St Andrew's Mission Hospital


St Andrew

The St Andrew’s Mission Hospital (SAMH) was founded as a dispensary, the St Andrew’s Medical Mission, on 18 October 1913.1 It was established by medical doctor Charlotte Ferguson-Davie, the wife of the first Anglican bishop of Singapore, the Right Reverend Charles James Ferguson-Davie.2 In its founding years, the mission focused on providing medical care to poor women and children. With changes in Singapore’s demographics and healthcare patterns, the mission evolved into a hospital.3

Founding
Charlotte was a medical missionary in India before she arrived in Malaya. In April 1911, she established a medical dispensary in Banda Hilir on the outskirts of Malacca.4 Its success gave Charlotte the confidence to replicate it in Singapore, observing similar medical needs in the women and children on the island.5


Charlotte established St Andrew’s Medical Mission at 14 Bencoolen Street on 18 October 1913. This was made possible with donations from St Andrew’s Cathedral, Singapore Diocesan Association, Society for Promoting Christian Knowledge and an anonymous Chinese donor, as well as a box of instruments and dressings from the Society for the Propagation of the Gospel.6 Its dispensary services were provided free to those who could not afford medical care.7

Early years
From her time in Malacca, Charlotte observed that Asian women refrained from seeking treatment from male doctors.8 To reach out to them, she had an all-female staff at the mission. Acting as the medical-officer-in-charge, Charlotte worked with two other expatriate doctors, G. E. Bartlett and J. A. Lyall. They were supported by an interpreter, a bible reader, as well as Indian, European and Chinese doctors and nurses.9


In 1914, four months after the first dispensary opened, a second was started on Upper Cross Street in a building leased from the colonial government. This clinic served poor women and children in Chinatown and was so popular that patients brought their own beds so they could receive night-time care. The clinic expanded to include a small inpatient surgery ward the following year. There were six beds for adults and two for children.10

Both clinics saw patients of different races, reflecting the population makeup of the two areas, with Chinese, Tamils, Malays, Jews, Armenians and Japanese patients. However, the mission observed that Malay women were not frequenting the clinics enough, and therefore C. Thompson, the first sister-in-charge, was assigned to make weekly visits to the kampongs (villages) where they live.11 Consequently, a third dispensary was established in Pasir Panjang in 1915, but closed four years later.12

The mission’s clinics received more patients than they could handle daily, showing a clear need for medical care among Singapore’s poor. Because death rates were high, particularly infant mortality, around the time of the mission’s establishment, the clinics’ services became inadequate for meeting the medical needs of female and young patients.13

With the donations received from philanthropists such as Tan Teck Neo – wife of property tycoon Lee Choon Guan – and like-minded organisations, including the Society for the Propagation of the Gospel, St Andrew’s Cathedral and the Society for Promoting Christian Knowledge,  the three-storey SAMH building on Erskine Road was opened on 22 May 1923.14

The 60-bed hospital comprised outpatient departments, main wards, an operating theatre and a delivery room on its ground floor, while staff quarters and a chapel occupied the second floor. Resident staff included medical officer Marjorie Chappell, matron MacIntire, six Asian nurses as well as subsidiary staff. The hospital was funded by donations, subscriptions and grants-in-aid from organisations such as the Society for Promoting Christian Knowledge; the annual grant of $1,800 from the government was insufficient to meet the hospital’s expenditure, which amounted to $23,516.54 in its first year of operation.15

With the better infrastructure of a hospital, specialist clinics were commenced in response to patients’ needs. In 1924, SAMH started a specialised eye clinic for abandoned blind children and a venereal disease clinic for women. An antenatal clinic followed later in 1933.16

The following year, in 1934, SAMH was incorporated by the colonial government under the St Andrew’s Mission Hospital Ordinance – its management became regulated by the government and the land on which it sat was guaranteed.17

When Charlotte and her husband left Singapore for Africa in 1927, Patricia Elliott became the medical-officer-in-charge for the hospital, a position she held until 1950. Elliott, too, had been a medical missionary in India, and upheld the vision of the mission.18

Establishing a local nursing pool
Since its founding, a shortage of trained nurses had been a perennial challenge for the mission. Hence, as early as 1916, it began the training of local women in general nursing and midwifery. The mission aimed to grow the nursing pool, as well as assist in the personal and career development of local women.19

As the mission evolved into a hospital, the programme on general nursing and midwifery that began in 1916 became a structured three-year course in 1922. Trained to provide personal, holistic care for patients, SAMH nurses were distinguished by their technical skills and their compassion for patients.20


