Reconstructive surgeries, organ transplant: How a migrant worker spent 7 years in hospital following a workplace accident
At 30, Rezaa Mohammad Salim has been through much more than others his age.
As the only son in a family of four, Rezaa travelled to Singapore in 2012 to work so that he could support his family in Bangladesh.
In 2016, however, he suffered a devastating injury after he was crushed between a crane and an iron pipe at the shipyard where he worked.
The freak accident destroyed the migrant worker's abdomen, and nearly killed him.
He was admitted to the National University Hospital (NUH), where he would spend the next seven years in a high-dependency ward.
"When he came to us, he was losing blood very rapidly in the stomach, and the entire lot of his intestines was severely damaged," Adjunct Assistant Professor Raj Menon, Centre Director of National University Centre for Trauma, told AsiaOne in an interview on Wednesday (July 3).
The young man was immediately rushed into the operating theatre, where Dr Raj and a team of surgeons helped to stop the bleeding.
"It was a catastrophic injury to his abdomen. In many cases, not many could have survived that kind of injury," said Dr Raj.
Even after undergoing several surgeries to reconstruct his intestines, Rezaa was still plagued by recurrent infections and intestinal failure.
His gut was unable to absorb the nutrients and water that he needed to survive, so he was placed on parenteral feeding, where all his nutrients were given to him intravenously.
"I missed eating food," Rezaa told AsiaOne in the interview.
"He knew that it was difficult to eat, and he had to fight the feeling of wanting food, but he just accepted that this was something he was not able to do," said Dr Raj. "We did have many conversations about what he would eat when he's well, Rezza's a big fan of local briyani."
Apart from food, Rezaa also missed his family dearly, as he was in the hospital wards alone for six years.
He could only communicate with them via video calls, which made it difficult for him to convey the extent of his injuries and his struggles.
"My journey was not easy, but all the nurses and doctors really helped me a lot," Rezaa said.
"There were times where I asked the doctors and nurses, 'What can I do?', but they would tell me not to worry."
Besides the doctors and nurses, a multidisciplinary healthcare team including medical social workers, therapists and administrative departments, also helped Rezza on the road to recovery.
Meanwhile, the migrant worker's employer, the Ministry of Manpower and some non-governmental organisations took care of his medical bills.
Finding a cure
During Rezza’s lengthy stay at NUH, Dr Raj and his team were continuously searching for ways to treat the patient's intestinal failure, which was considered a rare condition.
"The only possible treatment for him was an intestinal transplant, which is an incredibly rare procedure and only done a handful of times in Singapore with living related donors," said Dr Raj.
"For migrant workers, we don't have a list of donors. Many countries don't have this as well because this is a very new field."
After speaking to medical experts from around the world, Dr Raj finally found a hospital in Mumbai, India, that was willing to perform the surgery on Rezza.
Rezaa, accompanied by Dr Raj, flew to India in February last year and underwent the transplant successfully in April. Five months later, he was discharged from the hospital and returned to Bangladesh to reunite with his family.
He now lives in Bangladesh with his family, and is able to enjoy food normally.
NUH launches trauma centre
To help trauma patients like Rezaa, NUH launched the National University Centre for Trauma on Thursday (July 4).
Each year, NUH attends to an average of 1,300 severe and critical trauma cases, which include 140 industrial accidents and 70 paediatric trauma incidents, NUH said in a press release.
The new trauma centre aims to provide a full spectrum of trauma care capabilities for both adults and children.
"The National University Centre for Trauma represents decades of efforts in refining our trauma care expertise, for our injured patients to return to their lives and achieve their dreams," said Dr Raj.
"It also aims to prevent trauma from occurring in the first place with data-driven injury prevention efforts."
Besides improving trauma care for patients, the centre will also prioritise outreach and education efforts among three key groups that are most susceptible to trauma — children, older adults, and migrant workers. It will also bolster long-term support for trauma survivors.
The centre has also introduced Code Trauma, a response code that seeks to reduce the duration required to transfer a patient from the emergency department to the operating theatre by half.
It will mobilise essential parties, such as emergency physicians, surgeons and intensive-care physicians to accelerate decision-making and enhance the speed of response to manage bleeding in patients with multiple injuries.
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