A helping hand
In Northern Sulawesi’s coastal village of Tinombo, medical care isn’t always easily accessible. So the RSN and the Indonesian Navy (TNIAL) brought it to the village in this year’s operation Surya Bhaskara Jaya (SBJ).
Story by Clara Lock
Photos by Clara Lock, Jonathan Ryan and Yong Shu Fui
The crowd had gathered by six in the morning at Tinombo’s Raja Tombolitutu hospital, even though the clinic was only meant to start at nine.
There were young mothers with babies in their arms, old women being helped along by husbands or sons, old men shuffling through the queue with a limp. Some had travelled up to 100km from the surrounding villages, on foot, motorcycle or the family van.
They had come to seek free primary health care, dental treatment, and minor surgeries which were being offered by the RSN as part of this year’s socio-civic mission, Operation Surya Bhaskara Jaya (SBJ).
To deliver the medical care, landing ship tank RSS Endeavour called into Tinombo, which was the second of three ports on the 74th Midshipmen Sea Training Deployment/11th Military Domain Experts Course.
The primary health care and dental treatments were delivered at the hospital, while surgeries were carried out on RSS Endeavour.
Besides medical services, RSN personnel painted two schools and performed dental screenings and oral health education on the students there. They also distributed sports equipment to the two schools, and 1000 boxes containing basic essential supplies such as rice, salt, sugar and cooking oil to local residents.
Making a difference
It made a different to a community used to getting by with less.
Most people in Tinombo work as farmers, fishermen or construction workers. According to local hospital officials, the average family has four children, and gets by on 500,000 to a million Rupiah a month, or about SGD50-100.
When most of the income goes to meeting the family’s daily needs, there isn’t much left over for medical treatment of conditions that are not life threatening.
General surgeon MAJ (Dr) (NS) Chong Chee Keong operated on a 53-year-old man with a 8cm-long lipoma, or growth of fatty tissue, on the back of his neck.
The lump was not painful, merely uncomfortable when he lay on his back – so the patient had lived with it for the past six years as it slowly grew in size.
MAJ (Dr) (NS) Chong said: “I’m happy to be able to help. The patient was probably worried because the lump kept getting bigger, so removing it helped relive his stress.”
He added that as the lump was located near the patient’s spine, there was a risk that if the lump grew bigger, it could compress on his nerves and cause pain.
Surgery at sea
The lipoma removal was one of the ten surgeries conducted in the Rapidly Deployable Maritime Containers (RDMC), which were used for the first time during Ops SBJ. Two containers wre mounted on RSS Endeavour's flight deck, containing an operating theatre and an intensive care unit.
The containers are designed according to a matchbox concept, and feature overlapping layers. When in use, they can be expanded to about three times their original size.
MAJ (Dr) (NS) Chong Chee Keong, who used to be senior consultant at Changi General Hospital before moving to private practise in Mounta Elizabeth Hospital (Novena), said that the RDMC is similar to a hospital operating theatre in terms of temperature, light, space and equipment available.
Although Indonesia offers health insurance to its citizens, the nearest hospital where they can receive surgical treatment is in Parigi, about 220km away by road.
Some locals cannot afford to make the journey, or lack a place to stay when they are there, said Dr Andika Sulaiman, a doctor who works in Palasa village, about 24km from Tinombo.
One such person was 13-year-old Sadri, who suffered from a cleft lip, a congenital condition that affects about one in 500 Asians.
The condition is caused by an incomplete fusion of the face, resulting in abnormalities of the lips, nose and palate. For Sadri, it appeared as a break in his upper lip, just under his nose.
Sadri could speak, goes to school, and wants to be a doctor, said his father Mr Alwin, 43. But he lacked the confidence when speaking to his friends, especially to girls, said his father, a cacao farmer.
Plastic surgeon LTC (Dr) (NS) Chong Si Jack performed the reconstructive surgery on Sadri, reorienting the abnormally inserted muscles in his face.
It would help Sadri’s speech, appearance and swallowing, said LTC (Dr) (NS) Chong, as he watched the boy sip water, recuperating before fast crafts took him back to shore.
LTC (Dr) (NS) Chong added, with a smile: “This is the first time he is drinking through a straw.”
Learning through service
A team of active servicemen and Operationally Ready National Servicemen performed a total of 21 surgeries over two days.
For some, such as Full-Time National Serviceman 3SG Kwek Shao Yang, it was his first time as a scrub nurse in the operating theatre.
Although he has spent four days shadowing the nurses in Tan Tock Seng Hospital’s Operating Theatre, the medic was still nervous at the start of the operation.
But CPL (NS) Kumerasun Shen Long, a scrub nurse at Tan Tock Seng Hospital, guided 3SG Kwek along, showing him how to prepare the equipment for surgery while keeping them sterile. 3SG Kwek also assisted surgeon MAJ (Dr) (NS) Chong in the lipoma surgery.
3SG Kwek said: “I’m more confident of my skills after helping out with this surgery. As a medic, sometimes we need to do simple dressings which require a sterile environment. I don’t always get a chance to practice that.”
He added: “It’s a sense of accomplishment, being able to help people through surgery.”