the 1940s, causing school closures in the region.

In 1941, Tanglin’s Cameron Highlands Boarding School closed due to the epidemic, and remained closed during the WWII occupation. Tanglin alumna, Dorothy (Webber) Weigall, who attended the school from 1940-1941, remembers: “We finished school early in November 1941 because of a polio outbreak, and shortly after that the war started in Malaya with the fall of Singapore on 14 February 1942.”

Mrs E. M. Turner, who was a teacher there from 1939 to 1941, also remembers the epidemic in a diary she wrote during her wartime internment in Sumatra. This diary is now in the Documents Department of the Imperial War Museum and was used as a basis for the TV series Tenko:

“… breaking out just before the evacuation of Cameron Highlands, there was a terrible tragedy, in no way connected with the war, but its repercussions collided with the invasion of the Japanese: this catastrophe had been the outbreak of a polio epidemic … We had all been obliged to go into quarantine. I am only briefly touching on these tragic days, since they were irrelevant to the war situation. The one and only ‘iron lung’ in the whole of Malaya, was rushed to Batu Gadju Hospital, but was too late to save the life of [the] first girl.”

After the war, Tanglin’s Singapore school and Cameron Highlands Boarding School reopened. But in 1948 the disease resurged in Malaya, and the Cameron Highlands campus closed again.

The Straits Times, in a bulletin reminiscent of recent COVID-19 updates, reported the school’s reopening on 10 June 1948: “Tanglin School in the Cameron Highlands will reopen on June 21. The school has been closed because of the infantile paralysis epidemic. Neither any new cases nor any deaths from infantile paralysis were reported in Singapore yesterday. The number of cases so far is 95.” (Polio is also known as infantile paralysis due to its propensity to affect children.)

On 22 July 1948, another bulletin from the Straits Times records how health screenings and travel bans were used to prevent the spread of infection, just as they are today: “Australia is taking every precaution to prevent poliomyelitis infection from Malaya … every person entering Australia by ship or by plane is subjected to strict examination. The only effective way to control the import of such a disease is to ban all travel between the affected countries and Australia, officials say.”

And the positives?

The polio epidemics of the first half of the 20th century irreparably altered the lives of survivors, but they also brought about profound medical and cultural changes. In fact, intensive care medicine has its origin in the fight against polio. Most hospitals at the time had limited access to iron lungs for patients unable to breathe without mechanical assistance. Respiratory centres designed to assist severely affected patients were established in 1952 in Denmark by Danish anesthesiologist Bjørn Ibsen; a year later, Ibsen would establish the world’s first intensive care unit. These were the precursors of modern ICUs that are so crucial in treating severely ill patients in the current pandemic.What’s more, the vast community of disabled polio survivors propelled the development of rehabilitation therapy, and advanced the disability rights movement.

#2 SARS

Before coronavirus, there was another severe acute respiratory syndrome – better known as SARS. It came to Singapore in March 2003. At that point, little information had been shared about the new disease. The first patient spent five days in an open ward before the MOH was informed of a case of infection that was not responding to antibiotics. It was enough time to seed community transmission. From then on, the government moved swiftly to put in measures that gave Singapore a reputation for having the toughest strategies against the virus.

And the positives?

Singapore learnt a lot from SARS. With quicker and more organised deployment, the same measures used then (contact tracing, quarantine, travel advisories and health checks) have been used to great effect in limiting the spread of coronavirus in 2020.

Closer to home, Tanglin teacher and alumna Nadia Candy has these memories of distance learning during SARS:

“I was in Year 9 when it happened. The school sent us home with what felt like a textbook worth of learning. (As a teacher, I now know the amount of last-minute organisation involved. But as a child I wasn’t happy about lugging home pages of work!)

“My sister and I sat at the dining table for ‘school hours’ and my mum timetabled our day. The whole thing lasted two or three weeks, and I remember a lot of fear around the country; being told not to take taxis and buses, and people stocking up on canned goods and water. Singapore has learnt a lot from that, and I think it’s why everything is so calm and organised. We’ve been through it before!

“I have fond memories of that time. My whole family was at home more, I played with my sister in our garden, and my mum created little games for us. The internet wasn’t used to the same extent, so we were shielded from the news and our parents didn’t talk about it around us. We created our own little bubble, so the experience wasn’t a negative one. I hope that in 17 years, when our children are adults, they’ll remember all the fun things they got to do too!”

#3 H1N1

Singapore confirmed its first case of H1N1 – or Swine Flu – in late May 2009. Prior to the outbreak, there was already a disease surveillance system and influenza pandemic preparedness plan in place: the Disease Outbreak Response System Condition (DORSCON). This five-colour alert system progresses from green to yellow, orange, red and black.

On 28 April 2009, MOH raised the alert mode to yellow for the first time. Two days later, it was raised to orange. While H1N1 was very contagious, infected persons experienced mild illness. So there wasn’t the same threat to health service capacity as there is with COVID-19. MOH downgraded the alert to yellow on 11 May 2009.

Omar Chaudhuri, alumnus and Head Boy in 2009, has this anecdote about his H1N1 experience:

“I was on an end-of-year trip with my year group to Phuket when I started to feel ill. On my return to Singapore, I passed the temperature check, but that night my fever was extremely high, and I was taken to Gleneagles Hospital. I tested positive the next day. About a dozen students from my group contracted the disease, so graduation had to be postponed until September. I made a speech as Head Boy where I referenced Swine Flu, but what I really remember is feeling sad that not all the students could attend as many had already travelled to the UK to start university. The silver lining was that it made a good anecdote at Freshers Week!”

And the positives?

Tanglin‘s Lead Nurse Sarah Le Grice describes how the school’s pandemic plan was further developed in the aftermath of H1N1:

“We developed the temperature sticker system during H1N1. I remember standing by the car line on the first day it was used, hoping it was going to work, and seeing a sea of blue stickers on children getting out of cars. Such a relief. And then being complimented by a parent who worked at a big international company in Singapore who’d taken the same system on.

“We put together a more robust Pandemic Plan straight after H1N1, along with a Pandemic Box with stickers, thermometers and other equipment. This has been regularly checked and updated over the years. So, the initial reaction on hearing about COVID-19 was to check the box and see what other equipment we needed.”

Being intergenerational learners has provided some foresight. As we learn how to manage in the moment, we are always reimagining how to thrive in the future.

This article first appeared in the June 2020 edition of Expat Living. You can purchase a copy or subscribe so you never miss an issue!