My Newsradio Scripts

My Blatherings on Razor TV

2009-11-18T12:54:00.005+08:00

Had an out-of-the-blue interview with Razor TV on handphone etiquette.

Producer and Interviewer was Ms Goh Shi Ting
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OTGV #59 - GM Food

2006-07-01T16:23:00.000+08:00

Broadcast Date: 07/06/04

The European Union has lifted its controversial 1998 ban on Genetically-Modified or GM food.

Environmentalists called GM food "Frankenstein food" as these are plants that have been tweaked genetically to be more parasite and climate resistant or provide either greater yields or better taste.

The biotech companies and most governments say GM food is safe and it'll feed the world's hunger.

But consumers have reacted suspiciously saying that the long-term health risks are yet unknown.

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

As far as GM-food is concerned, a recent workshop for regional stakeholders is significant.

CEO of the Agrifood and Veterinary Authority of Singapore Dr Ngiam Tong Tau.

"The First Asean workshop for testing for genetically modified food is an important step for Asean members to have a deeper understanding of GM-food. It is also necessary for us to have methods to detect GM food coming into this region. That's why that we are very glad that at this workshop there are experts from different countries here to inform us in the advances in testing for genetically modified food."

As the world heads into an era dominated by biotechnology, the issue of quality control and food safety becomes crucial, hence GM testing is now considered indispensable in many regions.

In regions like Europe and Japan where there're great consumer suspicions of GM food, a rigorous test is written into the law.

Dr Guy van dan Eede of the European Commission's Institute of Health and Consumer Protection.

"For us within the European community, testing is essential, there is a new law into force on the 19th of April, we need to have testing procedures for every GMO that's being place on the European market. My organisation, the joint research centre of European commission actually checks the validity of such a method."

Proper testing and policing will ensure that only GM-food that's been certified safe by the World Health Organisation or individual countries will reach our neighbourhood supermarkets.

Karen Chan, a local consumer and expectant mother, says she wouldn't mind eating GM-food if stringent checks exist.

"I am trusting the authorities are giving us sufficient knowledge or at least are disseminating sufficient accurate information to consumers like us. There is a certain level of trust that we have to have in terms of it is a safe product to consume. Ultimately if it is safe, I guess I am not against taking it."

But in countries like Europe, Japan, and other developed western economies, food retailers are require to label GM food products clearly.

Dr van dan Eede thinks this will eventually become a global movement and not just a European idiosyncrasy.

"Labelling requirement as they are applied in the European Union is also taken over by a number of international like Codex Alimentarius. I also hear that a number of non-EU countries, even the United States, Japan. It is certainly the case in Australia and New Zealand so it is not that the EU is an island in terms of labelling. There may be a tendency towards world-wide labelling."

GM-food in the form of soya, corn and canola oil has been in Singapore the last four to five years.

But many Singaporeans don't know about them being GM food as they have never been labelled as such.

Dr Ngiam of the A-V-A explains why Singapore hasn't adopted this practice.

"The labeling of GM food is something being discussed at the international level, at WHO and Codex Alimentarius [Commission] and we are participating in this discussion because it is quite a complex procedures to label and it is very difficult to detect GM material in compound food and therefore that has to be sorted out first and we will adhere to international guidelines on this when it comes about."

But the situation here in Singapore may change as people get savvier and desire more information about the food they eat.

Dr van dan Eede feels this trend of wanting to know more is a natural progression.

"More and more are concern with not just GMOs but in general people would like to know what kind of food they are eating, where the food is coming from. After a number of problems that we have seen with food, people tend to have more and more interests in the quality and the origins of their food. Labelling and traceability may be a solution to that."

Singapore may only be moving towards clear labelling of GM food only if a world standard has been reached because of certain constraints, highlights Dr Ngiam.

"We cannot insist GM producing countries to label because Singapore is a very small market for food and we don't produce our own. It will be quite difficult for us to access sources of food in the world."

While it may be slower in coming, most if not all Singaporeans will one day ask for the labelling of GM food.

Ms Karen Chan with the reasons why.

"I would like to know if they have been genetically altered or not so that if I have young children or the elderly or parents who may choose not to eat it for whatever the health reasons, then at least that gives me the choice."

The old cliché goes, we are what we eat.

So perhaps, it isn't too much to ask for, when we ask to know what exactly is it that we are eating.

This is Chong Ching Liang for Newsradio 938.

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Related Links:

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

European Union FAQ on GM Food
http://ec.europa.eu/food/food/biotechnology/gmfood/qanda_en.htm

Agrifood and Veterinary Authority Singapore
http://www.ava.gov.sg/

The Institute for Health and Consumer Protection (IHCP)
http://ihcp.jrc.cec.eu.int/

World Health Organisation
http://www.who.int/foodsafety/en/

Codex Alimentarius Commission
http://www.codexalimentarius.net/web/index_en.jsp

OTGV #58 - Fundraising

2006-07-01T15:33:00.000+08:00

Broadcast Date: 31/05/04

Singapore is a country that is fiercely proud that it isn't a welfare state.

It also seeks to be a country where the wealthy help out the poor.

Where the government doesn't provide, the non-profit sector welfare organisation will step in.

But where will the funds come from?

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

For the longest time, the non-profit sector depended on a central body Community Chest to raise their funds for them.

But as some grew savvier, non-profit organisations or NPOs start to raise their own funds.

NPOs like NKF has became wildly successful and are subsequently targetted by the public for veering into the area of using professional fundraisers.

So is the old system still useful?

Executive Director of the National Volunteer and Philanthropy Centre or NVPC, Mrs Tan Chee Koon.

"The Comm Chest model still has its usefulness especially for the smaller charities that don't have the benefit of sufficient resources themselves to brand, to market, to brand their cause. Having said that, there is a need for CommChest to also re-invent itself. One reason for this is that more and more donors want to dictate where their money goes to. So under that kind of environment, the CommChest equivalent organisations have to see how they can accommodate donors' advice."

The Singapore now is different from the olden days.

These days Singapore sees massive television charity galas, direct mailers and myriad charity events.

Is there a danger of compassion fatigue?

"Compassion fatigue? No I don't think so. It is for us then to put the need across to the giving public or the ones who are not already giving but who could be on the fringe, who just need to be told that there is an opportunity for them to give to and I think it is for the NPOs to be able to enunciate that need and not necessarily just tug on people's emotions but sometimes also to make a good business case as to why it makes sense for the grant makers to come in and support them."

It is generally accepted by the NPO community that fund-raising is a tedious and awkward exercise.

Most feel that having to worry about and to seek funds detracts from their core services.

But some, especially those with the backing of religious societies or the marketing clout of NKF don't seem to worry too much.

Dr Lee Tuck Siang, CEO of the Thye Hwa Kuang Moral Society who runs some 50 family service centres, home for the aged and the Ang Mo Kio Hospital.

"We do not have much problems fund-raising. We do not go out all the way to fund-raise. We believe in live and let live. So we just fund-raise when there is a need but since we took over Ang Mo Kio Hospital 2002, the deficit is 2.57 million per year and with the recent deduction in subvention, we may have to go for fundraising."

Others find that it is easy to raise funds when donors think it is a one-time charge of paying for the construction of a facility.

President of the Hospice Care Association, Dr Seet Ai Mee.

"For most fund-raising, it is very easy to fund-raise for a building project even for renovation, there is a tendency for people to give to a certain object but for people to give towards supports, and towards salaries of doctors and nurses, it is not very common."

This is something that NVPC hopes very much to change says Mrs Tan.

"What we want to see is corporate donors go beyond programme funding into infrastructural overheads needs of these new initiatives or new programmes. These programmes need people to run it but traditionally, the givers have fought shy of funding overheads. So we also trying to encourage companies to take a strategic approach to giving, empower these organisations especially in their start-up years, by helping to cover whether its their staff, their rent, so that they can concentrate on delivering their services to their beneficiaries."

