HIS memories of what happened that fateful day are hazy.
He remembers the chaos and everything catching fire.
And that his body was burning.
An ambulance rushed him and another survivor to hospital where he was washed and sedated with painkillers to ease the unbearable pain coursing through him.
Mr Karthigayan Ramakrishnan can count himself lucky to be alive today to talk about his ordeal.
He was among seven Singaporean soldiers who were injured in Taiwan when a fighter jet crashed into a storeroom on May 11 last year.
The accident killed three Singapore soldiers and two Taiwanese pilots.
Mr Karthigayan was serving his national service then. He was airlifted back to Singapore on 12 May.
Today, Mr Karthigayan, 24, who suffered 45 degree burns on his hands, body, and superficially on his face, is on the road to full recovery.
He owes his life to the skins of other people.
The skins - harvested from dead donors - kept his extensive wounds from getting infected after the removal of his burnt skin.
'Now I know how important donor skins are,' said Mr Karthigayan.
And he wants to spread the message for more people to pledge their skins for harvesting when they die.
'I know how hard the doctors at the Singapore General Hospital's Burns Centre fought to save me and they couldn't have done it without the donor skins,' he told The New Paper.
He underwent a dozen operations, including skin grafting.
'In the beginning, they used donor skin to cover my wounds to help prevent infection,' he said.
He is a little hazy about the early days as he was kept sedated.
'My father told me when I was airlifted back that my head was 2 1/2 times its normal size,' he said.
In the first few weeks, he was constantly running a high fever as a result of infection.
'At one point, my heart was functioning like a man twice my age. It was touch and go,' he said.
According to Associate ProfessorColin Song, SGH's senior consultant and head of the Plastic Reconstructive and Aesthetic Surgery Department, donor skin could be key to a burns victim's survival.
NO BARRIER TO INFECTION
'Not having enough skin can cause death as there is no skin to act as a barrier to prevent infection,' added Assoc Prof Song, who is also director of the Burns Centre.
The leading cause of death in severe burns cases is overwhelming infection.
If there isn't enough of the patient's own skin to cover the wounds, the next best thing is donor skin, which acts as a temporary skin.
It can remain on a patient for up to three weeks before his immune system starts rejecting it.
This buys doctors time to culture the patient's skin to graft onto his wounds.
After about six weeks of unconsciousness, Mr Karthigayan opened his eyes and realised he was in a hospital.
'I felt pain and was sore all over,' he said.
He was also extremely parched.
A breathing tube down his throat meant he could not drink but could only have ice chips.
After he was taken off sedation, the nurses had a tough time changing his dressings.
'Every time they changed the dressing, I felt sharp pain,' he said.
He was discharged after two months in hospital, but his wounds were far from healed.
'I was told that healing would take about a year to 18 months,' he said.
Mr Karthigayan, on the road to
recovery.
Now, eight months after the accident, he no longer needs strong medication but must wear pressure garments for 23 hours a day to prevent scarring.
'Putting on the garments is a tiring process,' he said.
Before wearing anything, he must first moisturise his skin with cream because burnt skin lacks moisture.
He was initially upset at having to rely on his family members for help, but it's now become second nature to him.
Mr Karthigayan, who now looks fit, said: 'I am taking care of my health and exercising regularly at the gym.'
But his badly marked skin still attracts stares when he is on the MRT or bus.
'Maybe there is a lack of awareness of what a burns patient goes through and the treatment required. But I'm learning to take all this in my stride and am looking ahead.
'After all the help I received, there is no reason for me not to recover fully,' he said.
He has had help from the physiotherapist who taught him how to walk and the occupational therapist who taught him simple daily tasks such as feeding himself.
He also got psychological help from the psychiatrist in case he suffered from post traumatic stress disorder.
STRENGTH
The Ngee Ann Polytechnic graduate in logistics engineering and management plans to take up political science.
He has applied to the Singapore Management University and the British Council for an overseas scholarship.
He also plans to apply to the National University of Singapore.
He has also returned to his polytechnic to help the Indian Cultural Society Alumnus raise awareness and get donations for the Singapore Spastic Children's Association.
'I felt the collective consciousness and strength of all my friends and family who were praying for me when I was so ill.
'There is definitely a deeper meaning to life and part of that is helping to make it better for others,' he said.
That is why he also wants to pledge his skin for donation and some of his friends and family want to do the same after seeing what he went through.
'There's nothing to stop me from donating my skin after I have healed,' he said.
More skin donors needed
THERE are not enough skin donors in Singapore.
Last year, only one person donated his skin when he died.
Between 2004 and 2006, the number of donors hovered between two and four per year.
The reason may be a common misconception people have about donating skin. Skin is not taken from the head to toe of the donor, leaving him 'bare'.
Said Associate Professor Colin Song, director of the Singapore General Hospital's Burns Centre: 'On average, we take about 0.25mm to 0.4mm in terms of skin depth - from flat surfaces like the thighs and back.'
A shaver-like device is used to harvest theskin.
SKIN LEFT INTACT
As only the outermost layer of the skin is removed, the harvested areas will appear slightly pale compared to the rest of the body where the skin has been left intact.
These areas, when concealed with clothing, will not affect the donor's appearance.
Up to 2,000 sq cm of skin can be taken from one donor.
The harvested pieces are processed and packed individually, then stored in a special freezer at -196 deg C.
The skin can be stored up to five years in these conditions.
Because there are not enough donors here, Singapore has had to import skin from Australia, US and recently, the Netherlands, said Assoc Prof Song.
Skin is not covered under the Human Organ Transplant Act (Hota). As such, hospital staff will need to ask the consent of the deceased's family members for skin donation.
Such requests are often turned down and may be due to low public awareness on the benefits of skin donation, said Assoc Prof Song.