In the postwar years, interest in child nursing developed. In 1949, Gordon Keys Smith (SAMH medical-officer-in-charge from 1949 to 1959) launched a local three-year programme modelled after the Certificate for Nursing of Sick Children of the General Nursing Council for England and Wales. It was the first of its kind in Malaya. In 1951, the General Nursing Council of England recognised the Singapore Nursing Training Scheme and the SAMH Training School that came under it.21

By 1959, the Singapore General Hospital and SAMH had established a collaborative partnership in the nursing of sick children, with the general hospital conducting a two-year postgraduate course while SAMH continued with undergraduate nursing.22 Under the charge of Smith, Janet Lim was appointed as matron in 1954, making her Singapore’s first Asian nursing matron.23

St Andrew’s Orthopaedic Hospital and postwar developments
There was great demand for tuberculosis treatment in the late 1930s, and Patricia Elliot championed the establishment of an orthopaedic hospital. The government granted land in the seaside district of Siglap in 1937, and the mission raised the required funds to construct such a hospital the following year.24 St Andrew’s Orthopaedic Hospital (SAOH) was opened on 28 February 1939, with Elliott as its medical-officer-in-charge. The hospital, which cost $69,000, provided treatment to children with tuberculosis and was equipped with an operating theatre, X-ray room and two wards with a total of 60 beds.25


Both SAMH and SAOH were closed during the Japanese Occupation (1942–1945). SAMH was in the vicinity of a gas storage facility and short of staff, while the Japanese used SAOH as a radio station. Patients were either transferred to operating government hospitals like Tan Tock Seng Hospital or sent home. During this period, the SAMH ran outpatient clinics manned by local doctors Ho Boon Liat and his wife.26

Following the end of World War II, the government announced the development of Kandang Kerbau Hospital into a maternity and gynaecological facility and Tan Tock Seng Hospital into a tuberculosis treatment centre. SAMH then reviewed its mission and decided to focus on caring for children aged 14 and below, with the government’s endorsement.27 As the Erskine Road premises was near a gas utility installation, the hospital sought out a new location.28

Subsequently, an old warehouse at Tanjong Pagar was refitted as the new St Andrew’s Mission Hospital, and opened on 25 January 1949 with Gordon Keys Smith as its medical-officer-in-charge.29 In the decade following the war, medical services were once again in high demand. SAMH expanded its capacity from 60 to 80 beds and set up a new ward in 1963 in celebration of its 50th anniversary, with financial support from donors such as tycoon and philanthropist Lee Kong Chian, and the Rotary Club of Singapore.30

SAMH also opened satellite clinics to expand its reach in Singapore. Our Saviour’s Mission (later moved to Prince Charles Crescent in 1956) was established off Havelock Road, and the hospital also started a clinic in the Church of the True Light on Perak Road.31

In 1950, Smith identified tuberculosis as a key disease afflicting children. One in every 50 new child patients at the hospital suffered from active tuberculosis, and most were sent to hospital too late for active treatment. Smith felt that attending to the social and economic roots of the disease, and educating parents on caring for sick children, were important for combating the high affliction rate.32

In the same year, SAMH started an almoner department with the help of Catherine Smith, Smith’s wife, who was also a social worker. The almoner helped families in need cope with the demands of treatment, educated parents on proper home care and referred them to the Social Welfare Department for financial assistance. In 1953, the hospital was recognised by the University of Malaya (now National University of Singapore) as a training school for almoner students.33

By the late 1960s, there was substantially reduced need for free or highly subsidised medical services for children in the heart of town. The health of children had markedly improved with cleaner home environments, better nutrition and informed care provided by their parents.34 In addition, the nation’s development of housing estates also moved people out of the neighbourhood of SAMH. The success of family planning programmes, launched nationally in 1966 by the Singapore Family Planning and Population Board, also lowered birth rates.35

With improved general health and evolved patterns of ill health in Singapore, SAMH repositioned its medical services. In 1972, specialist outpatient clinics operating on a weekly or biweekly basis were established at SAMH for ophthalmology, ear, nose and throat, skin, speech therapy, as well as surgical and dental services. These were run by volunteer specialists, and charged nominal fees with free or subsidised treatment for the needy.36 Inpatient services were ceased in 1982 due to reduced demand.37

Eldercare, special needs and mental health
In 1983, SAMH identified three groups of people that it would serve: the elderly, people with autism and those with mental issues.38 SAOH was closed in 1986; following a renovation, the building was converted into the St Andrew’s Community Hospital, a 60-bed subsidised step-down healthcare facility for the elderly.39 In 2005, the community hospital expanded to a 200-bed facility in Simei, working closely with the Changi General Hospital to provide medical services to elderly patients moving from acute medical care to rehabilitative or continuing care. Home nursing services, mobile clinics, physiotherapy and occupational therapy services were also established.40