If NPVC is to succeed, it will certainly be much welcome by groups such as Action for Aids or AFA.

The funds raised by AFA go into subsidies for AIDS sufferers’ treatment.

The medication is incredibly expensive and the group estimates over half of the AIDS patients here can't afford the tab.

And yet, AFA's Brenton Wong says their outreach is small and he explains why.

"It's been difficult and because we have been dealing with this particular stigmatised subject of HIV/AIDS many people do not want to be involved in fundraising for us because they find that it is a topic that is not socially acceptable. And there are very few people who understand the issues as well and they tend to be judgmental so they do not give as freely as to other charities."

For groups like AFA, smaller NPOs or startup NPOs, NVPC hopes that there will be more horizontal cooperation to pool their resources together when it comes to raising funds.

Mrs Tan.

"We are trying to encourage is for some of these smaller, like-minded charities perhaps in the same cause to band together and jointly promote their interests as a cause so that when givers give, they give to maybe 3, 4 , 5 of these charities as a way to go."

Right now, an NPO has the best chance of being surviving if it enlists a high-profile political or entertainment celebrity to help it source for funds.

NPVC hopes that when the Singaporean society will mature as a giving society, it will be the NPO's mission that draws the cash from Singaporeans,

and not who is supporting them or what prizes they can win to draw them into parting with their cash.

This is Chong Ching Liang for Newsradio 938.

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Related Links:

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

Community Chest at National Council of Social Service
http://www.ncss.org.sg/ncss/donate/comchest_home.asp

Hospice Care Association
http://www.hca.org.sg/

National Volunteer and Philanthropy Centre
http://www.nvpc.org.sg/

Ang Mo Kio/Thye Hwa Kuang Moral Society Hospital
http://www.amkh.com.sg/

Action for Aids
http://www.afa.org.sg/

OTGV #57 - Aids Memorial

2006-06-01T17:08:00.000+08:00

Broadcast Date: 17/05/04

There are a few reasons why HIV/AIDS patients aren't called patients, but sufferers.

They suffer the burden of knowing that their affliction has no cure;
That the only medication that can prolong their life may be far too expensive for them to buy;
And that the society will stigmatise them.

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

In Singapore, the media highlights the disease only in two occasions, the AIDS Candlelight Memorial on May 16th, and World AIDS Day on December first.

Action for Aids or AFA organiser for the Candlelight Memorial, Kelvin Wee on its significance.

"May 16th is the date that everyone in the world will be observing the AIDS Candlelight Memorial. It's an event that is held in over 85 countries and by 3000 communities. Singapore is just one of that many that's just doing it."

AFA's Vice-President Brenton Wong says it's the reluctance by the society to deal with HIV bug openly that hampers Singapore's fight against AIDS.

World Health Organisation's Director General Lee Jong Wook on why the world's losing the battle against the AIDS pandemic.

"We've been talking about prevention using condom without talking about mentioning the ability of medicine. Nobody told them that this is too expensive for them to buy so that you just go back and wait and die but people in the other parts of the world can live another ten, 15 years more. Nowadays, eight thousand people a day dying is equivalent to 30 jumbo jets crashing every day."

The costs of one year of HIV/AIDS medication in the form of the "triple cocktails" of required anti-retroviral may cost up to $10 thousand yearly.

Not many in Singapore can afford this exorbitant price tag so some go over to Thailand where the cheaper generic drugs are available.

Generic drugs are cheaper copies of brand-name drugs that cost about US$400.

The World Trade Organisation allows generic drugs to be produce if HIV/AIDS is classified as public healthcare threat by the country.

AFA's Brenton says developing countries have taken advantage of this provision but not developed economies like Singapore.

"The Doha declaration which states very specifically that it is public health over everything else which very few countries invoke because of the threat of sanctions from the US. Well, basically Singapore has signed off most of its rights with the American free trade agreement. So it is countries like Brazil who have flouted those rules by declaring an emergency and then producing their own drugs and they give 100 percent to their patients. And this is a developing country."

The UN health agency head Dr Lee Jong Wook talks about the W-H-O plans known as "3 by 5", to take the battle to the HIV/AIDS virus.

"Three million comes from the number 6 million who need the medicine today. People said at the time that this is a really ambitious, unattainable plan. When my staff presented this to me, I was under whelmed because we need to provide the drugs for six million people. Depending on where you stand, this can be overly ambitious or it is really too small."

Thailand, the country most hit by HIV/AIDS in Southeast Asia now has access to generic drugs

The sufferers here who couldn't afford the HIV drugs here but can afford to travel go to Thailand for the generic drugs.

But the sheer inconvenience of this may result in some of the HIV sufferers lapse in their medication.

This will create a more serious problem of cultivating drug-resistance strains of the HIV bug says Brenton.

"From our experience in talking to HIV-positive people in Singapore, we know that more than half of them cannot afford name-brand anti-retroviral so many of them either have to look for it elsewhere or go without medication. When a person takes HIV medication, it has to be for life to suppress the virus. Now if a person does not consistently take the drug, the chances of resistance developing is much higher. It has public health implications because if this person infects another person, then it would be a resistance strain."

That, incidentally, is Dr Lee Jong Wook's greatest fear.

"At this stage we have to be very very careful that this '3 By 5' if unwisely implemented can be an invitation for massive scale of drug resistance. With a limited number of drugs still effective for HIV-AIDS, this will be a real catastrophe."

Dr Lee says the government and public health planners must get into the act.

In Singapore, because of the social stigma and the costs of medication a HIV-positive diagnosis is viewed as a semi-death sentence.

This sense of fatalism that accompanies a diagnosis presents the most danger to society.

The existence of this mindset won't help the public health planners in their fight against HIV/AIDS says Brenton.

"I have spoken to many people and they say why bother to go for testing when I can't afford treatment in Singapore and there's no support anyway. So it shows up in our figures because more than half our patients who discover that they are HIV-positive discover it only when they are very sick and they are hospitalised and the doctors suggests an HIV-test. That means there are many people out there who are HIV-positive but do not know it because they do not want to be tested."

If not all "at-risk" Singapore residents go for HIV screening, then the total population of sufferers in Singapore will never be known.

This makes the silent risk even more silent, and even riskier.

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

OTGV #56 - WHO AIDS Fight

2006-06-01T16:54:00.000+08:00

Broadcast Date : 10/05/04

HIV/AIDS is an infectious disease that has plagued the human society for more than two decades.

The World Health Organisation or W-H-O has been leading the fight since the beginning, but the UN agency is better known for its role in fighting SARS.

This is an indication of the taboo associated with the illness and the low priority the world gives to HIV/AIDs as a public health threat.

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

Some 8,000 people or 30 jumbo jets worth of passengers are dying from HIV/AIDS everyday

It is no wonder that W-H-O Director General, Lee Jong Wook, was in town recently, focused on this issue for his public lecture here

"Right now 40 million people around the world are infected with HIV-AIDS and 6 million people need the medicine today but only about 50 thousand people have access in the developing world. In India, officially there are 5 million people; In China, last year for the first time, said there are at least 850 thousand living with the virus; Thailand, Vietnam, Indonesia these are countries struggling with the virus and Singapore is right in the middle. Clearly, this is knocking at the gate."

The current W-H-O HIV/AIDS initiative is snazzily known as the 3-by-5 campaign

It aims to supply medication to three million HIV-AIDS sufferers by 2005.

Most HIV-AIDS campaigns have been restricted to public education and prevention, but Dr Lee says this has to change.

"This is the world's worst public health threat that the world had faced. I believe Black Death in the 15th, 16th century in Europe was probably less significant problem than HIV-AIDS today. We believe, in WHO, that we have to focus very strongly on prevention to deal with this problem. But now we have to also introduce treatment. 'Without health, there is no development'. "

HIV is a virus that mutates very quickly to defend against any medication, so effective medications are almost always new and experimental.

