SINGAPORE: The Singapore Armed Forces (SAF) is housing about 3,000 recovering migrant workers with COVID-19 in six military camps across Singapore.
The Jurong, Bedok, Amoy Quee, Guillemard, Tanjong Gul and Lim Chu Kang camps have been converted into community recovery facilities (CRFs).
Operational since Apr 28, the CRFs are for COVID-19 patients who remain well at Day 14 of the disease and do not require further medical care.
With Singapore reporting hundreds of new coronavirus infections among migrant workers every day, the Ministry of Health (MOH) aims to have more than 10,000 bed spaces in CRFs by the end of June. This includes non-SAF facilities and is part of a broader strategy to ensure sufficient healthcare capacity.
To establish the CRFs, camps that were either temporarily vacant or camps with standalone accommodation facilities that are separated from other camp facilities and have ceased operations were identified.
The SAF facilities can take in 300 patients each day, with a maximum capacity of 5,300 patients. Colonel (COL) Chua Jin Kiat, who is the task force commander of SAF-managed CRF camps, told reporters on Wednesday (May 6) that this is sufficient to meet national requirements.
Foreign workers at CRFs will be discharged based on MOH guidelines, which state that two swab tests conducted on consecutive days must come out negative prior to discharge. COL Chua said he expects a number of workers to be discharged over the next two days.
Personnel managing day-to-day activities on the ground, including auxiliary officers and civilian vendors, must adhere to strict protocols to reduce exposure to the virus.
This includes dividing the facilities into different zones depending on the risk of exposure to the virus. Personnel in the different zones are required to wear personal protective equipment (PPE) commensurate to the level of risk.
LIFE IN CAMP
Workers who first come in are medically screened and have particulars - such as dietary preferences - taken down before being brought to the living area. Technology like infrared fever scanning, information management systems and health monitoring applications are also used.
The workers are then split into smaller groups to ensure safe distancing. These groups have designated amenities, like food collection points, dining and outdoor recreational areas, to minimise transmission risks.
They are also given three meals a day, access to Wi-Fi and SIM cards, as well as mobile minimarts to buy things like snacks and basic clothing. Roving SAF medical teams will attend to their medical needs at a designated time every day.
Beyond meeting their needs, COL Chua said it is important for SAF personnel to reassure these workers that they are well on their way to recovery.
“For some of these patients, especially the foreign workers, it has not been an entirely good experience because they are COVID-19 positive. There is a huge element of fear,” he said.
“This last step is to tell them: ‘Brother, you’re almost there. One more place, you’re cured and you can go back to work.’ And letting them know we will continue to take care of them.”
Another important thing, COL Chua said, is ensuring that they have enough space to move around within their living areas, especially if they have been cooped up in community care facilities such as the Singapore Expo.
“In Expo they are in an indoor place, so when they first came to us they were quite happy to see the sunrise and sunset,” he said.
Then there are the little things like providing pails and drying points so they can wash their own clothes and ensuring each bed has its own charging point. Workers can also scan a QR code to give feedback on their meals.
“I would say that the general approach is one of engaging them with some degree of empathy,” COL Chua added.“I suppose as a military this is something that we have learnt over the years (as this is) how we treat our soldiers.”
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This involves introducing a sense of routine. For those who are not fasting, breakfast is at about 7am, after which some will rest in the bunks, walk around in the sun or do their laundry.
There’s also a morning “sick parade” where workers can report to the roving medical teams to get medicine for ailments such as body aches and headaches. COL Chua said the most serious condition he has seen is chickenpox.
After lunch at noon, vendors in PPE will drive food trucks to the entrances of their living areas.
Items on sale include snacks, non-alcoholic beverages and necessities like towels and clothing for those who might not have packed enough before being isolated. These items are reviewed based on workers’ feedback too, COL Chua said.
Dinner is past 6pm and then it’s the end of the day. “It’s not as if it’s very exciting,” COL Chua admitted. “But we try to make sure that their basic needs and welfare are met.”
When it comes to safety, COL Chua said the SAF and external personnel on the ground must wear face masks at all times. Those who enter the “yellow zones”, which include corridors and entrances where workers pass through, must put on gloves and face shields.
The living areas are considered “red zones” that are self-contained with all the amenities workers need. “Typically, we would not need to go in,” he added. “We do very clear zoning, and we have very clear rules about who actually needs to go in to interact.”
READ: Stretched but coping: How Singapore's healthcare system has cranked up efforts to deal with COVID-19
With cases of healthcare personnel being infected in other community facilities, COL Chua said personnel on the ground are properly fitted and trained in wearing industry-standard PPE.
“We have a strict training protocol that governs this, and we put all our people through it, including civilian contractors and vendors who need to go near the workers,” he said.
“Sometimes fatigue sets in and you take off your gown and gloves in the wrong sequence, so little things like this we just continue to remind our people. We have roving teams that go around to check on this.”
On the issue of security, COL Chua said auxiliary officers guard the camp entrances and operate in the yellow zones to enforce zoning measures. The SAF has also linked up with the various police divisions.
“In case there is any trouble or anything more serious, the police will be the second line of response,” he said.
HOW IT BEGAN
Considering that the SAF only had two weeks to set up the facilities, COL Chua acknowledged that there was time pressure to get it done. A total of 600 SAF personnel, mostly regulars, were involved in setting up and running the CRFs.
This includes engaging contractors to build large tents in three vacant camps – Guillemard, Tanjong Gul and Lim Chu Kang – where buildings are structurally unsound.
For the other three camps with existing units, hoardings were set up to physically separate the workers’ living areas.
More beds needed to be added to maximise capacity, and dining areas had to be set up. Mobile toilets were brought in where necessary.
After slightly more than a week of operations, COL Chua said the SAF is in the process of handing over management of these facilities to external contractors who operate dormitories.
This is because the SAF needs to resume training and its regulars need to go back to their primary jobs. The contractors are also professionals in the business of managing CRFs.
“The regulars are trying to hand over processes, systems and a lot of the little things that go on behind the scenes,” COL Chua said, adding that the handover will be completed in the next two to three weeks.
“So that the facility managers can continue to provide the same level of care and welfare for the patients.”
COL Chua said feedback from the workers has been “pretty positive”, based on the chatter in WhatsApp groups that tell them when to collect their meals.
“Some of them even openly share that they have friends with COVID-19 who work in other countries, and they are certainly not as well treated as the way they are in Singapore,” he said, describing it as a national effort.
“My guys on the ground will feel it even more. You can see real gratitude and genuine appreciation for what the country has done for them.”