Ida Simmons – Singapore’s first Public Health Nurse

Ida Mabel Murray Simmons (b.1881 or 1888, unknown–d. 7 January 1958, Stirling, Scotland) joined the Straits Settlements Medical Department in December 1926 and became Singapore’s first Public Health Nurse.^[1] She trained to be a nurse at the Royal Infirmary of Edinburgh and worked there until her departure for Singapore.^[2] When Simmons first arrived, she was tasked to introduce infant and maternal health services in rural Singapore, an area covering 200 square miles (518 sq km).^[3]

Health conditions in Singapore during the early 20th century were appalling, with both the town and country populations plagued by diseases such as malaria, tuberculosis, beriberi, smallpox, hookworm, diphtheria, dysentery and venereal diseases. Infant mortality was also extremely high, with malnutrition of infants and mothers being a primary cause. In 1927, 263 babies out of every 1,000 died before the age of one.^[4]

The rural population was suspicious of Western medicine and shunned clinic visits. Simmons’s key challenge then was to erase this perception and change the people’s behaviour towards observing medical appointments. Simmons learned Malay and focused her efforts on improving the health conditions of newborns and their mothers. In 1927, at her recommendation, the Medical Department provided a mobile dispensary manned by a dresser to ply the rural areas. Simmons made use of the dispensary to seek out all reported newborns. Routine visits were made to monitor the development of newborns in their first year and mothers were educated on infant feeding methods, maternal and infant nutrition, as well as basic infant care. People who were ill were sent to the dispensary or visited by the dresser in more serious cases. Simmons also trained local nurses and midwives, who formed the core team of staff manning rural welfare centres.^[5]  

Once Simmons and her team overcame the resistance of the rural dwellers to Western medicine, she persuaded them to meet at the mobile dispensary at agreed places for their medical needs. These “wayside clinics” soon developed into more permanent “welfare centres”. Due to the shortage of facilities and nursing staff, these centres were initially set up in former shophouses, coolie lines and even police stations, and operated for short hours daily. Experiencing the benefits of a medical and nursing service, the rural folks began to turn up for their appointments and sought medical help when required.^[6]

In 1938, the infant mortality rate was drastically reduced to 86.36 per 1,000 babies.^[7] In 1941, Simmons was honoured as a Member of the Order of the British Empire (M.B.E.) for her work in Singapore’s Rural Health Service.^[8] Upon her retirement in 1948, Simmons had established a rural health care service that comprised 17 rural maternity and child health centres operated by a team of local nurses.^[9] This health service eventually formed part of the Institute of Health that was established in Outram Road in 1958.^[10]

References
1. General Register Office for Scotland. Register of Deaths. 1958. Simmons, Ida Mabel Murray (Statutory Deaths 490/000012). Retrieved from http://gro-scotland.gov.uk/famrec/index.html
2. Royal Infirmary of Edinburgh, Register of Nurses Trained (LHB1/97/5). Lothian Health Services Archive, Edinburgh University Library. Retrieved from http://www.lhsa.lib.ed.ac.uk/collections/LHB1/lhb1_index.html
3. Simmons, I. M. M. (1940). Pioneer maternity and child welfare in rural Singapore from 1927 to 1938 (p. 1) [Microfilm: NL 26233]. Health Talk on Maternity and Child Welfare, No. 1. Singapore: Government Printing Office.
4. Simmons, 1940, p. 1.
5. Simmons, 1940, pp. 1–2; Singapore health pioneer retires. (1948, June 2). The Straits Times, p. 4. Retrieved from NewspaperSG.
6. Simmons, 1940, pp. 2–3; Free medical service now welcome in kampongs. (1939, July 9). The Straits Times, p. 32. Retrieved from NewspaperSG.
7. Simmons, 1940, p. 3.
8. 18 Malayans receive first new year honours of the war. (1941, January 1). The Singapore Free Press and Mercantile Advertiser (1884–1942), p. 4. Retrieved from NewspaperSG.
9. The Straits Times, 2 Jun 1948, p. 4.
10. Singapore’s new multi-purpose $2 mil. health institute. (1958, March 27). The Singapore Free Press, p. 7. Retrieved from NewspaperSG.