New rules, education see heat injury cases fall 90% from 1990s
WHEN it comes to heat injuries, Singapore soldiers are increasingly keeping their cool. Based on statistics from the Singapore Armed Forces (SAF) Medical Corps, the number of cases has fallen from about 200 per year in the 1990s to 20 per year now – a dip of 90 per cent.
New training regulations and education have helped reduce the number of heat injuries. The number of cases has stabilised over the last five years, during which the SAF stepped up training at home and overseas. It also deployed a record number of servicemen in peace support missions in Afghanistan and the Gulf of Aden last year. Each year, more than 20,000 male Singaporeans report for national service, introduced in 1967 to strengthen Singapore’s defence capability. Lieutenant-Colonel (Dr) Lionel Cheng, deputy chief army medical officer, said soldiers succumbing to heat are mostly full-time national servicemen.
The common heat injuries are heat exhaustion – marked by symptoms such as headaches, nausea and fainting – and heat cramp, a painful muscle contraction in the thigh or calf as a result of excessive loss of water and salts. Heat stroke, which is potentially fatal, strikes when the body temperature shoots up beyond 41 deg C. The normal body temperature is about 37 deg C. The SAF medical corps declined to
reveal the number of heat stroke cases, saying only that they are “a small number”. The last reported death in the military due to heat stroke was in 2008, when a 20-year-old trainee pilot collapsed during a three-day jungle course in Brunei. He died later in hospital.
Lt-Col (Dr) Cheng said the new training regulations and education are important because most of the new recruits, despite living in an equatorial climate, have a more “air-conditioned lifestyle”. “National service may be the first prolonged time during which they are doing physical activity outdoors,” he added. The moves, which have been in place since 2009, include putting recruits through a heat acclimatisation phase during the first four weeks of basic military training.
Training also includes “work-rest” periods to allow for adequate rest. This process, also known as periodisation, can range from 15 minutes of rest after a 45-minute workout, to a day of light activities such as indoor lectures after two or three days of outfield training. Recruits have been told to drink beyond the point of thirst and/or until their urine is clear. Servicemen are also taught to watch out for their buddies and identify early signs of heat injuries and how to deal with them.
Besides measuring temperature, Major (Dr) Jonah Kua, a medical officer in the Soldier Performance Centre, said the SAF also monitors wind movement, humidity and how fast human bodies conduct heat to ascertain whether it is safe to train. He added that the 33 medical centres in camps and training schools – including the Basic Military Training Centre on Pulau Tekong – have body cooling units to deal with heat injuries.
The military is sharing its winning formula, with the guidelines compiled in a 35-page dossier. It has been published and circulated since November to doctors in hospitals and clinics. But Lt-Col (Dr) Cheng cautioned that as long as the SAF continues to train, it can only keep heat injuries low but not “down to zero”.
Agreeing, housewife Clare Tan, 50, whose 19-year-old will be enlisted later this year, said: “Tough training is important to make a good soldier so long as safety is not compromised. “But I’ll probably have to get my son outdoors more often and get him used to doing things under the sun.”