This creates the single largest obstacle to treating HIV/AIDS in the public health sector -- the problem of expensive drugs.

Here's a Newsradio 938 listener's contribution to the station's World Aids Day radio forum last year.

"Dennis Yim [DY]: Let's take a caller right now. Victor good morning to you. Victor: Er Morning. DY: Yes what would you like to tell us? Victor: Those who catch AIDS is in a terrible state. The cocktail is very expensive you see. If they can't afford it don't know how they continue their treatment."

So how achievable is the W-H-O's 3-By-5 campaign, given the sheer costs of treatment?

Dr Lee says there's been outside help for public health planners.

"Today it will be about ten thousand dollars to treat one person per year because R&D costs are in the price. Many activist groups fought for many years to lower this drug price. Now after 20 years, generic drugs are offering the same combination of drugs at 300 dollars per year."

Generic or cheaper versions of HIV/AIDS medications are governed by strict intellectual property agreement endorsed by the World Trade Organization.

However, Dr Lee says there are abuses to this system.

"The TRIPPS agreement at the DOHA declaration there was some intellectual property exemptions for those drugs used for public health purpose. This will only work if rules are observed by everybody. Some European countries provided drugs to certain countries in Africa and in no time these drugs re-cycled back to their own market in Netherlands. And if this happen, it will be a great dis-incentive for anybody to provide drugs at reduced price."

But there is a reason why such black markets exist.

The lower-income HIV/AIDS sufferers in the developed countries can't afford the 10,000-US-dollar-medicine bill.

Vice-President for Singapore's HIV/AIDS activist group, Action for AIDS Brenton Wong, highlights the plight of sufferers in Singapore.

"More than half our patients cannot afford the triple drug therapy in Singapore. That is why many are going to Thailand for treatment. The 3-in-1 drug costs about 60 to 70 a month and in Singapore pay almost 900 to a thousand dollars for that."

The poor and the rich in Thailand gets help because they have access to generic drugs.

Singapore is a different case, as Minister of State for Health Balaji Sadasivan explained at a Newsradio's radio forum last year.

"We have strict patent laws and as a result only patented medicine is sold. And the costs of patented medicine is determined by the company that makes the medication. Generic drugs available in Thailand are very cheap and Singaporeans do go to Thailand to buy generic drugs as a result. But that's not because there's a big subsidy but because of patent laws."

Dr Lee agrees that the discrepancies in the pricing of HIV/AIDS medications are hard to fathom.

"Drug prices are a big mystery. The more you know, the more you don't know. One example, the price of polio vaccine which is manufactured in France and purchased by UNICEF and used for us in the field, is 11 US cents. The same vaccine, you have to pay maybe twenty or thirty dollars in a more advanced market. Exactly the same vaccine!"

But if you don't give the giant pharmaceutical companies their profits, they won't do the research.

On the other hand, when these companies recover their research costs through the retail price of their products, you deny the latest drugs to a sizable group of patients in developed economies.

How's that for a Catch-22 situation?

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

OTGV #55 - New DownTown

2006-05-01T16:18:00.000+08:00

Broadcast Date: 03/05/04

The future may be more different than you think. First, there may no longer be something as clear-cut as a Central Business District or CBD anymore.

People will live and play near the very place where they work in the New Downtown.

But can you afford this luxury?

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

The government means business when it says it wants the Marina Bay to develop from nothingness to a district of an ilk that Singapore has never seen before.

National Development Minister Mah Bow Tan.

"The Downtown at Marina Bay is slated to become a unique business and financial hub, integrated with quality housing, recreational and leisure facilities, providing a total live-work-play environment. The development of the Downtown at Marina Bay will require the coordinated efforts of all agencies. The Government has tasked the URA to be the development agency to champion and focus efforts on the development."

He also revealed plans to pump some 300 million dollars through the building of infrastructures and facilities to kick start the new Downtown at Marina Bay project.

"The opening up of the bay through the proposed infrastructural and low-intensity uses will complement the development of the BFC. So that in around 10 to 15 years, besides prime office place, it will offer a variety of housing options in the heart of the city, with magnificent views out across the waterfront and parks and the city's attractions."

Mr Mah says the old CBD must also change or face a decline.

"Many buildings in the existing CBD actually have not realised their full development potential. Developers have always looked at commercial offices, not even retail for the CBD areas because of the relative pricing. But I think with the nature of the area changing, I expect some of them may be viable for conversion to residential. And as more people get used to the idea of inner city living, that may be one viable alternative."

This inner city is gradually being coaxed into transforming into a place of residence.

What impact will it have on the society?

First of all, land will be so expensive that only the very rich can afford making their homes at the new or old Downtown.

Managing Director of Colliers International Dennis Yeo expects to see a neighbourhood where there may be less Singaporeans than expatriates.

"Yes there will be a higher population coming from overseas. In fact it will be attractive to expatriates that is working in Singapore that might have might have a few years contract working in Singapore. It is quite possible that some of these foreign expatriates would purchase a property if they feel the location is right and if they feel that this is really an investment especially a downtown, Manhattan style of living."

One wonders if that the New Downtown if it arrives will become such an elitist neighbourhood where only the well-heeled can saunter.

Mr Mah hopes not.

"It is not a placed designed for well-heeled Singaporeans or visitors alone. I mean, everybody can come and enjoy themselves. In fact I would go further and say if it is just catering for the well-heeled alone, I don't think you are going to get a critical mass. So that place must be for everybody."

In a best case scenario, and the one most hoped for by the public planners, the New Downtown is for everyone, rich and poor.

For the heartlanders, or your average Singaporeans in the HDB suburbs , the new Downtown will still be a source of pride and a place where there are shops to browse, parks to relax in and bayside spots for their family to enjoy.

President of the Singapore Institute of Architects John Ting suggest a way to bring the posh city dwellers and the heartlanders together.

"One is to integrate the two slowly at the fringes where they interface. You can never merge the two into one. There will be a lot of them who will be uncomfortable if they are totally thrown into the deep end so to speak. To mix with the Cosmos. Now what you do is you develop certain interface areas where it is up tot he cosmos and the heartlanders to mix and then you allow that activities to eventually organically over time. You don't force them. The idea is to create a nexus for their activities to change and to happen rather than forcing one to become the other."

But will the private and public housing types in the HDB heartlands see a drastic drop in their values and their locales transformed into second-class neighbourhoods.

Mr Yeo doesn't think so and here's the reason why.

"When you look at the population that have a family of two, three children, in the middle income, they may not be able to afford the New Downtown. There may be some competition for 99 years in say the Orchard, District 9 and 15 areas. But suburban areas say in Woodlands or even Tiong Bahru, the prices will generally be quite well maintained because they do have their catchment buyer. People pick certain location because maybe they were brought up there, maybe their families is still there. In that sense, they still have their own attractions for the buyers. And in any case, suburban areas tend to be freehold whereas what you get in the New DownTown will all be 99 years."

But one things for sure, the majority of native born Singaporeans will be on the outside looking in at the marvels and convenience of inner city living.

What the social impact this will have will perhaps sustain many an interesting studies by sociologists and other social scientists.

This is Chong Ching Liang for Newsradio 938.

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Related Links:

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

Ministry of National Development
www.mnd.gov.sg

OTGV #54 - Heritage Tours

2006-04-02T15:34:00.000+08:00

Broadcast Date: 19/04/04

Uniquely Singapore, the new advertising sting adopted by the Singapore Tourism Board. But can Singapore live up to the title?

Chong Ching Liang ponders this question.

======================

STB's new brand campaign "Uniquely Singapore" is chosen as it's designed to highlight the country's blend of traditions, culture and modernity.

