OTGV #45 - Disability Sports

Broadcast Date: 22/12/03

Some athletes get paid to perform and winning honour for Singapore provides.

Rewards ranges from 10 thousand dollars for the SEA Games Gold to a whopping one million dollars for the much coveted Olympic Gold.

But there is another group of athlete that quietly does Singapore proud without such financial perks and yet they wouldn't give up.

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

The abled bodied athletes participating in the Hanoi Games received ballyhooed sending off and returning parties.

By contrast, Singapore's contingent of disabled athletes leaving for the parallel or Para ASEAN Games in Hanoi and the youth Asian games or FESPIC in Hong Kong has a rather quiet sending off party.

But at least, the Minister of State for Sports Chan Soo Sen is there to send them off.

"Although compared with the SEA games sending off event, this event rather modest in scale, fewer people around. Don't have the rah rahs, and the poms poms, but to me this is even more significant especially when we hear Mr Tan Ju Seng say, that relative to our abled athletes, we actually do relatively better in ranking in these two parallel games. [applause]"

How well did they do?

A Singaporean athlete Theresa Goh won top individual honours at the inaugural ASEAN para games in Kuala Lumpur two years ago.

The team also brought honour to Singapore with some 20 athletes winning a 16 golds and a total haul of 37 medals.

President of the Singapore Disability Sports Council or SDSC, Tan Ju Seng has a single vision and dream.

"What we like to see is more integration. You know this idea of the disabled going off on their own, and competing, training on their own separate from the able bodied, I think that has to change. There is so much synergy. The able bodied can learn from the disabled, and the disabled can learn from the able-bodied as well. Facilities can be shared; we don't have to re-invent the wheel in so many cases. We don't have to organise our sports events. There are already in existence, events for the able bodied, all that is needed is for us to just create a division within these events for the disabled, and in this way, we can sort of ride on what is already happening."

What can abled bodied athletes learn from their disabled fellow national athletes?

Local swim legend Ang Peng Siong, who is also the swim coach for the squad going to Hanoi, says sheer grit, determination and dedication.

"What I find is pretty amazing is that this group of disabled athletes are behaving just like anyone else and just making the best of their opportunities to train hard and improve on their performances. So they get up early in the morning if need be. And if someone is wheelchair bound, I am sure that they take a lot more time to prepare themselves for training. Sometimes our abled athletes may groan and be disgruntled about getting up so early and making the trip to the swimming pool, I find that these disabled athletes you don't have to say much, if they need to be at training, they will turn up with no complaints at all."

Mr Chan says the athletes must be lauded for daring to break societal norms and help bring the greater society closer to the world of people with disability.

"You are trying to prove that you are a fellow member of the committee please treat us and don't treat us different. This is a not an easy battle to win but I am sure that our athletes have led the way in paving for integration of the people with disability."

Kevin Tay is one of our national athletes going to the Fespic Games in Hong Kong.

He tells me how he feels and his training routines.

"A little nervous cause this one is my first time." "I train every week lah, Monday, Wednesday, and Friday, every session two hours."

Kevin hopes to win a gold for Singapore.

He's a newbie but here's another who has done Singapore proud before.

"My name is Ahmad bin Yusoff. I represent athletics in Singapore for disability sports council. Our first ASEAN para games, I got 2 gold medals. [Did you receive any rewards] Yeah. I just got sportsman of the year, last friday. I never think I will get sportsman of the year award."

Ahmad also trains multiple times weekly.

He is luckier as he isn't wheel-chair bound.

Quite a number of this group of national athletes is wheelchair-bound.

This means they can only take London or minivan cabs.

This means more cash outlay.

Ang Peng Siong on some difficulties encounter by his swimmers.

"There are situations where I will have to do my part as the coach and assist the athletes to the venues accordingly because there are some venues that are not flexible for disabled individuals. So I would have to actually carry some of the athletes up the stairs and to the venues."

Mr Chan Soo Sen says society will eventually catch up with this group of very brave individuals so that eventually, accessibility to facilities and places will no longer be an issue.

"As Singapore becomes a more aged society, I am sure there will be greater public demand for facilities to overcome those things that you've just mentioned. As we have more older people, you can argue that there are more disabled people. And so as a society becomes more aged, I am confident of the society's appreciation of the difficulties of the disabled persons will also increase. In the next ten years, it will definitely be better than what it is now and now it has been better than ten years ago."

They wear their differences physically, and their hearts on their sleeves bleeding scarlet crescent moons and stars.

Their exploit aren't well covered in the media but the honour they brought to Singapore is as tangible as the glittering gold medals they won.

This is Chong Ching Liang for Newsradio 938.

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Related Links:

Newsradio 938 (now 938Live)
http://www.938live.sg/

Wikipedia page on 2003 SEA Games
http://en.wikipedia.org/wiki/2003_Southeast_Asian_Games

Singapore Disability Sports Council
http://www.sdsc.org.sg/

OTGV #44 - Patient Management

Date of Broadcast: 15/12/03

Medical technology has advanced so far that equipment and newly discovered knowledge have overtaken traditional medical practic.

