OTGV #42 - Diabetes

Broadcast Date: 24/11/03

Each year over three hundred thousands Singapore visit the polyclinics to treat their diabetes.

Yet this staggering numbers may be the tip of the ice-berg.

The 1998 National Health Survey found that as high as one out of two diabetic Singaporeans went un-diagnosed.

Chong Ching Liang examines diabetes situation here in this week's On the Grapevine.

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Diabetes.

Doctors dub it the silent killer.

People have suffered from it for years without even knowing that they are down with the disease.

And they pay for this ignorance with terminal health threats at the end.

Hi Welcome to On the Grapevine with me Chong Ching Liang as I take a look at diabetes and Singaporeans.

First off what is diabetes?

It is a condition where the body doesn't have enough insulin.

President of the Diabetics Society of Singapore or DSS Tan Hwee Huan explains.

"The insulin is a hormone produced by the body. It is produced by the pancreas and it is the hormone that actually helps us to bring the sugar into the body. And if you do not have that what happens is the sugar remains in the blood stream and you have a condition called high sugar level and that's diabetes."

And there are 2 kinds of people who suffer from this disease which is categorized into Type 1 and Type 2.

Type 1 diabetics are insulin jabs-dependent.

Their body no longer or could never produce insulin.

In Singapore, most diabetics are of the common Type 2 variety says Dr Tan Hwee Huan.

"Most of the diabetics are actually type2 diabetics and that is more like a lifestyle kind of disease. It's actually associated with obesity, that is a weight problem and non-active sedentary kind of lifestyle. Singaporeans are mainly dependent on cars rather than public transportation, walking and the other thing maybe diet. High fat diet in most of our cultural food items."

Here are some somber statistics regarding diabetes in Singapore.

It's the sixth most common cause of death in Singapore.

One in every eleven Singaporeans is diabetic.

What is even more worrying, the last national health survey conducted 5 years ago found that over 6 out of ten diabetics are not aware they are diabetic.

DSS' Honorary Secretary, Dr Kevin Tan says it is hard to ascertain the historical baseline for the number of diabetics in Singapore.

"We don't have all the data. We have an idea of how big the problem is. We know that kidney disease is one of the top ten killers in Singapore. We do know that people with diabetes form about slightly less than half, about 47% of all those undergoing kidney dialysis."

Dr Kevin Tan also cautioned against over labeling diabetes as a lifestyle disease.

"I know it is seen as a lifestyle disease but at the same time we try not to label it as a lifestyle disease because once you do that, it means that once you see someone with diabetes you say 'oh, you get diabetes because you are living like that. What do you expect?' There is a genetic input that sometimes you cannot avoid and then of course there is the lifestyle bit which of course part of it is culture and that's why Indians have the highest prevalence in Singapore and part of it is over-weight, not exercising enough. You know all the modern conveniences, cars and all that."

In developed countries, one in twenty suffers from diabetes.

Singapore's rate is much higher.

Dr Kevin Tan explains why.

"Part of it is probably genes because even among our population the Indians skew the figures because it is so high among Indians and it is high among Indians not just because of their culture what they eat but it is also the genes. So genes is definitely one factor. If you look at the United States if you ask them who among your population is at high risk of getting diabetes, they will tell you it is the Asian group. Straightaway we get lumped in the high risk category. We regarded even more high-risk than Caucasians."

The genetic trend becomes even more worryingly clear when younger and younger Singaporeans are coming down with diabetes.

Dr Tan Hwee Huan.

"Working in the hospital, we are actually getting quite a few patients who are young onset. This means they are diagnosed with diabetes even in their teens. Most of them actually have very strong family history. Either father or mother may have diabetes. Because of that, in our clinical guidelines, we have a clause: Anyone with family history of diabetes is considered at-risk patients. That means they are more prone to developing diabetes sometime in their life time so they are actually encouraged to come forward for screening tests."

