She transported over 90 suspected Covid-19 cases per day to the NCID

COL (Dr) Shalini Arulanandam is responsible for prepping and priming her crew of 83 ambulances and over 1,400 emergency medical services personnel during this outbreak.

During the Circuit Breaker, urgent wails of the ambulance siren resounded throughout Singapore, amplified by the silence of the roads. What we did not know then was that an ambulance was rushing someone to a hospital every 15 minutes or so.

During the peak of the outbreak, we conveyed about 90 cases per day to NCID,” recalls Colonel (Dr) Shalini Arulanandam, chief medical officer of the Singapore Civil Defence Force (SCDF). The sheer volume of patients was something that stood out to her vividly during that time.

“The caseload was very high. If you went down to the dormitories you would see several SCDF ambulances there,” she adds.

As of Oct 31, 2020, SCDF’s 995 hotline had received over 8,000 calls regarding suspected Covid-19 cases. Its fleet of 83 emergency ambulances, manned by over 1,400 emergency medical services personnel, transported these cases to the hospitals. Later, over 60 of them turned out to be confirmed cases of Covid-19.

Guardian of the front line

Dr Arulanandam recalls the first time she received a notification from the Ministry of Health, informing her that the SCDF crew had just conveyed a confirmed case of Covid-19. The fear was palpable.

“You can put yourself in the crew’s shoes – there was a lot that was unknown about Covid-19 at that time, and people were worried about infecting their families,” she says.

By then, the ambulance crew had already started donning the enhanced PPE for suspect cases. Although it is known that when worn correctly, PPE will provide protection from the Covid-19 virus, some front liners still took extra measures – such as moving out to live alone, staying in a hotel, and not hugging their children.

Dr Arulanandam, 41, who is a mother to three primary school-aged children, understood their concerns all too well. That’s why she and her team made all the necessary arrangements as soon as they received notice, to ensure that her force would be adequately protected.

It was in January when she first received a MOH advisory notifying all medical practitioners to look out for a type of pneumonia in travellers from Wuhan. Immediately, she had a hunch that this was going to be serious.

“I remember thinking ‘Oh no, Lunar New Year is around the corner and a lot of people are going to be travelling. This thing is going to be spread around very quickly.’”

True enough, it wasn’t long before SCDF had to deploy its pandemic stockpile – including personal protective equipment such as N95 masks, goggles and gowns – to its ambulance crew stationed across 22 fire stations around the island.

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Over the Chinese New Year weekend, while Singaporeans were celebrating the festivities and enjoying the public holiday, Dr Arulanandam and her team were working tirelessly behind the scenes, making sure that everyone in emergency medical services was mask-fitted and familiar with PPE protocols.

“When a pandemic is looming, the main thing is to make sure our force is adequately protected because we don’t want any of our crew getting infected and passing on the infection to other patients,” she explains. SCDF’s 995 hotline operators, too, had to be briefed.

Based on the information available at that time, she and her team worked out a triage protocol that would help the operators determine if a patient is a suspect case, which would then trigger an appropriate response from the first responders.

“Touch wood, but after conveying thousands of suspect cases, none of my crew contracted Covid-19,” she says, giving her office desk a gentle tap with her fingers.

''We can’t help but notice a smile behind her mask. When asked if that feels like a personal achievement, she shakes her head vigorously. “Not at all – it’s a testament to SCDF’s good protective equipment, and good adherence to it.”

Her frequent interactions with the ground crew during this time had also brought much assurance to the team.

“During one of the visits to my fire station, I consulted Dr Arulanandam on some medical concerns a colleague of mine had. Despite her extremely busy schedule, she requested to speak directly with my colleague to provide personal guidance and reassurance.

''She even referred my colleague to another medical practitioner for further assessment,” recounts warrant officer Quek Zuoyi, a paramedic officer-in-charge. “This episode really reflected the genuine care and concern she has for her people.”

Mother, wife, MBA grad

Given that she was dealing with an unprecedented public health crisis at work, it was surprising to learn that Dr Arulanandam also managed to complete her Master of Business Administration from NUS in August this year.

She readily admits that those few months were intense. Work usually ended at 9 or 10pm, and she had to rely on recordings of the Zoom classes – which happen twice or thrice a week – to catch up. Add home-based learning for three children into the mix, and it’s little wonder that she only slept about four hours each night. Still, Dr Arulanandam maintains a good sense of humour about it.

“There would be days when the three of them were at home on their own – supposedly doing home-based learning – while I was out swabbing at the dorms,” she says.

“Then I’d get a call from a teacher, telling me ‘Your son isn’t in the Zoom class’. And I’m like, ‘I’m sorry, I can’t do anything about it now!’” she laughs, adding that it was a life-saving moment for her when the school holidays were brought forward during the second month of the Circuit Breaker.

When asked how she pulled through, she’s quick to credit her team and the camaraderie they share. That, and her experience from being at the migrant workers’ dormitories.

“The most striking thing for me was that while we were all under lockdown, we could still order Grab Food, go to the supermarket, buy what we like to cook, or bake what we wanted to – like sourdough bread. But the migrant workers’ situation in lockdown was very different.

''They couldn’t cook what they wanted, couldn’t eat what they wanted, and they were away from their families. It just put things into perspective,” she adds. This is also something that she talks to her children about.

“I always tell them that they are very privileged, and it is totally due to luck – it is not something that they have earned or deserved. And because they are this privileged, they should work hard and aim to be able to give back to society in some way when they are grown up,” she explains.

First woman with SAF scholarship in medicine

For Dr Arulanandam, that calling came when she was in her second year of junior college. A stint at a hospital as a research assistant affirmed her desire to work in healthcare, and she decided to apply for a scholarship with SAF. In 1998, at 19 years old, she became the first woman to receive a local medicine scholarship from SAF.

“I know Basic Military Training was quite a challenge for her,” recalls Dr Shivani Arulanandam, younger sister of Dr Shalini. The 38-year-old is a paediatric oncologist based in the UK.

“My parents never allowed us to make excuses for ourselves, and taught us that hard work and determination can overcome any obstacle in our path. It was therefore not particularly surprising that she graduated from Officer Cadet School as Best Cadet.”

“She also graduated from the Medical Officers Cadet Corps at the top of her group of primarily male officers!” she adds. She cites Dr Arulanandam as an inspiration, and that she’s always held herself to “incredibly high standards”.

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“Shalini has demonstrated that the pursuit of excellence is its own reward, and that if you set your goals and work towards them, you may well find at the end that you have shattered many a glass ceiling along the way.”

Following her military career, Dr Arulanandam was seconded to SCDF in 2018.

After a hectic few months, she reveals during our chat that she is thankful for the time she gets to spend with her family, especially on days when she’s working from home.

She finds joy in being able to cook dinner for them, having cosy movie nights in, and taking care of their newly adopted dog – a golden-brown Singapore Special named Baasha. And something that she’s looking forward to after this pandemic ends?

“Travelling, like everyone else! I miss my sister – she lives in the UK, and normally we’d meet up every year. We also do a yearly holiday with the extended family, but we had to give that a miss this year. I’m looking forward to next year, where we might be able to do that again.”

This article was first published in Her World Online.