But some sardonic Singaporeans have questioned -- Just what is so Unique about Singapore?

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

Some tour agencies see the branding as a good start.

Journeys is a heritage tour agency and its founder, Jeyathurai gives his take on the re-branding of Singapore.

"Because they are trying to focus on what is unique about Singapore so it is important that the investments that goes in actually amplifies and enhances what is unique about Singapore so that it cannot be replicated somewhere else."

Others such as Ow Yong Kit Fun, of JTB tour agency feel it's about time that Singapore starts working at developing some kind of character.

"We often received feedback from our tour planners in Japan saying that Singapore has no identity of its own. Only Merlion is not a big impact for them. I hope there will be more and more aggressive promotions on Singapore in Japan targeting repeaters. You know they travel to Hong Kong many times, they travel to Bangkok many times but Singapore, only once is enough."

But a glitzy campaign won't help if there isn't any substance to what you are advertising.

One of Singapore's pioneer architects and now urban thinker and writer William Lim recalls an interview he had with me some four years ago.

"Years ago, last time we interviewed we say let's preserve Changi Prison. I say let's use it as prison hotel. A few of us also mention that in serious discussion, in interviews everywhere. Now we are perhaps in a process of tearing them down. Are they listening? I mean why are they not preserving Changi Prison?"

Back then, Mr Lim had said Changi Prison won't be a white elephant if it's converted into the world's most unique youth hostel.

Some analysts think it's a radical idea but it may well work with heritage and tourism going hand-in-hand in a brazen combination.

But we may never find out if it'll ever work as all that may be left of Changi Prison is just one segment of its outer walls.

The historic clock tower where Lord Mountbatten announced the Japanese surrender to the prisoners-of-war may be gone.

Old prisons have a certain character that help the Uniquely Singapore slogan says Mr Jeyathurai.

"Saving Changi Prison or other heritage sites can easily turn into tourists dollars and therefore has economic utility. You cannot even get a ticket into Alcatraz nowadays; it is so difficult and thinks of the thousand of people that visit it. The economic argument is an argument that cannot be used for saving Singaporean heritage because by creating an identity that is uniquely Singaporean everybody would come. If you are the same as every other place in the world, what is the point of coming to Singapore?"

Alcatraz has its Al Capones, Changi Prison -- its Adrian Lims and other notorious criminals that are the subjects of many a local drama serial.

But more importantly, it is the closest Singapore has to a truly international heritage site, explains Mr Jeyathurai.

"Changi Prison Singapore not only has the story of what prison life is about and to see what colonial prison were like, but it goes all the way back to the WWII, and it connects with so many other countries who is interested in the history of what their soldiers and civilians have gone through in Singapore."

The problem is STB doesn't own any of the land titles for these heritage sites.

The various stakeholders do.

So for Changi Prison, the Home Affairs Ministry must be consulted and overall, there's still the Urban Redevelopment Authority to convince.

The URA makes all the master plan to ensure Singapore's physical development is smooth, through what it thinks are timely buildings and demolishing.

Take for instance, the older one or two-room HDB flats in town, themselves an interesting social heritage sites, will be gone at some time.

Mr William Lim wonders why there isn't an alternative to "tear" and "rebuild".

"Why tear them down? They are right in the centre of the city. Why don't just let go and say, okay you guys, you can do whatever you like, you can have a boarding place there, you can have a shop there, artists can stay there, artist studios can operate there, it becomes an energy area. One of the biggest problems with Singapore is that we are too damn efficient. So these areas are immediately being "corrected" -- re-built, tear down for who-ever it is so that you don't have these rather run-down places."

Think that's upsetting for the heritage activist?

Just listen to what Mr Lim has to say about rumblings that the Newton Hawker Centre may soon make way for more condominiums.

"You find there's some vibrancy in certain areas which the combination is highly complex and location as well as circumstantial specific. If you find there is an exciting place, plan round it. Don't disturb it. Newton Hawker Centre is an example. Nobody understands why. The food is good but not that good, there is better food. It's terribly expensive, why everybody wants to go. It cannot be explained. And you say 'oh, the thing is old-fashioned and some of the pavement is breaking up' but nobody complains. Best thing for the planners, you see good things don't touch it!"

Newton used to be the congregation place for Singapore's musicians and artistes.

One expatriate travel writer even called it Singapore's Greenwich Village.

Changi Prison was the place British and Australian tourists would flock to relive how they or someone they knew, once suffered in the second great war of modern human history.

Strip away all these physical icons of national character and heritage away in the name of development -- what else is there to make Singapore truly unique?

This is Chong Ching Liang for Newsradio 938.

===============================

Related Links:

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

Singapore Tourism Board
app.stb.com.sg/asp/index.asp

Journeys Pte Ltd
www.journeys.com.sg

Changi Chapel and Museum
www.changimuseum.com

OTGV #53 - Green Cabs

2006-04-01T15:06:00.000+08:00

Broadcast Date : 22/03/04

How clean is the air we breathe?

You'll be surprised to find out that even on a clear day, there are contaminants infiltrating our bodies.

These contaminants are the latest target for eradication by the Environment Ministry.

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

The European Union has set limits for diesel engines' emissions through a series of directives known as Euro I to IV.

Diesel engines in Singapore now conforms to Euro II but will leap frogged to Euro 4 standards come October 2006, as announced by Environment Minister Lim Swee Say in Parliament.

Environment Ministry's top civil servant Tan Yong Soon explains Mr Lim's objectives.

"He mentioned that we will do two things. First we are giving this two and a half year lead time for the industry to plan to prepare itself for the new standard. And secondly, we will try and kick start the CNG, compressed natural gas vehicle so that by 2006 October, there is this viable option."

Head of Planning and Development at the National Environment Agency Joseph Hui on how to get people to switch to CNG and Euro-4 vehicles even before implementation date.

"In order to encourage them to bring it earlier you must provide the incentives to make it worth their while. From first of January 06 to 30th of September 06, they will continue to enjoy the 80% rebate of OMV. In the case of CNG and Euro IV buses and commercial vehicles, they will continue to be ARF exempt all the way up till 30-09-06."

Early adoption will be better for public health says Mr Hui as he explains the invisible threat of the older diesel engine emissions.

"This pollutant is matter that is less than 2.5 micron in size and this is what we called PM 2.5. And it is so small that one particle is less than one twentieth the diameter of a human hair. You can't see it with the naked eye. And because of its fineness, it is able to get into our lungs and reach places that bigger particles cannot reach. As a result, it has a more significant impact on health. It increases the risk of bronchitis; particularly those people who are asthmatic are more vulnerable."

This threat becomes even more significant when taking into account the Singapore Asthma Association's estimate that the illness hits one in five children and one in twenty adults here.

NEA's Director General, Loh Ah Tuan on the damage done by the current and older diesel engines.

"If we took a total amount of PM2.5 in Singapore, about 50% comes from diesel engines. So therefore we have to address this."

But the new Euro-4 engine that's required of all diesel vehicles after October 2006 isn't the cleanest option, CNG engines may be cleaner.

However, Mr Tan Yong Soon, says the government has no preference between the two.

"CNG hardly emit PM2.5 so in that aspect it is a better option but we are not prescribing an option. We are quite comfortable if a company want to adopt Euro-IV. What we particularly want now is to create CNG as a feasible option. Otherwise, if we don't introduce this policy, CNG is non-feasible. Over the last two years, there were hardly more than twenty thirty vehicles."

While the 2006 Euro-4 regulations target all diesel vehicles, Mr Hui explains why taxis are a natural target.

"Taxis are very heavily used, they are on the roads virtually 24 hours a day so in terms of emissions, it is significant compared to any other types of vehicles."

The environment stands to gain the most if all taxi cabs and buses adopt CNG vehicles.

