As a pioneer in the field of paediatrics in Singapore, Professor Phua Kong Boo, has seen the remarkable evolution of the profession since the 1960s.  He reflects on these changes and the achievements of Singapore paediatric clinician researchers.

Paediatrics in Singapore has undergone major changes over the past five decades, in large part due to technological advances. The profession has also evolved from one that was a general discipline to one that now features multiple subspecialties. The number of paediatricians in Singapore has also grown substantially.

When Professor Phua Kong Boo, Senior Consultant at KK Women’s and Children’s Hospital (KKH), started practising in 1967, Singapore General Hospital (SGH) was the only public hospital providing specialist paediatric services.


Kandang Kerbau Hospital, 1940s, with Bukit Timah Road and canal in the foreground. Note the trishaws and the road bridge over the canal.
(Credit: ‘The history of obstetrics and gynaecology in Singapore’ Tan K. H. & Tay E. H. (eds.) (2003)

Over the subsequent decades however, paediatrics departments sprang up in other major hospitals, including the National University Hospital (NUH), Tan Tock Seng Hospital (TTSH) and Alexandra Hospital (AH). From the late 1970s, Singapore paediatricians began to develop subspecialty interests and the practice of subspecialisation expanded greatly when all the public hospital paediatric departments were consolidated and moved to KKH in 1997. 

The main block and entrance of the New Wing of the old Kandang Kerbau Hospital.
(Credit: ‘The history of obstetrics and gynaecology in Singapore’ Tan K. H. & Tay E. H. (eds.) (2003)

At the same time as Singapore’s paediatric profession evolved, Singapore modernised and transformed into a developed country and its infant mortality rate improved significantly over the decades. “In 1967, it was 24.8 [per 1,000 resident live births]. Now it’s only 2.0 per 1,000 – comparing favourably with other developed countries,” according to Prof Phua. Child health care has improved by leaps and bounds since the 1960s, with improvements in neonatal care and advances in medical care, knowledge and technology. The environment has also changed to positively impact paediatric health. “Factors that contribute include a much cleaner Singapore, better education, greater awareness of health hygiene and improved social behaviour,” he adds.

The current KK Women’s and Children’s Hospital built in 1997. (Credit: KKH)

Prof Phua and many of his colleagues have also been at the forefront of clinical research. In collaboration with his colleagues, he helped test a vaccine for Rotavirus. Rotavirus infection can cause severe diarrhoea in infants and young children. It has a mortality of half a million children worldwide annually – mostly in the third world. Globally, death from rotavirus has decreased significantly with the introduction of the Rotavirus vaccine. Rotavirus induced diarrhoea is still common amongst paediatric patients in Singapore. However, with administration of the vaccine, the disease in immunised babies and young children has become milder and they may not need to seek medical attention, or be admitted to hospital. “While many diseases have almost disappeared from Singapore, ‘diseases of affluence’ such as obesity, inflammatory bowel disease, diabetes and asthma are on the rise,” says Prof Phua. Researchers are monitoring these trends and clinical research will no doubt play an important role in the future in defining Singapore paediatric care.

“While many diseases have almost disappeared from Singapore, ‘diseases of affluence’ such as obesity, inflammatory bowel disease, diabetes and asthma are on the rise”



Did you know?

In the early 2000s, a large pharmaceutical company partnered with the public healthcare institutions such as KKH, NUH and several polyclinics to conduct the largest clinical trial in Singapore - involving more than 9,000 infants for the Rotavirus vaccine Phase 2 and then Phase 3 trial. The strong private public partnership contributed to the success of this landmark trial, facilitating the Rotavirus vaccine to be licensed in Singapore in 2005, ahead of other key global regulatory agencies. To this day, the vaccine continues to help protect children in Singapore.