By CHANG AI-LIEN, SENIOR CORRESPONDENT

HIS desire to heal was sparked by the suffering of the sick and wounded he saw all around him as a boy growing up in Singapore during World War II.

Dr Chew Chin Hin went on to help break the stranglehold of tuberculosis (TB) here, and to initiate the Advance Medical Directive (AMD) or living will in Singapore.

For his contributions to medicine, the 79-year-old was the first Singaporean elected to the prestigious Mastership of the American College of Physicians yesterday.

"I grew up in hospitals, I saw patients in the wards and saw my first malaria parasite and TB bacterium in the laboratories when I was around nine years old," he said.

As a boy, he lived in the doctors' quarters of the Singapore General Hospital (SGH) and Tan Tock Seng Hospital because his father, Dr Benjamin Chew, worked there.

"I remember seeing bodies haphazardly placed on grass slopes outside the overfilled mortuary. It was a horrendous sight," he recalled, adding that the first wave of bombs missed SGH by a whisker on the morning of Dec 8, 1941.
On another occasion, the casualties included 11 medical students, hit by Japanese shells in the open field near the College of Medicine Building.

At the time, tuberculosis (TB), dysentery and malaria were widespread. Medical supplies were scarce.
Staff did their best to stretch out the available stocks, working long hours under desperate conditions, he said, and this was when he decided to become a doctor.

"The cruel effects of the war, coupled with the example of my father and his colleagues and how they cared for their patients with so much compassion, convinced me to go into medicine," he said.

After medical school, Dr Chew took a special interest in chest diseases. TB was a major health threat after the war, with more than 5,000 cases in Singapore each year.

As chairman of the Health Ministry's TB Research Committee, he contributed to landmark studies on treatment regimens done with the British Medical Research Council. The results were published in major journals, including the Bulletin of the World Health Organisation and the Lancet.

Among the breakthroughs, his team pared down the treatment period for TB from two years to six months through new drugs, the proper use of drugs and full supervision of patients.

"By making sure patients took their medicine and following up with phone calls and visits when they didn't turn up in hospital, we were very successful in preventing resistance and relapses," he explained.

There are now more than 1,000 cases of TB here each year, with 1,451 in 2008.

His passion has also been in medical education. Dr Chew played a major role in developing specialist training and examinations, and continues to examine medical students at the university. "It is wonderful to see bright, young students learn, especially when they have the thirst for learning."

Said Professor Lee Eng Hin, director of Graduate Medical Studies at the National University of Singapore's (NUS) Yong Loo Lin School of Medicine: "Dr Chew is a compassionate, steadfast and devoted leader who has made significant contributions to the development of postgraduate medical education."

He has also been instrumental in shaping medical ethics here. From 1994 to 2000, he was chairman of the Health Ministry's National Medical Ethics Committee, which published ethical guidelines in areas such as organ and tissue transplantation, genetic technology and therapy. These are used as a reference for hospitals' ethics committees.

The committee reviewed the teaching of medical ethics in the medical undergraduate curriculum and recommended adopting a more structured and formal approach, which has since been implemented.

It also initiated the AMD, which Singapore passed in 1996. This is a legal document a person signs to indicate he does not wish to have extraordinary life-sustaining treatment to prolong his life if he becomes terminally ill and unconscious.

"With modern technology able to sustain essential functions and prolong life, this had become a pressing issue," Dr Chew explained.

"A doctor has a duty to sustain life, but he has no duty to prolong the distress of a dying patient."

Throughout his career, he said, he has been guided by three principles: Patients must be treated with care and compassion; lifelong learning coupled with integrity is important; and both heart and head are equally important in medicine, which is a calling, not a business.

He still gets a thrill when he bumps into former patients or students who approach and thank him.
"As a doctor, I learnt that I may not be a very rich person, but I will always have a living," he said. "The most important thing is I have to stay true to my calling."

Yesterday, Dr Chew received his Mastership at a convocation ceremony in Toronto, Canada. The Mastership has been given to fewer than 700 doctors worldwide since 1923.

Professor John Wong, dean of the NUS Yong Loo Lin School of Medicine, said Dr Chew has made a major contribution to the development of clinical medicine, medical education, research and medical ethics in Singapore.
"Throughout his 35 years of service in the Ministry of Health and in every task he has undertaken, Dr Chew has consistently and tenaciously pursued excellence," he said.

ailien@sph.com.sg

This article was first published in The Straits Times.

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