Coming forward for screening tests is important.

Dr Tan Hwee Huan says she has come across diabetics who were only diagnosed as such after 7 years.

The problem with diabetes is that the symptoms are so mild or undetectable until serious complications occur.

One of these includes end-stage kidney failure.

Singapore has the dubious honour of having the world's highest number of diabetics developing into end-stage kidney failure.

If properly monitored, this unwanted statistic can be brought down.

If diabetics are diagnosed early, that is a huge battle won.

Once the diabetics have been identified, and they are tested for early stage kidney damage, the battle against kidney failure will most likely be won.

The early stage kidney deterioration is known as microalbuminuria where there are minute traces of protein leaked into the urine via the kidneys.

The test for this condition isn't difficult nor is it slow.

Plus, there's now good clinical treatment for micro-albumin-uria.

Nearly 5 out of ten Singaporeans are diabetics who left their treatment too late.

Don't be one of the statistics.

Take a couple of screening tests to find out if you belong to the high-risk group.

And you are if any of your parents or family-line is diabetic.

Take heed.

This is Chong Ching Liang for Newsradio 938.



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Related Links:

Newsradio 938 (now 938Live)

http://www.938live.sg/

Diabetic Society of Singapore

http://www.dss.org.sg

Ministry of Health

www.moh.gov.sg/cmaweb/attachments/ publication/diabetes.pdf

OTGV #41 - Jurong Upgrade

Broadcast Date: 17/11/03

The new causeway checkpoint was officially opened by Deputy Prime Minister Tony Tan this month.

The thirty million dollars complex is equipped with bomb blast curtains and facilities to repel chemical attacks.

Chong Ching Liang on what he had seen and heard at the official opening ceremony.

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There used to be a time when peace is peace and war is war.

Such clear demarcation exists -- no longer.

Now in peace time, countries must prepare for war.

Hi Welcome to On the Grapevine with me Chong Ching Liang.

Jurong Island, the petrol-chemical hub of Singapore.

A juicy, high impact target for any would be terrorists.

But new security upgrades has reduced that possibility says JTC Corporation CEO Chong Lit Cheong.

"The checkpoint is able to clear a vehicle within one minute. During this one minute interval, the identity of the visitor is verified and the undercarriage of the vehicle is scanned for unusual objects. Container trucks are inspected in 2 minutes using advanced backscatter X-ray technology. Runaway vehicles will be stopped by our three tier anti-vehicle barrier, and this will easily withstand a 3-tonner."

"Soundbyte of Obstacle rising."

That's the sound of barriers rising to meet any vehicles that try to charge into the causeway connecting the Singapore mainland to Jurong Island.

Jurong Island Panoramic view

Picture from www.jurongisland.com

Peace-time vigilance is no longer the actions provoked by kiasuism.

Deputy Prime Minister Tony Tan explains.

"Underlying our efforts to develop Singapore economically and improve the life of our people is the need for security and defence. The link between security and economic development is inextricable. Without a secure environment in which to live and work, a country cannot achieve economic progress."

Mr Chong concurs, saying that the increased security may well persuade more foreign companies to sink roots in Jurong Island.

"Well according to tenants, Exxon-Mobil and so on, told us that with this security put in place, firstly it helps them to reduce insurance costs for example. Because when they put up for insurance premium they can show that its a very safe location with all these security and when they benchmarked their location in Singapore with the rest of the world, Singapore stands up very highly in terms of security. I think that's a very good feedback that we got."

But protecting Jurong Island isn't that straightforward a process.

For a start, JTC didn't even possess a security unit until after September 11.

It had to develop a Risk and Security division and deal with Jurong Island being designated by the government as a protected area.

A protected area is easy to enforce if it is a military installation.

But Jurong Island is a viable and vibrant commercial hub.

Lorries, containers, buses, civilian cars pass in and out of the island each day.

Security can't be too stifling or the commercial operations will grind to an expensive halt.