Two renown endocrinologists from the United States say that general practitioners and medical care-givers must re-orient the way they manage their patients. Chong Ching Liang with more.

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Medicine has transcended the medieval days of harmonising the four humours; blood, phlegm, yellow and black bile to cure ailments.

Later, as a science, medicine employed the use of x-rays to see the organs, the electro-encephalogram, or e-e-g to map out a patient's brain activity, and the electro-cardiogram or e-c-g to peep into a heart's health.

Doctors saving more lives but are they doing so in the most efficient way?

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

Biotechnology has now provided computer-aided surgery, Magnetic Resonance Imaging or MRI to peer to the tiniest of nooks and crannies that the human body can offer.

Inventions aside, epidemiological knowledge has also been gushing forward from researches and studies.

The fight against the threat of diabetes becoming a major world epidemic is an example.

Professor Willa Hsueh, chief endocrinologist of UCLA on the virtues of treating any conditions early.

"There are many chronic illnesses throughout the world. These include high-blood pressure, diabetes, cancer, arthritis. And the earlier we recognised the patients have the disease, the better we can approach treatment. Intervention early prevents damage and in the end it can save the patients a lot of pain, suffering and perhaps even an earlier death. Therefore we need to recognise some these chronic diseases as early as they appear."

Prof Willa says doctors now have the tools.

Doctors just need to learn how to optimise their efficiency.

But this shift away from the focus of a specific disease to looking at a multitude of syndrome, will it cause confusion and mis-diagnosis?

Unlikely, says Professor Willa Hsueh.

"I don't think so. The current trends in medicine allow us to recognise diseases much earlier. There are a number of epidemiologic studies, for example for diabetes and heart disease, that allow us to recognise which humans are at high risk, will ultimately getting, for example, a heart attack, stroke or diabetes."

Medical care-givers be it the neighbourhood family physicians or the specialists at any hospitals must upgrade their management of patients.

Think out of the box.

Using diabetes as an example, University of Alabama's Professor Bell with this critique of conventional treatment of diabetic patients.

"Well traditionally diabetologists and endocrinologists who treat diabetes have traditionally been what we called glucose-centric. They, in other words, concentrate on the glucose and not looked at the other risk factors. But we have to look at the patients holistically. 75% of the people with Type2 diabetes are going to die of cardio-vascular disease, and 2 thirds of those from coronary artery disease. So we have to look for the other risk factors for heart disease and that would include hypertension, cholesterol."

For instance, diabetes has a strong genetic load.

People with diabetic parents are very prone to becoming diabetic themselves.

Obese individuals mustn't be too complacent either.

These are the epidemiological studies that have arose to help doctors identify the highly at risk groups as far as diabetes are concerned.

Intervention doesn't simply mean to just simply lower blood sugar level anymore.

Treatment of diabetics must now come with a whole suite of routine.

Professor David Bell explains.

"And that also making sure the patients is on an aspirin a day, making sure those patients who are more liable for infections also have vaccination for pneumonia, that those patients also have flu vaccines. And also that we check for organ damage. Not only the eyes and the kidneys but that we try and diagnose it as early as possible any cardiac or cardio-vascular condition that could lead to acute events for the patients. So we got to move beyond glucose and obviously we have to be much more holistic in managing our patients."

It is to also check for protein leakage from the kidneys as this is an early sign of kidney damage.

Singapore has one of the highest percentages of diabetic patients ending up with end stage kidney failure.

It isn't a proud statistics.

The protein leakage is known microalbuminuria and can now be easily detected in the doctor's office.

More importantly, the process can be easily reversed.

But most doctors outside of developed economies don't really do this.

It may well be a question of not being equipped with the knowledge.

Professor Willa Hsueh says medical students in the United States are now being taught to make use of the knowledge and take a more holistic approach to treating diabetes.

But she says more can be done.

"There are number of things that I think can be done. Number one, I think the people that sponsor medical education whether it be the government, whether it be the medical school, whether it would be, sometimes, pharmaceutical companies, or sometimes like the meeting that we are having, this AFES meeting, they need to emphasise education to the private practicing or government-practicing physicians. These are primary care doctors, primary internal medicine doctors, they need to understand problems, for example the kidney complications and what they can do for early intervention to prevent."

The other thing is for government to ensure that proper tests are conducted and for patients to be better educated.

That way patients can ask for a microalbumin test even if their doctors don't order it.

But diabetes is just one disease; there are many others that have varied linkages to other chronic illnesses.

Doctors now have the tools.

They must use them, and the patients must be less passive recipients of treatment.

They too, must learn and demand.

This is Chong Ching Liang for Newsradio 938.

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Related Links:

Newsradio 938 (now 938Live)
http://www.938live.sg/


Willa Hsueh's page in UCLA Medicine
http://www.endocrinology.med.ucla.edu/willa_hsueh.htm

Ministry of Health
http://www.moh.gov.sg/

OTGV #43 - AIDS Stigma

Broadcast Date: 01/12/2003

Intro:

But the biggest challenge of HIV/AIDS isn't fighting the disease itself but the discrimination and stigma that come along with it.

