by LCNA:Sutherland, Duncan, 1905-
Ida Mabel Murray Simmons (b. 1881 or 1888, unknown–d. 7 January 1958, Stirling, Scotland) was a public health matron who transformed maternal and infant health care standards in Singapore. She improved facilities and services in rural areas, and educated families on infant health, thereby sharply reducing the acute infant mortality rate.
Education and training
Simmons was educated in Eastbourne, East Sussex. During World War I, she became a nurse with the Volunteer Aid Detachment (VAD), serving with distinction at military hospitals in England and France between 1916 and 1919. Like many wartime volunteer nurses, Simmons subsequently sought more formal qualifications and received a VAD scholarship to train at the Royal Edinburgh Infirmary. Soon after receiving her certification in 1922, Simmons won the only British scholarship for a one-year International Red Cross public health course in London. She then worked as a sister tutor at the Royal Edinburgh Infirmary from 1924 until 1926.
Career in Singapore
In December 1926, Simmons joined the Straits Settlements Medical Department and became Singapore’s first Health Sister. She was tasked with introducing infant and maternal health services in rural Singapore, an area then covering 200 sq miles (518 sq km) of the island’s 217 sq miles (562 sq km). She encountered many challenges since many of Singapore’s 100,000 rural dwellers lived in isolated villages and distrusted Western medicine.
In 1927, some 263 out of every 1,000 babies in rural Singapore died in their first year, while among rural Malays the number was almost 300 per 1,000. Those who survived were generally sickly due to widespread ignorance of proper hygiene and infant care practices. Many babies contracted rickets despite Singapore’s abundant sunlight as they were kept in dark and stuffy huts. Many mothers and babies also suffered or died from beriberi due to malnutrition.
Simmons learned Malay and set out to visit every kampong (“village” or “settlement” in Malay) to uncover the extent of the problem. A priority was to improve the reporting of births and ensuring that all new babies were examined quickly. Attention was also paid to general family health.
During Simmons’s first year, the health department launched a mobile dispensary to make her work easier. It travelled rural byways and parked nearby while Simmons and her team made house calls, sending those needing medical attention to the dispensary or summoning the accompanying doctor to the house. Within her first three years, Simmons had covered 43,000 miles (69,200 km) with the aid of the dispensary.
Simmons supervised the recruitment and training of many new nurses and midwives, especially Asians. By 1930, the health department was able to extend the regulation of midwifery from municipal Singapore to the whole island. However, suppressing the dangerous practices of unlicensed midwives took some time. Both government and independent midwives were regularly provided with clean equipment and dressings, and the networks they created improved the reporting of births.
Simmons and her staff earned patients' trust through their increasingly popular home visits and by 1930, more formal welfare centres had been established. Initially, coverage and opening hours were limited but by the time she retired in 1948, there were 15 full-time centres and 11 more that opened fortnightly.
A Chinese businessman built one centre but most operated from primitive makeshift accommodation such as former shophouses, a coolie line and even a police station verandah. Despite such unsatisfactory conditions, the centres received 92,000 visits in 1948 as families became more proactive in seeking advice regarding their children instead of waiting until they became sick.
Larger centres were staffed by a health nurse and a midwife, while smaller ones only had the latter. These centres focused on education and prevention, and provided regular check-ups, free milk, referrals to hospitals, lectures and counselling.
Simmons and her team convinced families that babies needed baths, sunlight, fresh air, and regular feeding and weighing. Vaccinations became compulsory and women were persuaded to eat the less popular but healthier unpolished rice instead of milled rice. This reduced beriberi deaths and strengthened mothers, resultung in women who in extreme cases had lost up to seven babies previously now being able to finally produce healthy newborns.
Other career highlights
In 1934, Simmons was promoted to Public Health Matron for rural Singapore, and was one of the United Kingdom’s delegates to the International Red Cross conference in Tokyo. During this period, she also attended conferences in Paris and Brussels, and examined first-hand Germany’s public health and social welfare systems. In 1941, Simmons was made a Member of the Order of the British Empire in recognition of her work.
During the Japanese Occupation of Singapore (1942–1945), Simmons was interned at Sime Road Camp, where she sewed 3,000 pairs of trousers for male prisoners. After the Occupation, she was tasked with rebuilding the infant health services, which had been neglected under the Japanese. Infant mortality had worsened but the damage was soon reversed and services were extended to the small outlying islands of Singapore.
Retirement and legacy
In 1948, Simmons retired to England, after having overseen a drop in infant mortality rate from 263 deaths per 1,000 babies in 1927 to an exceptional record of 57 deaths per 1,000 babies that year. This reduction in infant mortality rate was achieved despite a rising birth rate. Along with other individuals working in various hospitals and the King Edward VII College of Medicine, her efforts contributed to the early development of paediatrics in Singapore.
Simmons returned to Southeast Asia in 1950 as part of a World Health Organization programme teaching modern obstetrical methods to rural midwives in Brunei. She later moved to Scotland and died in 1958.
Parents: George and Elizabeth Simmons
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(Call no.: RCLOS 618.92 JSPS)
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(Call no.: RSING 959.51 STR-[AR] v.9)
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Simmons, I.M.M. (1940). Beri-beri [Microfiche: MFC NL 0024/097]. Health Talks on Maternity and Child Welfare, 2, 1. Singapore: Government Printing Office.
Simmons, I.M.M. (1940). Pioneer maternity and child welfare in rural Singapore from 1927 to 1938 [Microfilm: NL 26233]. Health Talks on Maternity and Child Welfare, 1, 1–4. Singapore: Government Printing Office.
Simmons, I.M.M. (1940). Unpolished rice [Microfiche: MFC NL 0024/097]. Health Talks on Maternity and Child Welfare, 3, 1–2. Singapore: Government Printing Office.
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Vickers, W. J. (1948). Annual report of the Medical Dept 1947 (pp. 19, 90) [Microfilm: NL 12101]. Singapore: Government Printing Office.
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Wong, H. B. (1997, December). History of paediatrics in Singapore. Singapore Paediatric Journal, 39(4), 151. Singapore: Singapore Paediatric Society.
(Call no.: RSING 618.92 SPJ)
The information in this article is valid as at 25 March 2013 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.