Mr Chong on how JTC had sought the actions of its tenants in Jurong Island.

"When we were asked to protect Jurong Island as a protected area, we initiated various security measures and we were very mindful of the inconvenience caused. So we actually have a lot of dialogue sessions with the companies, the representatives to help us to ensure that the framework to put in place suits their needs. And that allowed them to understand what we are doing and compliment what they are doing within their own compound so that there are no duplication of security measures."

To minimize stoppage time in the security screenings of vehicles, Jurong Island causeway checkpoint boasts of under-vehicle cameras to search for bombs.

It also has a mobile back-scatter x-ray fixed in a truck to search for potential threats in bigger vehicles.

"The gentleman using the van really only started using the van this morning. Anybody can use the product. There's no radiation, there's no exclusion zone. It's very very safe. The analysis does take a little longer to learn."

That was the vendor explaining to reporters the pros and cons of the x-ray system that was also used by the US Customs to screen US-Bound containers in the Hong Kong ports.

The scanners that are mounted on trucks or on a soon-to-be-available fixed portal will allow security personnel to peep into a close truck or abandoned vehicle.

The signal from the scanners will be reflected in a screen.

Here, the vendor explains what the images mean.

"Anything that is white is organic. For example, tell you what these are: this is water. That is simulated C-4 explosives, that's a bag of rice. You see it start to appear the more dense it is the more organic it is. You can see the fuel level in the tank. So he's got about three quarter of a tank full so he can go on to Malaysia. [laughter]"

The checkpoint complex itself is impressively built.

The security control centre overlooking the checkpoint can be protected with massive cast-iron bomb-blast curtains.

JTC's Head of Risk and Security Loh Kim Hock says there are rooms prepared and ready for any tactical headquarters to be set up in the event of a crisis emerging in Jurong Island.

The new complex will also be able to withstand the impact of a terrorist attack or an industrial accident causing chemical spillage says Mr Loh.

"We will close all openings, we will allow entry exit from this side only. Now people come thru from there, they have to wash themselves, change their clothing before they go in. And anyone who goes out, they have to change into a protective suit, gas mask then they go out. So basically this area prevents the outside air from getting to the inside."

All thought out.

Jurong Island has the unfortunate initials J-I, but it is built to minimise the chance of any attacks by groups such as the more infamous J-I, Jemaah Islamiah.

By the end of the year, Jurong Island will have a full perimeter surveillance system in the form of infra-red camera and remote camera look-out posts.

Who would have thought a commercial centre will be guarded tighter than a military location?

A changed outlook for a much changed world.

This is Chong Ching Liang for Newsradio 938.


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Related Links:

Newsradio 938 (now 938Live)

http://www.938live.sg/

JTC Corporation

http://www.jtc.gov.sg/Corporate/

Jurong Island website

http://www.jurongisland.com/

OTGV #40 - Esplanade's Day

Broadcast Date: 20/10/03

A week and a year ago, a remarkable building was launched in Singapore but on the world stage.

This building is the Esplanade.

And as it caps a successful year in existence, has it really helped the local arts industry?

Hi Welcome to On the Grapevine with me Chong Ching Liang.

The Esplanade's CEO Benson Phua said Singapore’s premier arts center had a good first year.

"The 2000 events that we put out and the 8 million people that have passed thru our doors. That is a tremendous number of performances and people. I am sure life has been changed or touched. So perhaps we have made a difference but we only just begun."

The Esplanade has provided a world class venue to Singaporeans where, at long last, they can savor their favourite musicals, symphony or more.

Act3 Theatric's Chandran on the Esplanade’s good showing.

"I am pleasantly surprised that it is friendly to the audience. I am glad that as a space, that it is vibrant and things are happening. I was wondering if it is going to be a white elephant but from what I seen, it is not."

Has the Esplanade helped local arts companies with its presence?

Singapore Repertory Theatre or S-R-T's Charlotte North.