SAMH also set up the St Andrew’s Autism Centre on the 10th floor of the St Andrew’s Community Hospital in 2005. It outgrew the space quickly and a fully-integrated and comprehensive facility was opened on Elliot Road six years later. The autism centre operates a special school for autistic children, and a day activity centre for autistic adults.41

The SAMH building at Tanjong Pagar was demolished in 1996 and redeveloped as the St Andrew’s Centre, a commercial building.42 Among others, the centre housed the St Andrew’s Lifestreams (SAL), the arm of the SAMH that serves the mentally distressed. SAL has since moved to Potong Pasir.43

To reflect its emphasis on pastoral care to schools and churches within the Diocese of Singapore office, SAL restructured its services in 2006 to offer three core services in 2007: pastoral care training aimed at full-time church workers, training for the care and counselling industry and school-based services to counsel at-risk youths.44



Author
Irene Lim



References
1. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, p. 18. (Call no.: RSING 362.11095957 REI)
2.
 Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, p. 22. (Call no.: RSING 362.11095957 REI)
3. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, pp. 28–29. (Call no.: RSING 362.11095957 REI)
4. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, p. 22. (Call no.: RSING 362.11095957 REI)
5. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, p. 22. (Call no.: RSING 362.11095957 REI)
6. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, p. 18. (Call no.: RSING 362.11095957 REI); St Andrew’s Mission Hospital. (2013). From flicker to flame: 100 years of St Andrew’s Mission Hospital. Singapore: Author, p. 8. (Call no.: RSING 362.11095957 SAI)
7. St Andrew’s Medical Mission. (1913, October 3). The Straits Times, p. 8. Retrieved from NewspaperSG.
8. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, p. 22. (Call no.: RSING 362.11095957 REI)
9. St Andrew’s Mission Hospital. (2013). From flicker to flame: 100 years of St Andrew's Mission Hospital. Singapore: Author, p. 8. (Call no.: RSING 362.11095957 SAI)
10. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, p. 18. (Call no.: RSING 362.11095957 REI)
11. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, pp. 18–19. (Call no.: RSING 362.11095957 REI)
12. Smith, G. K. (1959). Medical report, 1949/58. Singapore: St Andrew’s Mission Hospital, pp. 28–32. (Call no.: RCLOS 618.92 SAI); Mudeliar, V., et al. (Eds.). (1979). Development of hospital care and nursing in Singapore. Singapore: Ministry of Health, p. 72. (Call no. RSING 610.73095957 MUD)
13. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, pp. 28–29. (Call no.: RSING 362.11095957 REI)
14. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, pp. 28–29. (Call no.: RSING 362.11095957 REI)
15. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, pp. 29–30. (Call no.: RSING 362.11095957 REI)
16. St Andrew’s Mission Hospital. (2013). From flicker to flame: 100 years of St Andrew’s Mission Hospital. Singapore: Author, p. 18. (Call no.: RSING 362.11095957 SAI)
17. St Andrew’s Mission Hospital. (n.d.). History. Retrieved from St Andrew’s Mission Hospital website: http://www.samh.org.sg/about-us/history; St Andrew’s Mission Hospital. (1934, March 31). The Singapore Free Press and Mercantile Advertiser (1884–1942), p. 3. Retrieved from NewspaperSG; Other bills. (1934, April 17). The Singapore Free Press and Mercantile Advertiser (1884–1942), p. 15. Retrieved from NewspaperSG; Singapore. The Statutes of the Republic of Singapore. (1985 Rev. ed.).Saint Andrew’s Mission Hospital Ordinance (Cap. 376). Retrieved from Attorney-General’s Chambers website: http://statutes.agc.gov.sg/
18. Reid, L., & Thay, W. (2006). A light that shines: The story of St. Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, p. 31. (Call no.: RSING 362.11095957 REI).
19. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, p. 27. (Call no.: RSING 362.11095957 REI); St Andrew’s Mission Hospital. (2013). From flicker to flame: 100 years of St. Andrew’s Mission Hospital. Singapore: Author, p. 17. (Call no.: RSING 362.11095957 SAI)
20. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, p. 37. (Call no.: RSING 362.11095957 REI); St Andrew’s Mission Hospital. (2013). From flicker to flame: 100 years of St Andrew’s Mission Hospital. Singapore: Author, p. 8. (Call no.: RSING 362.11095957 SAI); Smith, G. K. (1959). Medical report, 1949/58. Singapore: St Andrew’s Mission Hospital, p. 38. (Call no.: RCLOS 618.92 SAI)