But while CNG engines are much cheaper than the prohibitively expensive hydrogen fuel cells, they are still more expensive than diesel ones.

Comfort-Delgro that operates the two taxi giants Comfort and CityCabs told me that "even with the incentives, operating costs will be significantly higher than under current conditions".

In short, it doesn't think buying CNG taxis is a good business move.

This is in spite of CNG taxis being given more perks such as the waiving of the annual $5000 special tax and additional 20% rebate of the over the next 2 years.

But cost isn't the only issue.

Right now there's only one CNG refueling station and it’s in the middle of restricted access Jurong Island.

Comfort-Delgro's spokesperson Tammy Tan says refueling will be a great inconvenience because CNG tanks have smaller capacity and cabbies will have to top up twice daily.

A local CNG supplier, Gas Supply Private Limited is willing to open alternative refueling points but with a caveat.

It's spokesperson Leong Chee Wei.

"If we can get taxi companies to commit to a long-term ramp-up rate to convert their taxi fleet to CNG taxis, taking the total figures to say about 3 to 4 thousand taxis within the next two years, we are quite comfortable to kick start the CNG project."

A classic chicken and egg situation.

Shouldn't the government incentives the supply side further by providing incentives to gas companies as well?

Mr Tan Yong Soon

"What we are trying to incentivise here is to create the market, the demand the gas companies need not ask for any incentives. They will go and supply. That's why we have this package to induce the taxi companies to calculate and say 'yes, its worth bringing in CNG vehicles' over the next two years. When they make that decision, that is the best incentives the companies are looking for."

But will the market bite?

No public transport companies or fuel providers seem willing to think out of the cash box and see the wider picture of social responsibility.

It may well be when 2006 rolls around, Singapore still won't see any significant increases in CNG vehicles.

This is Chong Ching Liang for Newsradio 938.

===============================

Related Links:

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

Ministry of Environment and Water Resources

National Environment Agency
http://app.nea.gov.sg/

OTGV #52 - Eldercare 2

2006-03-28T12:23:00.000+08:00

Broadcast Date: 08/03/04

Care for aged relatives.

The state can only do so much.

What the state and society can offer only compliments what the family itself can provide.

Hi, welcome to On the Grapevine with me Chong Ching Liang as I take another look at the issues surrounding eldercare.

At a recent SingHealth-organised national health conference, Minister of State for Health Balaji Sadasivan highlighted the importance of proper disease management.

"The challenges we face are to better prevent chronic diseases, detect such diseases early, prevent complications arising from disease conditions and ensure that every Singaporean has the means to provide integrated, holistic and seamless care. While much of the components and tools are already in place in the clusters, much still remains to be done in terms of developing disease management as a cost-effective and efficient model of delivery of care for patients with multiple medical conditions."

And the elderly are most likely to be the ones with multiple medical conditions.

Yet some elderly Singaporeans are bed-ridden and their family members have given up on taking them to a doctor for proper disease management.

You can't blame the relatives because it's gotten too tough for them both financially and psychologically.

This isn't a problem yet but Singapore, in a decade or more, will see its population of elders double or even tripled.

Head of Geriatric Medicine at the Singapore General Hospital, Carol Goh is looking over her shoulder at the looming problems.

"And they are getting quite scary. We are facing a situation [where] we are not growing as fast as a population but the percentage of elderly is growing extremely fast. And that's the worrying thing because all these elderly will need someone to take care of them."

As the public healthcare system strives to catch up with the demographic curve, relatives must step up to help with the care of the elderly.

The first thing they must do is to get rid of certain myths such as the one that the hospital is the answer to all their prayers.

Head of SGH's orthopaedic surgery Tan Seang Beng.

"When a person comes to hospital, automatically the relatives assume everything will be taken care of because they are at the hospital. But they forget that while the hospitals have increased their advancement in delivery of healthcare but we have gone very much into specialisation. So you may go into oncology ward and so on. So you have very highly trained doctors, very highly trained nurses in that particular field of speciality. So when you say you bring your mother in and automatically all the needs will be taken care of, that may not actually be the case."

The family or the patient can help plug in the gaps in disease management.

Discharging from the hospital means the onus of managing a patient has been passed on to the step-down healthcare institutions, neighbourhood clinics or the family members.

SGH's Senior Consultant in orthopaedic surgery, Wong Meng Koon says the family must be the one in control of the information.

"Every patient that is discharged from the hospital has a discharge summary. There's pretty comprehensive information on investigations and the surgeries and findings. I think you really need to encourage the public how to take ownership of your own information. I don't think it applies to you and our generation but certainly when my grandma goes to see her doctor, she says 'yeah I have some sort of allergies' and she has no idea what that was. So take ownership of your own information."

Greater awareness of what's happening to their aged relatives will help families.

Family members can be the best assistants any doctors of elderly patients can have.

For example, they can observe the effects or side-effects of any medication and pass this information on to the doctors.

Also, don't rush to the hospital all the time as some of the chronic conditions don’t require specialists says Dr Tan Seang Beng.

"Many of these diabetes, high blood pressure, heart disease etc you don't really need to have super-specialists. So by centralising it and partnering with the geriatrician, be it training our doctors and nurses, the level of care and standards is now much better. You don't have to call a cardiologist every time the blood pressure goes up."

It is inconvenient for families to bring their aged relatives to hospitals for follow-ups and home-base care for elderly patients isn't yet available on a large scale in Singapore.

So the family members may have to turn to GPs at the neighbourhood clinics for help.

But Dr Wong points out a stumbling block to GP making house calls.

"But if you go into a very successful business, that guy may not even resuscitate a person that'd just had an accident outside. The fact is that he has other commitment to a whole group of people in his clinic. We really can't make the call whether he did the right or wrong thing. There will be GPs that are hungry for business and they just come down. And once you formed that relationship where you grow old together, he's not going to say no. "

Ultimately, while the families of elderly patients need to have some faith in the doctors, they shouldn't just take their words wholesale.

After all, the attending doctors or specialists observe their patients only in the little ten minute slots each visit.

They are dependent on their elderly patients' relatives for information.

Research, understand, observe and report.

You'll be surprise how much your little involvement can turn up.

This is Chong Ching Liang for Newsradio 938.

===============================

Related Links:

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

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

Tan Tock Seng Hospital
www.ttsh.com.sg

Singapore General Hospital
www.sgh.com.sg

OTGV #51 - Eldercare 1

2006-03-28T11:55:00.000+08:00

Broadcast Date: 01/03/04

The Singhealth group of healthcare institutions hopes to serve its aged patients better. Chong Ching Liang finds out why it is doing this now and what the changes involve.

========================

Everyone talks about Singapore becoming a graying society. Well, in less than thirty years' time, society may simply be white.

It is projected that two out of five Singaporeans will be over 65 years of age.

Hi Welcome to On the Grapevine with me Chong Ching Liang as I take a look at care for the elderly.

Singapore has one of the lowest fertility rates in the world, with a figure of just 1.37 live births per couple. The population isn't producing enough to replace itself.

Coupled with the aging statistics, it is a ticking time bomb.

Dr Carol Goh, Head of Geriatric Medicine at the Singapore General Hospital.

"The diseases that our population is facing are chronic diseases. We have a high incident of strokes and we all lead fairly sedentary lives. So we're all going to be facing a population that is going to have a lot of issues with regards to functional care. So we will have elderly who may be wheel chair bound or at least need help getting around. We are hoping that despite this, we are going to have a society where we support our elderly and promote their care and not have an elderly person left alone with no one to take care of him and no good quality of life."

Many of us already have or will have aged relatives. For superstition's sake or mere complacency, we often try not to think of bad things happening to our loved ones. So we never plan for what'll happen if our aged relatives have a nasty fall or illness that leaves them wheelchair bound.

When this happens, we panic.