"Obviously having a big space that attracts big international productions does add to the vibrancy of the market and with the opening of the Esplanade last year, there's certainly an international recognition of Singapore as an arts hub that hasn't been here before. I think Esplanade has definitely has become an icon but I think also what's going on in Singapore right now is a maturing arts scene where you see a lot of new theatre groups see the light of the day. We have run our own venue for two years now. There's a lot more going-ons in the arts."

Kaylene Tan, the President of Spell7, a local experimental theatre company on how the Esplanade energizes the local scene.

"It pushes the arts groups to work harder, you know, to be more professional and because of the audiences' expectation as well."

Indeed, the SRT's Forbidden City saw a huge P-R campaign and broke the box-office records for a local musical.

Could it have been due to the Esplanade?

Maybe says SRT's Charlotte.

"Selling more than 50 K tickets for a local production in Singapore is a bit of a record but I think it is also a combination of many factors. I think the package of a great story, beautiful music, a big campaign and obviously because it's a nice place and a lot of tourists want to go to the Esplanade and chose to see our production because it's also a local production and a lot of Singaporeans say 'we'll go and see this' Whether it's because at the Esplanade or we would have sold just as many tickets at any other venue is very difficult to say."

Some smaller local arts groups fear that the sheer presence of the Esplanade and glitzy foreign productions may eclipse the smaller, independent local players.

Spell7's Kaylene Tan says there's help from Esplanade.

"Now they have this programme called Sparks as well which is commissioning new works. Their support has been very useful for us, especially helping us with more sponsors as well because just having the name there makes it a more high profile event."

However, ACT3 Theatrics' Chandran says smaller groups are still plagued an age-old problem.

"For children theatre companies as a whole, we believe that the rental of any theatre space in Singapore is exaggerated, it’s very very high. And because of that, ticket prices have to be high. There's a problem there for us. How much a family spends counts you see, so you can't charge 70 or 80. We really have a problem, not just with the Esplanade but most venues in Singapore. Our hope is that the rental for theatre space as a whole will come down."

The Necessary Stage's Ngiam Su Lin explains why local players may find the Esplanade's costs prohibitive.

"Esplanade also have to understand that local groups, we are not like foreign groups that have done the tour, so you've done that show 100s of times and you can provide a text-bag and be very specific about what you want. Because most of our works are original or we don't have a long shelf life, we need time to manoeuvre and see how things were and that eats into rental time, which Esplanade is very strict about. You book the space for a certain amount of hours, you get this amount of staff make use of them, if you don't you still need to pay for them anyways because otherwise you didn't say that you don't need them."

But Esplanade's Benson Phua says that the Esplanade is intended to be at the high end of Singapore's performance venues, as such, local companies will have to adapt.

"Much of the cost structure is really cost-recovery and if we were to develop an arts industry, these costs are very much a factor of all productions. For instance, the venue costs, the cost for crew, which not many companies are yet accustomed to because they usually relied on volunteers. It will take time for local scenes to mature and be able to grapple with some of these costs issues."

It will take some give-and-take, maybe a little hand holding before homegrown theatre companies can compete with the big boys like the Cameron-Macintoshes or Andrew Lloyd Webbers.

But S-R-T with the Forbidden City has already proved it ISN'T impossible to do so.

Singaporeans must also do their part by dropping the mentality that foreign is better.

Then perhaps, the Esplanade and the promise it was entrusted with at its opening, can grow.

This is Chong Ching Liang for Newsradio 938.


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Related Links:

Newsradio 938 (now 938Live)

http://www.938live.sg/

The Esplanade

http://www.esplanade.com/


Act3 Theatrics

http://www.act3theatrics.com/

Singapore Repertory Theatre

http://www.srt.com.sg/03/SRT.com.sg.html

The Necessary Stage

http://www.necessary.org/home/home.htm

Spell 7

http://www.spell7.net/