By Sabrina Tay

He held his index finger out next to mine and the difference was stark. Rubel’s finger was deformed, the nail shorter than what it should have been and the flesh at his fingertip warped. “Can you feel anything?” I asked as I gently touched his finger. “Cannot feel, no pain, no feeling” he replied politely, and it was evident that his finger had lost its sense of touch, its nerves damaged.

Rubel explained that he was employed by a manpower supply company, which sent him to a shipyard for work. Around 3:30pm, 1 November 2014, while hammering, his right hand accidentally slipped and the hammer slammed into his left index finger. The tip of the finger became dislocated, dangling out and bleeding. Rubel approached his (supply) company’s safety officer who informed a shipyard officer of the incident. The supply company’s safety officer then took Rubel to West Point Hospital.

Seeing the injury, the doctor explained that “bone is fractured, need to operate” — in Rubel’s words. He was operated on at 7:30pm during which a metal splint was inserted into the finger to straighten it out.

So far, so good.

After the surgery, a decision was needed about medical leave. Rubel says the doctor first told him, “Doctor say you this one very serious, must give MC (medical leave certificate),” but then turns to consult with the company safety officer. Recounts Rubel: “Doctor ask (the safety officer) give how much? Safety say give one day MC, then light duty two days, then come back for next appointment.”

As Rubel recalls, “Safety say no give so much MC because so many problems direct company…” The term ‘direct company’ probably refers to the shipyard. It appears that the Safety officer’s words to the doctor was based on what he believed the shipyard would want.

Nevertheless, here’s the question: Should someone not medically qualified dictate the number of days of medical leave?

Two days later, after the MC had worn out, Rubel was expected to report to work. With a fractured finger that had just undergone surgery, “I tell company: I say, how to work? Company say, ‘You no working just stay inside sleep, or go jalan jalan (walk walk).’”

Remarks Alex Au, TWC2 Treasurer: “Isn’t that interesting? The company didn’t really need him to work. That was not the motivation for keeping the medical leave period to one day.”

Then what might the motivation be? “One can speculate that keeping a clean safety record was the priority,” adds Alex. The law is that any accident resulting in more than two days of medical leave has to be reported to the Ministry of Manpower. The ministry may carry out an investigation into safety practices at site.

A month later, the metal piece inside Rubel’s finger had to be removed. Seeing that the company doctor was easily swayed by the safety officer, and “company no help”, Rubel decided to borrow money from a friend and headed to Tan Tock Seng Hospital (TTSH) on his own to seek treatment.

At TTSH, the doctor asked Rubel “Why you coming here?” — in Rubel’s words. Rubel replied “my company light duty light duty, MC no give.” Assuring Rubel that “he will take care, ask me (him) no go westpoint hospital”, the follow-up operation was performed to remove the metal piece. Rubel was then given two months’ medical leave.

He had to pay about $700 for treatment at TTSH.

Rubel’s story highlights an issue of medical ethics. The seriousness of the injury can be seen from the fact that two operations were needed and the doctor at TTSH felt two months’ medical leave was appropriate. Yet, the doctor at West Point, taking advice from the safety officer, gave Rubel only one day.

It is part of a larger pattern. As Rubel reports, he was not given much opportunity to speak to the first doctor about his injury. The doctor at West Point mostly interacted with the company representative. Yet, this is the worker’s body, not the company’s and it should be — as clearly stated in the Singapore Medical Council’s Physician Pledge — the doctor’s responsibility to “make the health of his patient, his first consideration”.


See also: Medical Council hauls 2 doctors to disciplinary tribunal