There are stories of Singaporeans trying to "dump" their aged relatives onto the hospital system, or nursing homes. S-G-H's Orthopaedic Head, Tan Seang Beng describes an all too common scenario.

"All the things that we take for granted: Go to work and leave the old fogies managing by themselves. But when we have an injury suddenly is now magnified. You want to bring them home but when you find that when you physically have to do it, it is very difficult. So what do they do? They tell me, 'well, we still bring them home' and they manage the best that they can. But honestly, many of the times, most are not well managed. Because if your mother now is unable to walk well and the children or the family may be working, who's going to bring the mother to hospital?"

According to SingHealth statistics, one in three patients seeking orthopaedic treatment such as those for fractures and bone injuries are elderly.

For internal or respiratory medicines, the figure rises to nearly one in two.

And geriatric medicine, the branch of medicine looking after the ailments of the aged is terribly short-handed.

So Dr Carol Goh says it must innovate.

"For geriatrics for example, there are all of thirty in Singapore. And the number of geriatric trained nurses is very few. So if have a system that is dependent on any one specialty doing it all, then it is going to be very difficult. And that is where my orthopaedic surgeons have been most supportive. In the end this is part of what we called geriatrisation of services. You don't have to be only the geriatric trained or specialty services that manage the elderly. We are raising the awareness of the elderly in all specialities."

Singhealth plans to "geriatise" to all its institutions in two years time that is getting them to cater to the elderly. Part of this exercise is a discharge planning programme where aged patients are referred out to a community hospital for convalescence.

Taking them out of the acute-care hospitals like S-G-H, Alexandra or Tan Tock Seng hospitals will reduce their chance of catching nasty infections like pneumonia.

But there's also a social purpose explains Dr Goh.

"A lot of them are the referrals that we have diverted from nursing; this is not to say that a nursing home stay is wrong, but a lot of patients we want to give a chance when they were borderline cases. You know, the families were saying 'I am in a state of shock, my grandma fell down', 'she fractured her hip', 'I can't take care of her' and 'I don't have enough time' then the family will come to us and say, 'well, we want to put her in a nursing home.' And grandma may not want to go to a nursing home. She want to be given a chance to go back home. So they needed time. So for the grey cases especially, for those whose families were wavering, we wanted to send them to a place where they have more time, and more rehabilitation, and give her the chance."

But some of the elderly patients won't recover despite a lengthy stay. So inevitably, they will be discharged home from the community hospital. Ideally the next layer of care would be the neighbourhood doctors or GPs.

They help relatives manage their elderly relatives' chronic illnesses like diabetes or high blood pressure. But Dr Goh highlights some obstacles.

"We face two issues. Number one our GP simply don't have the time to go to patients' house because it takes a lot. But again we hope to expand and working with partners both for SGH patients as well as Ang Mo Kio as a continuum that have access to home medical. Home based service is really important. And working in partnership with Ang Mo Kio because they also have a home medical programme where they actually use a GP."

The day isn't here yet when GPs are willing to step up to this role where they take part in providing home care for the elderly.

Until that day, the public healthcare system has to pick up the slack.

One thing is for sure, if the family of aged patients feel they aren't supported enough to keep their parents home, they won't. And the ones who lose out the most will be the elders.

So this latest initiative by the Singhealth group and the Health Ministry is a breath of spring breeze for those heading into their autumn years.

This is Chong Ching Liang for Newsradio 938.

===============================

Related Links:

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

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

Tan Tock Seng Hospital
www.ttsh.com.sg

Singapore General Hospital
www.sgh.com.sg

Alexandra Hospital
www.alexhosp.com.sg

OTGV #50 - Biodiversity& Zoo -2

2006-02-15T18:19:00.000+08:00

Broadcast Date: 01/03/04

Each year the living things that share our planet get lesser and lesser.

The way of the dodo is the path most travelled for those organism that aren't human.

Will the zoological gardens and marine parks of the world be the eventual resting place of some species?

Join me Chong Ching Liang as I examine the debate of zoos and aquariums as conservation agencies.

"We again, call for the Underwater World to release 4 dolphins back to Thailand where they can be rehabilitated and released back into the wild. They took 4 dolphins, its time to release the four back into the wild. We stress again the same message that we have been repeating since Sept. Don't turn magnificent sea creatures into circus clowns. Stop the cruel shows, free the suffering dolphins."

That's Louis Ng, the president of Acres, a local Animal Rights group.

Underwater World says it seeks to help prevent the extinction of the highly endangered Indo-pacific humpback or pink dolphins.

Mr Peter Dollinger, the Director of the Geneva-based World Association of Zoos and Aquariums thinks his members have a role to play.

"Today almost every species can be successfully kept and under conditions where they are not damage. And it is always been claimed by animal rights people that these species would not be suitable for re-introduction. But obviously this is not true because we have about 200 programmes for 200 species that are re-introduced and these are ex-situ bred animals. So apart from big whales where it is technically not possible or some other marine life , deep sea fishes, almost all species can be kept."

Ex-situ as opposed to in-situ conservation refers to conservation away from the original environment.

But ex-situ conservation has its detractors.

Mr Louis Lim explains why he is against Underwater World keeping their pink dolphins that had been caught from the wild.

"If you look at the dolphins themselves, anatomically and anamorphically, they are all built for swimming at fast speed. So they're all built for large home ranges -- 30 to 400 square kilometres in the wild. When you take such animals with such large home ranges and confine them in captivity in 0.0003 percent of what they are used to in the last 15 years, it is strictly detrimental to their welfare."

Louis Ng and his team say they won't have a problem if Underwater World or institutions such as them bought animals that had been bred in captivity.

His explains this opposition.

"If you say now that there is too few left in the wild and if you take from the wild, you are putting it in a higher risk of attention. One dolphin has already died here, Underwater World spend 3 million dollars to build this dolphin lagoon. If you put the 3 million into in-situ conservation, I think there will be more success. If dolphinarium, if they take captive bred dolphins, they made a lot of money, they put the money back into research, they put the money back into in-situ conservation, they release some of the animals which other zoos have done, then perhaps that is a compromise."

But if the natural habitats of endangered species are disappearing fast with no real conservation efforts to prevent this, these animals will disappear without the intervention.

Dr Shawn Lum, Vice President of the Nature Society and a trainer of biologist teachers, muses on this problem.

"It’s a dilemma that people face. Hopefully the zoos do the research to learn how these animals can do well in captivity, to understand their physiology so that we can have a successful breeding programme and then integrate it with a programme for eventual re-introduction to the wild. Otherwise if you just keep zoo population going, then they just in a way become just like museum pieces if you just let them disappear in the wild."

Mr Dollinger says that zoos and aquariums have slowly picked up the role of repopulating the wild.

He explains.

"There could be project that are going on in an existing reserve, or there are also cases where they have purchase lands whether in their own country or in there country or run a consortium with the nature conservation authority of the country concerned to jointly manage the reserve. Ten years ago they may just provide just money for some conservation organisation and then they lost control of what was going on but now the trend is very clearly that we try to get permanently or long term involved."

Animal lover will tell you that an animal in the zoos or aquariums isn't worth anything unless efforts are made to preserve the wild populations.

Dr Shawn Lum says these institutions must educate the public so that collectively they can exert their political will to change the world.

"When I was a kid, I grew up in Honolulu and I used to take me to that zoo a lot, because I just love the animals. Now I look back, and my goodness, those animals are sometimes kept in really appalling conditions. It's not sufficient to just keep animals in zoos. The zoo-going public deserves something a lot better learning about the plight the animals in their natural habitat."

It's not impossible.

Companies have been forced to implement dolphin safe fishing methods so that consumers will buy their tinned fish again.

And, the meek may yet inherit the Earth.

This is Chong Ching Liang for Newsradio 938.

