Stories > Life-Saving Partnership

2018 • Issue 1

Life-Saving Partnership

Teams from Singapore and India join hands in a training effort to improve maternal and child health and survival rates in Karnataka.


FROM TOP: The skills that Dr Tan shares with the medical team in Karnataka include suturing, and how to safely handle the natural delivery of breech births.


ingapore is well known as a burgeoning medical hub, and it’s not just for complicated procedures like heart surgery – the standard of antenatal care here is among the best in the world. Singapore’s maternal mortality ratio is about 10 or less per 100,000 live births. The island boasts a world-class healthcare system, with state-of-the-art technology, outstanding medical facilities, and well-trained doctors and nurses.

For expectant mothers in less developed countries, however, quality healthcare is not always as easily within reach, and the survival of mothers and infants is not always assured. This has been a worrying problem in India’s Karnataka, for example, with the state registering 133 maternal deaths out of 100,000 live births in 2015 – the highest number in South India.

Infant mortality rates are also of concern in Karnataka, with 30 out of 1,000 infants dying before the age of five years.

Deciding to contribute to current efforts to improve the situation by pooling their networks, knowledge, and resources, the Singapore International Foundation (SIF) launched a training partnership with Singapore Health Services and the State Institute of Health and Family Welfare, Government of Karnataka, in August 2016.

The three-year Enhancing Maternal and Child Health Services Programme was designed to improve care for pregnant mothers and train medical staff in Karnataka to manage high-risk pregnancies. Since it began, approximately 200 healthcare professionals from tertiary and secondary care government hospitals in Karnataka have been trained by a multi-disciplinary team of obstetricians, neonatologists, midwives, and senior nurses from Singapore General Hospital (SGH).

Of the 200 trained Indian healthcare professionals, 40 master trainers will then train another 200 more medical professionals, cascading the impact of better healthcare within the community. This meaningful and high-impact collaboration is another milestone in the 21-year friendship between SIF and communities in India, all working together to uplift lives and build lasting relationships for a better future.

Leading last year’s volunteer mission to Karnataka was SIF specialist volunteer Dr Tan Hak Koon. He is an associate professor, senior consultant, and head of SGH’s Department of Obstetrics & Gynaecology. He witnessed a mother dying during childbirth 30 years ago when he was a medical student, and since then, maternal death has been an issue that’s close to his heart. “It’s one of the most important health issues in the world, and decreasing the maternal mortality ratio is one of the few Millennium Development Goals of the World Health Organization,” he points out. “A woman shouldn’t die having a baby.” The collaboration has proven successful, with the Karnataka medical team better equipped to treat and look after expectant mums and infants. “Participants who have attended the training programme tell us that they’re more confident handling high-risk deliveries now,” Dr Tan shares. “With the new skills and knowledge they’ve acquired, they’ve been able to save more lives.”

He is optimistic that the programme will soon see 5,000 trained healthcare workers, benefiting a large segment of India’s rural population, particularly in the country’s more remote areas. Unlike residents in its bigger cities, India’s remote rural populations have limited access to healthcare. Coupled with the high delivery rate – an estimated 25 million babies are born every year in India – it’s not surprising that existing medical resources are stretched.

“...we are not the greatest. Not at all. Other people have something to show us. With the world getting smaller, it is important to build more inclusiveness across cultures. ”

Associate Professor Tan Hak Koon, head of SGHʼs Department of Obstetrics & Gynaecology and SIF specialist volunteer

The Singaporean delegates learnt a lot from the programme, too. “We cannot achieve the desired outcome just by ourselves,” Dr Tan explains. “Medicine is a team game. We go there to share what we know – our way of practice, our system, our method of training doctors. At the same time, we hope to learn from them their way of practice and through these collaborations, get to know them better and understand their culture. The benefits go beyond medicine – we establish links and friendships.”

Dr Suresh S. Kanakannavar, a senior doctor at Vanivilasa Hospital and an associate professor at the Department of Obstetrics & Gynaecology at the Bangalore Medical College and Research Institute, is one of the many new friends Dr Tan has made over the last year.

Dr Kanakannavar has only positive feedback about Dr Tan and his team. Of his time spent training with them, he says: “They put in huge effort to compress the training into three working days. It was a splendid workshop. They were very disciplined, friendly, and approachable.”

According to Dr Tan, SIF plans to continue its collaboration with the Karnataka team, specifically in the areas of high-risk pregnancies and research. He says that anyone hoping to lend their help overseas must be open-minded and understanding of other cultures. One should also learn to look at things from different perspectives.

“My advice to those who want to go in, in the future, is to acknowledge that we are not the greatest,” he says. “Not at all. Other people have something to show us. With the world getting smaller, it is important to build more inclusiveness across cultures.”

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