'We learned to smile with our eyes': Doctors volunteer to care for migrant workers at dormitories hit by COVID-19

'We learned to smile with our eyes': Doctors volunteer to care for migrant workers at dormitories hit by COVID-19

Dr Maleena Supiah NUHS
Dr Maleena Suppiah (right) attending to a patient at the triage station in Tuas dormitory. (Photo: National University Health System)

SINGAPORE: Gowns, gloves, goggles, masks and shields – they’re girded for battle against an invisible coronavirus that can slip through the slightest gap in their defences. 

It’s necessary, but it’s also hot, stifling work and to the migrant workers they are caring for, it can seem intimidating.

Learning to communicate with them through the layers of plastic and latex, and despite language barriers, has been one of the challenges of working at migrant worker dormitories, said Dr Maleena Suppiah from Jurong Health Campus, which is under the National University Health System (NUHS).

“We learned to smile with our eyes – being masked up, there was no way they could see our lips or our teeth and a lot of empathy has to be communicated when we care for them,” she told CNA in an interview on Monday (Apr 27). “We slowly learnt to communicate with our eyes and certain pictorials for example."

Dr Maleena (right) with another volunteer at Tuas View Dormitory on Fri, 17 Apr
Dr Maleena Suppiah (right) with another volunteer, Assoc Prof Zubair Amin, at Tuas View Dormitory on Apr 17, 2020. (Photo: National University Health System)

Dr Maleena, 55, was trained as a food scientist and heads the training and education team at the JurongHealth Simulation and Clinical Education Centre.

She now spends three days a week volunteering at migrant worker dormitories where the number of COVID-19 cases has surged.

As of Friday, COVID-19 cases among workers living at dormitories have reached 14,776, and make up the majority of the 17,101 cases detected in Singapore so far.

Twenty-five foreign worker dormitories have been declared isolation areas and even at ungazetted dormitories, no worker is allowed to move in or out of the premises until May 4.

READ: Singapore reports 932 new COVID-19 cases, bringing total past 17,000

Teams which include police officers and military personnel have been sent to these to help with dormitory operations.

On Apr 14, the Health Ministry said that medical teams would be deployed to all 43 purpose-built dormitories to tend to the workers who are unwell and swab those who have coronavirus symptoms. About 200,000 workers live at these dormitories, authorities have said.

Many healthcare professionals willingly stepped forward for these duties, director of medical services Kenneth Mak said then.

Dr Maleena has done swabbing duty at a number of dormitories, including Tuas View Dormitory, Westlite Toh Guan and Toh Guan Dormitory. She was part of the team that set up the swabbing operations at Tuas View Dormitory from Apr 16, and also trains new staff volunteers on how to swab patients.

COVID-19 testing at the dormitories has increased substantially since the first few cases were detected around end-March. About 25,000 migrant workers have been tested for COVID-19 since the start of the outbreak here, authorities said on Friday.

COVID-19: On-site care facilities at some dormitories, designated spaces for recovered workers

To help run the swabbing and other medical operations, about 215 staff members from Ng Teng Fong General Hospital volunteered, she said. Across NUHS, more than 800 medical and non-medical staff have stepped forward and it has recently sent out a public call for more volunteers. 

Before day one of operations at Tuas View, Dr Maleena and a core team of volunteers worked with the dormitory operators, military officers and police officers to figure out how to run the medical stations to avoid contamination and also arrange for medical supplies, swab kits, water and refreshments.

“I know colleagues stayed up till late at night for preparatory work so that in the morning, everything will be perfect. They put in a lot of hard work and hours,” she told CNA. 

Daily morning briefing with team in the designated ‘clean’ area at the dorm before donning PPE
Dr Maleena Suppiah at a daily morning briefing with other volunteers at a dormitory before donning personal protective equipment. (Photo: National University Health System)

Away from the familiar setting of a hospital, everything at the dormitory had to be set up from scratch, she said: “With temperatures reaching 38 degrees, we had to conserve our energy and tend to as many patients as possible.”

One example of how the teams have adapted: Patients are asked to take the same chair they sit on while in the queue from station to station, before returning it at a designated collection point for disinfection. This cuts down on time spent sanitising chairs – which is required whenever a new patient sits down.

As they tend to the workers, they would be soaked in sweat “right up to (their) shoes” after working for just two hours without air conditioning - a “humbling experience” because it’s what the migrant workers experience in their daily work, she said.

Dr Maleena Suppiah donning PPE
A colleague helps Dr Maleena Suppiah don her personal protective equipment at Tuas View Dormitory on Apr 18, 2020. (Photo: National University Health System)

Besides swabbing, medical posts have been set up to provide primary healthcare to the migrant workers who cannot leave the dormitories.

Dr Djoni Huang, a family physician at the National University Polyclinics, runs the clinical operations for two of the dormitories in the west and has been helping out at Sungei Tengah Lodge, Acacia Lodge and Tuas View Dormitory. The workers come to them for conditions like headaches, back pain or to top up medication, he said.

“Those with acute respiratory infection will be offered the COVID-19 swab test. If they are medically unwell, we will refer them to the hospital for further assessment,” he said.

Besides the welfare of the workers, he is also one of the doctors in charge of ensuring the well-being of the medical team volunteers, and looks into areas such as their safety, rostering and ensuring that there is sufficient medical equipment. 

Dr Djoni Huang
Dr Djoni Huang (right) and other volunteers from National University Polyclinics in PPE gear. (Photo: National University Health System)

Making sure that the volunteers comply with personal protective equipment or PPE safety is most important, he said.

“Sometimes your PPE can be dislodged accidentally, your glove may tear. So it’s important that we actually help to remind each other that we have to change, as well as when we feel dehydrated, we need to de-gown and take a sip of water,” he said.

It’s not the first time the 47-year-old doctor has volunteered in an outbreak, having been involved in work for the Severe Acute Respiratory Syndrome while he was in the UK, and during the H1N1 outbreak in Singapore in 2009. His family is supportive of his current decision to volunteer in quarantined zones, an opportunity which he “seized”, he said.

“Migrant workers play an important part to help built Singapore to where we are today,” he said.
 
He recalled how one of the patients who came to the medical post appeared distressed and did not seem to know why he was there. He spoke very little English, so Dr Huang asked another doctor, who could speak his language, to communicate with him.

“Finally we could see a smile on his face and he was more reassured,” he said. “After the consultation, he came back to me and said ‘thank you for helping me’. That word of ‘thank you’ really hit me on my heart and it’s enough to feel being appreciated, to be there for them.”

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Source: CNA/hm

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