21. Smith, G. K. (1959). Medical report, 1949/58. Singapore: St Andrew’s Mission Hospital, pp. 36–38. (Call no.: RCLOS 618.92 SAI)
22. Smith, G. K. (1959). Medical report, 1949/58. Singapore: St Andrew’s Mission Hospital, pp. 36–38. (Call no.: RCLOS 618.92 SAI)
23. St Andrew’s Mission Hospital. (2013). From flicker to flame: 100 years of St Andrew’s Mission Hospital. Singapore: Author, p. 29. (Call no.: RSING 362.11095957 SAI)
24. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, p. 32. (Call no.: RSING 362.11095957 REI)
25. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, p. 33. (Call no.: RSING 362.11095957 REI); New hospital ready for opening. (1939, February 23). The Straits Times, p. 20. Retrieved from NewspaperSG; New hospital at Siglap. (1939, February 28). The Straits Times, p. 12. Retrieved from NewspaperSG.
26. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, p. 46. (Call no.: RSING 362.11095957 REI)
27. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, p. 57. (Call no.: RSING 362.11095957 REI)
28. St Andrew’s Mission Hospital. (2013). From flicker to flame: 100 years of St Andrew’s Mission Hospital. Singapore: Author, p. 24. (Call no.: RSING 362.11095957 SAI)
29. St Andrew’s Mission Hospital. (2013). From flicker to flame: 100 years of St Andrew’s Mission Hospital. Singapore: Author, pp. 25–26. (Call no.: RSING 362.11095957 SAI)
30. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, p. 86. (Call no.: RSING 362.11095957 REI)
31. St Andrew’s Mission Hospital. (2013). From flicker to flame: 100 years of St Andrew’s Mission Hospital. Singapore: Author, p. 31. (Call no.: RSING 362.11095957 SAI)
32. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, p. 71. (Call no.: RSING 362.11095957 REI)
33. Smith, G. K. (1959). Medical report, 1949/58. Singapore: St Andrew’s Mission Hospital, pp. 33–34. (Call no.: RCLOS 618.92 SAI); Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, pp. 71–72. (Call no.: RSING 362.11095957 REI)
34. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, p. 92. (Call no.: RSING 362.11095957 REI)
35. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, p. 91. (Call no.: RSING 362.11095957 REI)
36. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, pp. 94–95. (Call no.: RSING 362.11095957 REI)
37. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, pp. 95–96. (Call no.: RSING 362.11095957 REI)
38. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, p. 104. (Call no.: RSING 362.11095957 REI); St Andrew’s Mission Hospital. (2013). From flicker to flame: 100 years of St Andrews Mission Hospital. Singapore: Author, p. 39. (Call no.: RSING 362.11095957 SAI)
39. St Andrew’s Mission Hospital. (2013). From flicker to flame: 100 years of St Andrew’s Mission Hospital. Singapore: Author, p. 35–36. (Call no.: RSING 362.11095957 SAI); Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, p. 106. (Call no.: RSING 362.11095957 REI)
40. St Andrew’s Mission Hospital. (2013). From flicker to flame: 100 years of St Andrew’s Mission Hospital. Singapore: Author, pp. 43–47. (Call no.: RSING 362.11095957 SAI)
41. St Andrew’s Autism Centre. (n.d). The legacy at Elliot Road – A rich history. Retrieved from St Andrew’s Autism Centre website: http://www.saac.org.sg/index.php/about-us/organisational-milestones; St Andrew’s Autism Centre. (n.d). Our centre. Retrieved from St Andrew’s Autism Centre website: http://www.saac.org.sg/index.php/about-us/our-centre
42. Reid, L., & Thay, W. (2006). A light that shines: The story of St Andrew’s Mission Hospital. Singapore: St Andrew’s Mission Hospital, p. 108. (Call no.: RSING 362.11095957 REI); St Andrew's Mission Hospital. (n.d.). History. Retrieved from http://www.samh.org.sg/about-us/history
43. St. Andrew’s Mission Hospital. (2013). From flicker to flame: 100 years of St Andrew’s Mission Hospital. Singapore: Author, pp. 50–51. (Call no.: RSING 362.11095957 SAI)
44. St. Andrew’s Mission Hospital. (2013). From flicker to flame: 100 years of St. Andrew’s Mission Hospital. Singapore: Author, pp. 50-51. (Call no.: RSING 362.11095957 SAI)




The information in this article is valid as at 27 February 2015 and correct as far as we are able to ascertain from our sources. It is not intended to be an exhaustive or complete history of the subject. Please contact the Library for further reading materials on the topic. 

Subject
Community and Social Services
Hospitals--Singapore
Streets and Places
Architecture and Landscape>>Building Types>>Commercial Buildings
Health and medicine>>Health services
Arts>>Architecture>>Public and commercial buildings

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