===============================================

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

World Association of Zoos and Aquariums
http://www.waza.org

Nature Society Singapore
http://www.nss.org.sg/

Animal Concerns, Research & Educations Society
http://www.acres.org.sg/

Underwater World, Singapore
http://www.underwaterworld.com.sg/

OTGV #49 - Biodiversity Zoo -1

2006-02-15T17:58:00.000+08:00

Broadcast Date: 23/02/04

The world is getting smaller.

No, no .. Not the physical size of the Earth,

It’s the living space for the non-human species that's shrinking.

Hi Welcome to On the Grapevine with me Chong Ching Liang as I look at the ever narrowing biodiversity of our world.

The United Nation Environment Programme or UNEP estimates that some 60 thousand species are disappearing off the face of the Earth each year.

Dr Shawn Lum, Vice President of the Nature Society and a trainer of biologist teachers explains what this figure means.

"This 60 thousand figure is based on an estimate. If you assume there's 'X' number of species over a given area that are found no where else, then with this rate of destruction then this is the magic number, 60 thousand. So I don't think there are 60 thousand documented species which is not say there aren't 60 thousand species disappearing."

Director of Geneva-based World Association of Zoos and Aquariums Peter Dollinger says it is the smaller organisms and plants that constitute the number, not the larger animals.

"It’s a natural fact that we have a huge loss of biodiversity. However, the majority of the species UNEP referred to are invertebrate species or plant species. The number of vertebrate species such as mammals, birds, reptile that are disappearing is of course much, much smaller."

Is over ten years since the first Earth Summit in Rio de Janeiro, Brazil to take stock of the world's shrinking biodiversity and environmental degradation.

Yet, each year that passed saw more environmental destruction, greater global warming and loss of species.

Some people say throughout history species come and go and extinction is a natural order of things.

Dr Lum disagrees.

"Even after humans are long gone and there's some sort of animals left then they might re-evolved into a whole array of diversity again but you know this is a cop out because this potential mass extinction is caused basically by human activity and large scale habitat destruction which we could possibly could avoid if we put our minds to doing it and we can do something about this. Do we have the will to this? Are we going to make this a priority and tackle that as the global crisis that it is? If not are we just going to quietly watch these things going away before we even know sometimes what it is that were lost. To just say well extinction has happened in the past. Frankly that's a pretty weak excuse."

Dr Lum lists the reasons why we, the humans are the cause for the current mass extinctions.

"One is the continued growth in human population. Industrial revolution which allowed us to manufactured things at a large scale but also we use resources at a high and sometimes unsustainable rate. All those factors put together with the last thing which I think is extremely, well if you want to call it, greedy sort of lifestyle that just consumes and consumes resources and take away natural habitat. So essentially that's bad news for all the other living things that share the planet with us."

Those running botanic and zoological gardens, aquariums or marine parks see they have a role to play in providing some reservoir of biodiversity however small.

Mr Dolliner again.

"Already in the 1940s, the role of zoos was defined by a Swiss scientist as serving Recreation, Education, Research and Conservation. Then in 1993, the zoos issued the first World Zoo Conservation Strategy, they stipulate that the roles of recreation, education and research must also serve conservation. So conservation has the priority."

But some nature lovers feel that such institutions must do more than in the education component.

Dr Shawn Lum on how zoos can help modify their visitors’ behaviour by getting them to ask certain questions such as this.

"What can I do to help save that particular habitat? Either through my behaviour as a consumer, you know buying certain kinds of environmentally-friendly, dolphin-friendly kind of things, or don't invest in corporation that are involved in destruction of natural habitat and so on. But I think that information needs be made available to a zoo-going public. You have to bring up that level of public knowledge so that individuals can say this is what I need to do and can do as an individual. As oppose to saying well, that’s a problem far away, I know nothing about it, I am helpless you know."

But other animal lovers see the zoos and aquariums more for their shortcomings.

Some animals such as polar bears exhibit certain obsessive-compulsive traits in an enclosed environment.

President of local Animal Rights group, Acres Louis Ng

"If you based a study by Oxford University, the larger the home range in the wild, the more stress an animal would be in captivity. So for example for tigers, for cheetahs, which everyday, they are territorial, they walk around, they scent mark their areas. If you keep them in captivity, it drives them insane. They miss the varied environment in the wild. So they start pacing as a means to cope with captivity."

Will institutions such as zoos and marine parks be good agents for saving some fast disappearing species of animals?

Should they do more besides being just being a place where animals are kept for the viewing pleasure of humans?

Tune in to next week's On The Grapevine as I look at the debate on the role of zoos and aquariums in the fight to preserve the biodiversity left in this world.

This is Chong Ching Liang for Newsradio 938.

OTGV #48 - Elder Abuse

2006-01-03T12:09:00.000+08:00

Date of Broadcast: 16/02/04

Family violence.

Most of the times, the victims don't have a voice.

If they do, they don't to use it because they don't wish to see bad things happening to their loved ones.

So the suffering goes on in silence.

Hi Welcome to On the Grapevine with me Chong Ching Liang as I explore the dark social realm of elder abuse.

Most abused elderly Singaporeans are over eighty years of age.

Eight out of ten cases involved an abuser who's related to the victim.

And the average annual count is a hundred cases.

Will the statistics get worse for a graying Singapore?

Community Development and Sports Ministry, Director of Elderly Development, Tong Min Way muses the answer.

"There's probably a lot more out there in the community that we don't know about. Or, people don't want to report it. It's very difficult to say right now whether it's going to increase or decrease. But if you do an international survey, I suppose that as the number of elderly does grow, care-giving needs are going to increase as well. As you know families are getting smaller in Singapore, you have children looking after your elderly parents. You might get a tendency for more families to be at risk."

Minister of State for MCDS, Chan Soo Sen suspects the current annual average figures mask a bigger problem.

But this under-reporting of cases of elder abuse isn't unique to Singapore.

Keynote Speaker to the national conference on family violence, Paula Mixson says even in the US, the actual number of abuse cases is hard to collate.

"There was a study a few years ago, it was 1998 I think, and it estimates that five times more what is out there than what is known. And that may be an under-estimate."

Elders want to keep their family's dirty linen from fluttering in public.

Neighbours and witnesses also tend look the other way, thinking it’s not their right to interfere.

This is something that MCDS' Director of Social Welfare Ang Bee Lian wants to change.

"We want the service providers who are in touch with the ground to also spread the message to alert people to refer. We like to believe that people don't refer because they don't know who to refer to, where to refer to. So we have to educate people, give them the benefit of doubt that they want to do something. It's not so much that people willfully want to turn a deaf ear on these things."

Is it possible to enact a law to penalise bystanders for non-action when they see an elderly person being abuse and say nothing?

Geriatric Consulting and training expert Paula Mixson says it won't work.

"In Texas, we have a law that can prosecute someone for failure to report. But to my knowledge, no one has ever been prosecuted. Just having a law in the book doesn't mean you can help them. I think it is more important that people realised the elder protection team is there to help, not to label someone as an abuser. It's very important how people see you because we don't get anywhere by blaming. When things are bad enough to be prosecuted, they will be prosecuted."

But Ms Ang cautions that a hard-nose approach won't be successful.

"When you approach an elderly person to say 'I help you report', you can know the answer. Right?, I don't have to tell you. You will know what the answer is: 'Nothing is wrong, don't da da da...'. Enter gently, engage the elderly person, you will get the information to help the older person to accept help. And I think that's some of the soft skills that people need at the ground. Very often we like to do the harsh approach. Report! Report! And the poor person is so scared, you know?"

Ms Yee-Chow Choy Yin is the Director of TRANS Centre, an inter-disciplinary outfit set up to deal with issues of familial violence.

She says the family must not be excluded if a sustainable solution is to be reached.

