By: Y.K. Hu

For reasons that are unclear, Singapore’s leading public hospital – the one that Patriarch Lee Kuan Yew died in – delayed for months telling the public that an outbreak of hepatitis C had infected 23 kidney patients while receiving treatment, and that five had died.

The episode marks a blip in the history of the nation’s healthcare system, not helped by the delay in informing the public of the outbreak. The first press conference on the issue was on Oct 6 when the hospital said in a statement that 22 patients with renal diseases were hospitalized from mid-April April to June 2015 were diagnosed with hepatitis C virus infection and four of the 22 had died.

The announcement sent tremors through Singapore’s health care system, often described as the best in the region. The flagship of the system, Singapore General Hospital, is also the oldest and largest on the island.  The country has long prided itself on having an efficient and quality health care system. The World Health Organization listed Singapore as sixth in the world in overall healthcare in 2000.

It is a major destination for health tourists, especially the wealthy from Indonesia and Malaysia who don’t trust their own health care systems.

For instance, Nina Gundowan (not her real name), an Indonesian who sometimes travels to Singapore for medical treatment said, “The hospital even filed a police report, compared to other countries, hospitals in other countries won’t even admit” to a lapse in care.

Last year, Bloomberg picked Singapore as the “most efficient healthcare system” in the world. It is also a notable medical tourism hub in the region, with the tourism board of Singapore billing the country as a “leading destination for advanced medical care” in Asia.  Thus, publicity over a major outbreak of a communicable disease in the island republic’s most prominent public hospital was problematic to say the least.

The outbreak was first identified when abnormal clustering of seven cases in four weeks was discovered in the same period. The hepatitis C virus is largely transmitted by blood, acquired mainly through intravenous use, sharing of syringe needles or exchange of bodily fluids.

The four patients who died had other serious conditions, but the hospital was not able to rule out hepatitis C as a contributing factor for their deaths. The cause of one other death was pending review has since been concluded on Oct 19 that hepatitis C infection could have been a contributing factor, bringing the total number of deaths to five. 

Following additional screening of patients who had been at the two renal wards during the period when the outbreak occurred, one of the 598 patients screened tested positive for the hepatitis C virus, bringing the total number to 23, with 66 results pending as of Oct 21.

Social media began raising questions over the delays in informing the public. The hospital first notified the health ministry of an “usually large cluster” of Hepatitis C patients in late August, more than two months after the 18th case was detected in June 26. The Health Minister Gan Kim Yong was first notified on Sept 18, according to the health ministry. The public was only informed almost five months after the first indication of the abnormal cluster.

The delay in notifying the public has also drawn the comments from members of opposition parties in Singapore. The Workers’ Party, Singapore’s main opposition party, called on the government to set up a committee of inquiry to investigate the delays from the hospital to the health ministry and from the ministry to the Health Minister. The Singapore Democratic Party, led by Chee Soon Juan, also called questioned whether there were any “political consideration” in the delay in informing the public, as the time lapse coincided with the Sept 11 general elections in Singapore.