Singapore Shophouse Fire In April Could Have Resulted In More Casualties

Mark Shankar, the seven-year-old son of Andhra Pradesh Deputy Chief Minister Pawan Kalyan, was among those injured in the blazing building where classes were held for children. In total, 16 children, aged between 6-10, and six adults, aged between 23-55, were injured in the fire. A 10-year-old Australian girl died of injuries at a hospital.

“If not for the public and migrant workers, I think we would probably have more casualties,” said Dr Fua Tzay-Ping, a consultant from the Singapore General Hospital's (SGH) Department of Emergency Medicine, who recounted handling of fire-victim being hospitalized in batches “When we are working ... you just think of it as a fire,” she said.

But the human cost became real later, she said, adding that she “felt very deep sadness for all those who were affected”.

She is relieved that her team managed to do its best for every victim, and remains grateful to bystanders who helped in the rescue.

“Caring for the surge of critically ill paediatric patients was mentally challenging as many of the staff are parents of young children as well,” the Channel News Asia (CNA) quoted Dr Fua as saying.

The hospital conducted a debrief to help staff process the event, according to a CNA report.

Fua described a wave of sadness that came after her shift, once she watched the viral videos of the fire.

While clinical focus remained the priority during the emergency, emotional tolls emerged later, according to the report.

Nurse Lim Zi Ying at KK Women's and Children's Hospital (KKH) was pulled from her routine duties to respond to an emergency of unprecedented scale in her 21 years of service.

Videos of the rescue, showing victims perched precariously on a narrow ledge on the second storey, quickly went viral and gripped the nation.

Some of the rescued children were unconscious, their eyes rolled back, and they were badly burnt, the CNA on April 8 cited an eyewitness Shaik Amirudin, a personal trainer, as saying from the fire site on the outskirts of Central Business District.

Migrant workers, including some from India, moved quickly from a construction site near the blazed shophouse and put up scaffoldings to bring down children perched on the ledge.

About 80 people in the shophouse and nearby premises were evacuated by the police and Singapore Civil Defence Force.

The hospitals cannot reveal the number of casualties they received or the extent of their injuries, but Associate Professor Sashikumar Ganapathy, the head of KKH's emergency medicine department, said that casualties arrived in batches until past noon.

He described the logistical challenge of managing an unknown number of incoming casualties, and it was his first time receiving paediatric casualties from a fire of such a scale.

Over the next few hours, more than nine medical departments were activated, including ear, nose and throat specialists, paediatric anaesthetists and plastic surgeons.

Fire-related injuries can lead to severe inhalation trauma in children, making airway management a top priority. For children, it falls to the paediatric anaesthesia team to ensure that the respiratory tract functions normally and the patient's breathing is not obstructed.

Treatment included administering medication via face masks, inserting IV lines, managing pain and stabilising breathing.

Among those called into action was Dr Gale Lim, head of the department of plastic, reconstructive and aesthetic surgery, who had experience managing mass casualties from a Singapore coffee shop gas explosion a decade ago.

When casualties from River Valley began arriving, the first thing she did was to organise and activate a team of about five doctors and up to eight nurses, who were split between the Children's Emergency and the ICU, where they saw burn wounds.

Nurse clinician Muqtasidatum Mustaffa said the situation was complicated by not knowing how many patients to expect. “There was a lot of uncertainty. We just had to prepare our resources, prepare our manpower,” she said.

Emergency medicine specialist Fua added: “It's always good to over-prepare ... from past experience, details may follow as the situation unfolds.”

The hospital converted areas within its critical care zone to make room for incoming casualties, moving existing patients elsewhere in the department. Staff prepped child-sized equipment and dosages and deployed airway teams, plastic surgeons and neonatology staff before the first ambulance arrived.

It was the largest number of casualties from a fire that she had ever dealt with in her more than 20 years at SGH, Muqtasidatum said.