Tune in to this week's On the Grapevine as Chong Ching Liang discusses the difficulties of being a HIV/AIDS patient.

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Some 20 years after the world was first alerted to Aids, the pandemic has become what UN chief Kofi Annan says is one of the world's biggest security threats

Worldwide, some 40 million people have been infected with HIV/Aids

In Singapore, 201 people tested positive for HIV in the first ten months of this year (2003).

It was a seven percent increase over the same period last year.

Despite the threat posed by Aids, the world it seems lacks political will to fight it

What's worse, many shun those who have it.

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

How big is the stigma surrounding HIV/AIDS patients and their family?

Well, for a start even getting a place in a school for your HIV/AIDS child is a daunting task.

Noraini adopted Ariq, her son, before she even knew he has AIDS.

When it was discovered that he's HIV positive, her family's ties with him became even stronger, so strong that they wouldn't give him up.

Now, Ariq is three years old, and Noraini and her husband will need to look for a school for him.

They know it isn't going to be easy.

"Right now we have not register him for any schools because a few weeks ago, SPH did some surveys and from the surveys we understand that no schools will want to accept him because of his condition. They are afraid that other parents will not agree with him being in school. I dare not try. Right now we've seen what Ariq has gone thru, so... honestly, I am afraid of rejection."

The last two years have seen a series of high-profile AIDS prevention campaigns across all media here.

The infamous tombstone as headboard of a bed was seen on TV, in newspapers, and near bus-stops and train stations.

But such campaigns are sometimes a double-edged sword.

AIDS sufferers may be further stigmatised by the reinforcement of public perception that HIV/AIDs is an immoral disease.

Minister of State for Health Balaji Sadasivan calls this type of labelling as problematic.

Dr Balaji says Ariq is a prime example of why such stigma mustn't be entertained.

"It's wrong to call it an immoral disease particularly in referring to the disease and then refering to the child. That child was totally innocent. The linkage of the two actually helps create bias and this is what we must all ensure that we do not do. Now KK Hospital and social groups will work as hard as possible to integrate children with AIDS in society try our best to ensure that no discrimination is against them because they are innocent. We will work with schools, we will work with parents, we will work with society to ensure they are integrated."

In Singapore, the Action for Aids group seeks to create greater awareness and understanding for those with Aids.

Its Vice-President, Brenton Wong, on what sets HIV/AIDS sufferers apart.

"Why HIV/AIDS is so different from other diseases or treated differently is because of the perception and ignorance involved and the heavy stigma and discrimination. And that stigma and discrimination heavily impacts on prevention efforts as well as care for the patient because even now we have patients who do not want to go to the CDC for treatment because they do not want to even be seen there."

In fact, until recently, all hospices had refused to admit HIV/AIDS patients, saying their staff would resign out of fear.

Is this disease then the modern equivalent of leprosy, where sufferers are shunned and ostracised by society?

Dr Balaji says not on his watch.

"As Brenton pointed out, we are very serious about preventing discrimination against AIDS. And we issued a directive to the hospices that they are not allowed to discriminate against AIDS patients. And that directive is for all health establishments. We will have to work with schools and work with the Ministry of Education."

The Singaporean society has always considered itself to be conservative.

But conservatism can be used as an excuse not to change.

Singaporean parents delegate the sexual education of their children to the schools and other external agents.

There's almost a delusional belief that if you don't talk about sex, then their children won't be tempted carnally.

Noraini says it is difficult to talk about sex education, and sexually transmitted infections, let alone HIV/AIDS.

"Most of the time when we talk about HIV/AIDS, people tend to shun from the topic. It's a taboo to discuss AIDS at all. So when the story of Ariq came out in media, many people, you know, were afraid to come forward and talk to us."

Wrongly held taboos kill life.

Actor Gillian Anderson or Agent Scully in X-Files with her take during the BBC radio show, Talking Point.

"Sure it's tough but it's a fact of our life in the world that we are living in today. And I think it's absolutely necessary for us to put all our squeamishness and the taboo behind us in - effectively to save lives. And that should come first and foremost."

Even if there exists a cure tomorrow, Singaporeans and indeed the world must still change their views for HIV/AIDS to be combatted effectively.

Noraini with this plea for compassion.

"I hope Singaporean family members will give support to their family members who are infected with the disease because they need the emotional as well as the moral support. The disease itself is a punishment whatever you may call it. So as families we have to give a strong moral and emotional support to people who have AIDS."

This is Chong Ching Liang for Newsradio 938.

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Related Links:

Newsradio 938 (now 938Live)
http://www.938live.sg/

UNAIDS
http://www.unaids.org/en/default.asp

Ministry of Health
http://www.moh.gov.sg/corp/about/newsroom/pressreleases/details.do?id=8519689


Action for AIDS
www.afa.org.sg