First Intensive Care Unit in JBGH

My memories of the Johor Baru General Hospital [The Iskandarian, Dec 2016], triggered by the recent fire tragedy in the hospital’s Intensive Care Unit (ICU), caught the attention of reader, Dr Anand Sachithanandan.

Dr T Sachithanandan [2nd from Left] receiving a
cheque from Menteri Besar Johor,, Datuk Othman
Saat [Right] at Bangunan Sultan Ibrahim,
BukitTimbalan in March 1968
Dr Anand, a Kuala Lumpur-based cardiothoracic surgeon who grew up in JB, shared with me his memories of the JBGH in particular about the ICU, because his father, the late Dr T. Sachithanandan, founded the ICU in 1968. 

The idea to establish an ICU in JBGH was first conceived in October 1965 by Dr T. Sachithanandan, the Chief Anaesthetist of Johor, a young specialist and Jaycee leader to provide “specialist care for patients during the critical stage of their illness.”

Dr Anand told me about its fascinating origins and as I read the historical accounts gleaned from writings by Tan Beng Hui in his book, Supporting Life: The Journey of Intensive Care in Malaysia, I had to share this story of how a handful of young men committed themselves to undertake a project that has perpetual benefit to the local community.

These young men aimed that the project to create an ICU in the JBGH, should give the “maximum benefit to all sections of the community regardless of age, sex, race, social status, religion or political beliefs” and decided that it should provide a service that was both pressing and urgent.
                                                                                                                             
The Jaycees or volunteers in the Johor Baru Junior Chamber International (JCI), actively involved in this project included Low Theng Kiang, Dr T. Sachithanandan, Talib Majid, Low Theng Siang, Gerry F. Pestana, Joseph Mah, Wong Leong, Mahan Singh Penu, Rejal Arbee, Yusof Abdul Rahim, H. L. Tennakoon, Sunny Low, Mohammed Masbah Ahmad, Looi Ah Lek, Dr Ahmad Yasin Mohd Said, Lau Sun Leong, Roy M. A. Lim, Mahmood Haji Nasir, Lee Tian Chew and Lim Sow Kooi.

Congratulatory message from then Prime Minister
Tunku Abdul Rahman Putra, to the Johor Baru
Jaycees dated 3 Feb 1969, on the official
opening of the ICU in JBGH
The JCI is a worldwide non-governmental federation of young leaders and entrepreneurs with a global network across all continents, which empowers and enables young men and women to improve the lives of their communities and country through volunteer work.

Creating an ICU in the JBGH was the biggest and most ambitious project ever undertaken by any Jaycee chapter in Malaysia and in the 1960s, every single Jaycee in JB took up the challenge with a clear objective that such a ward should become a reality.

At that time, there were no ICU wards in any of the few private hospitals in the nation. The only ICU in the country then was at the University Hospital, now known as University Malaya Medical Centre, which started service in late 1968 and was officially opened in January 1969.

When Dr Sachithanandan and the Jaycees considered the possibility of establishing the first ICU in a government hospital, it seemed like a novel idea but with foresight, sheer determination and hard work, the ICU in JBGH materialized and became the first ICU in Johor.

Dr T Sachithanandan [Centre] leading a clinical walk around the ICU ward in early 1969;
The ICU was separate into cubicles with mobile partitions (top half glass/lower half wood),
a feature jointly designed by the JBGH staff and Johor Public Works Department that received universal attention 
This ICU was built at a total estimated cost of RM120,000 through funding from three different sources: public funds, State government funds and Federal government funds.

Initially, the Jaycees raised funds from charitable donations by the Johorean public and received funds from the Johor state government led by then Menteri Besar Datuk Othman Saat.  However the RM60,000 raised was only sufficient to purchase the necessary medical equipment.

Dato Dr T Sachithanandan, teaching vital
'airway management' techniques to junior doctors
and ICU nurses at the JBGH in the early 1970s
Dr Sachithanandan then led the Jaycees in successfully petitioning the Federal government to match every Ringgit it had already collected and the resulting RM120,000 made the ICU dream a reality in JBGH.

This tripartite source of funding from the Federal government, Johor State government and an NGO like the JB Jaycees, was one of the earliest examples of state-civil society engagements in the nation.  

At a time when government finances to enhance and expand medical services were rather limited and strictly regulated, this was unprecedented!

Much care went into the structural and clinical design of the ward to ensure that it facilitated the needs of modern day medical and surgical care.  And when it was unveiled in February 1969, the ICU in JBGH was considered a state-of the art ward for that era!

Located in a refurbished ward on the second floor of the hospital’s East Wing, the ICU had 3000 square feet of floor space with capacity for eight beds.

It was fully air-conditioned with each of the four functional ICU beds being hooked up to monitors located at a central nursing station to provide the duty nurses with immediate and continuous recordings of patients’ vital functions like blood pressure, heart rate and respiration.

Dr T Sachithanandan presenting
his speech at the official opening
To maintain patient privacy and yet ensure continuous observation, a new design technique was introduced which divided the ICU ward into cubicles by means of mobile partitions.

The top half was made of glass while the lower half of solid wood incorporated the patient’s lockers.  Suspended curtains completed the cubicles into private “rooms.”  

This design technique, jointly designed by the JBGH staff and the Johor Public Works Department, received universal attention. 

At the National convention of Junior Chamber Malaya in Seremban in 1966, this ICU project won ‘Best Project of the Year.’

It was the efforts of a truly multi-racial group of ambitious young men who earnestly set about to bring positive change to their local community.  In our current climate of growing racial and religious intolerance, this is a sobering thought.

This ICU was a thoughtful and deliberate modification of existing facilities which only came about as a result of Dr Sachithanandan’s vision and commitment, and the outstanding fundraising work of the JB Jaycees.

The successful establishment of the first ICU at JBGH prompted then Prime Minister, Tunku Abdul Rahman Putra to challenge other NGOs to emulate this remarkable feat.

The success of this ICU project in JBGH illustrates how visionary leadership and collective, selfless, group effort can surmount financial and bureaucratic challenges, and should inspire others to do likewise.

As we acknowledge the JB Jaycees’ historic effort to establish the first ICU in JBGH, it is also a timely reminder of the power of genuine collaboration.

A version of this was published in the March 2017 issue of The Iskandarian

Photos and information, courtesy of Dr Anand Sachithanandan