"What we found helpful was not to just label the family. And we need to look more holistically into what is happening in these families. What are the concerns? Concerns about elderly not being fed, are there concerns of financial constraints? Our work is very much to work with the family as a whole to improve things, to improve relationships unless it is really life-and death [situation]. In our Singapore culture, most elderly still want to live with their children. Empowering the family in the care of the elderly, coming in with the appropriate community resources, will actually help to alleviate some of these stress, make care-giving a little bit easier."

Care giving.

It isn't easy in a country where different branches of geriatric or eldercare services for those who don't qualify for welfare has yet to catch up with the demographic curve.

In most major public hospitals, geriatric care or medicine for the elderly are either fledgling or inadequately staffed.

Information on home care assistance programme to help family members care for their sick elderly at home is available in the MCDS website.

But those who aren't internet savvy may not know how to get the information.

However, this lack of help should not translate to frustration leading to the abuse of an elderly.

MCDS hopes that Singaporeans will, when they think their back is to the wall in handling their elderly loved ones, turn to them or affiliated organisations such as TRANS centre for help.

This is Chong Ching Liang for Newsradio 938.

===============================================

Newsradio 938 (now 938Live)
http://www.938live.sg/
Ministry of Community Development, Youth and Sports
www.mcys.gov.sg

Trans Centre
www.transcentre.org.sg

OTGV #47 - Happy Workers?

2006-01-03T11:59:00.000+08:00

Date of Broadcast: 02/02/04

Are we a nation of happy workers?

Or, are we a nation of workers clinging on to jobs simply because we are too afraid to lose employment?

Two surveys, six months apart, seemingly different findings, yet strangely congruent.

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

The Sunday Times survey two weeks ago provocatively asked if we are a nation of happy workers.

Regional Practice Leader of the Gallup Organisation Ashok Gopal says such broad strokes hide the underlying details.

"The proportion of people who loved their job is only 59%. I mean that is little more than one in every two people. Now, can you look at every one in two people getting happy and say that this is a nation of happy people? I really hesitate to use that particular term."

Mr Gopal's own organisation had conducted a survey to examine the health of the Singapore workforce sometime back.

"The focus of our survey was really unearthing a set of issues that relate to how engaged employees are which is a predictor of how productive and non-productive they are going to be. I continue to believe there are issues within Singapore that are issues of concerns."

Workers being happy won't reveal how productive they actually are, and that's why the Gallup polls stayed away from questions on worker happiness, says Mr Gopal.

"The Gallup Survey was not to measure are people happy or not. Happiness can often be a bit of a negative. People say they are happy because they have a job and two because they have no accountability what-so-ever. So they can have a great time for their job and continue to get a salary for it. So happiness by itself doesn't count for too much as far as productivity is concerned."

Of course, workers are more likely to leave if they are unhappy, and more so if they felt their managers haven't being entirely on the square with them.

George has been with his private sector company for over 5 years.

He is contemplating moving on as he felt the management hasn't been holding up its end of the bargain when it comes to promises made.

"The management themselves did not give satisfactory sort of answers in a way and also due to the fact of work satisfaction."

Managers are the cogs between layers of a company.

Good ones will result in productive workers with a more smoothly functioning company and bad ones will result in workers who are detached from what they are doing.

Mr Ashok Gopal with a statement he claims Gallup Polls pioneered.

"People join companies and leave managers. The focus of our survey and that's about 6 months old now was to look at issues that managers can influence as far as manager performance in Singapore were concerned. Managers did not seem to do a good job when it comes to setting expectations, when it came to giving feedback, when it came to making people feel cared for. I think Singapore as a nation, the World, has a long long way to go when it comes to making people better managers."

The Gallup polls painted a darker, gloomier picture of employee-manager relations, while the Sunday Time survey seems more a ray of sunshine.

However, despite the seeming difference in polarity, Mr Gopal says there is some similarity.

"When I read some of the sub-pieces within the article, some of those things tie up exactly with the things that we find. It speaks about some people hating what they do but still actually showing up for work. Now that is a dangerous situation because they spending most of their time trying to undo what others are doing well. And obviously what you want to do is to reduce the proportion of such dis-engaged employees in the work place."

But it isn't always easy to get rid of dis-engaged workers.

Sometimes, the workers who leave the organisation aren't always the ones who have become disengaged.

Karen used to work for a statutory board.

She tells us why she left a seemingly secure job to re-enter the job market in such tough times.

"Well I left the job for the simple reasons that I found that I wasn't happy not just with the hours but with, I guess, management. And it wasn't due to the work environment so to speak, as in like with the colleagues because they are a great bunch of people. It's just that I decided that in terms of the management style and the kind of work they were giving out to us. I felt that I wouldn't be able to enjoy it and wouldn't be able to work on a long term kind of basis."

In private or public sectors, a significant portion of workers leave their work because they are frustrated they aren't allowed to carry on with their work.

This group of workers probably has quite a number of contributions left to make when they leave the company.

Loud vocal professing of loyalty by those who remain may not help employers identify who will be of the most ultimate value to the companies as well.

Mr Gopal explains.

"A statement of loyalty is not necessary a positive statement. It reflect, number one, a poor market environment for jobs. It could reflect some kind of handcuffs. We did a survey with a group of IT companies a few years ago and they told us something very fascinating. A group of people said, 'we hate what we are doing' but 90% of them say they see themselves continuing with the company 2 years from now. Now that sounds like an absolute paradox. But when you go into it further, they say that is because 'we have our stock options tied in and we will be leaving behind literally millions of dollars."

It really doesn't matter if the Sunday Times survey or the Gallup polls are right or wrong.

The important thing is that these polls are the proverbial mirrors, held up for us, useful only if we use it to correct our imperfections,

rather than for us to appraise our own beauty.

This is Chong Ching Liang for Newsradio 938.

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

Gallup Organisation
www.gallup.com

OTGV #46 - Birdlife Singapore

2006-01-03T10:42:00.000+08:00

Date of Broadcast: 05/01/04

Can you imagine any place where birds no longer sing?

Can't can you?

But reality is fast catching up with that somewhat dis-quieting scenario.

Hi welcome to On the Grapevine with me Chong Ching Liang as I take a look at the issues behind the vanishing birds of Asia.

The Executive Officer of the Nature Society of Singapore Lim Kim Seng is part of a wholly remarkable book, Saving Asia's Threatened Birds.

Kim Seng on the book's objective.

"This book identifies the birds which are becoming extinct as well as the ecological regions which are important for the conservation of these birds. It also identifies every country in Asia as well as the species of threatened birds which occur therein. This book identifies what government and civil society need to do to prevent birds from going extinct. Already we have some 12 percent of Asia's birds at risk of extinction. There is another 300 plus species, in total about 30 percent of Asia's birds which will become threatened with extinction if we don't do anything."

The book is published by a multinational NGO, Birdlife International, with inputs from over 160 national data compilers and over a thousand volunteers.

Kim Seng gives a situation report here.

"Singapore has eight internationally threatened species. One of which is resident, the Straw-headed Bulbul. In conserving the Straw-headed Bulbul, Singapore will be making an effort at global conservation of birds."

Fellow bird-lover and avid bird-watcher Alfred Chia supports this observation.

"If you are taking the local context for a start, the local habitat and the places to bird-watch are dwindling by the day. We know that because we have been bird-watching for a while and I co-incidentally have been planning trips for the Nature Society. Year-over-year, I find more difficult to plan trips. Many years back we are able to see them in quite a many places. Nowadays maybe you just get to see them in one or two localised areas."

The one or two localised areas are probably the protected areas and Singapore doesn't have a lot of nature reserves gazetted says Kim Seng.

"We have lost in the last 10 years, places like Senoko, Serangoon and Punggol. These were actually very key sites for the migratory birds. Over the last ten years, we have noticed there has been an overall decline of about 40% in terms of overall number of birds in Singapore."

Have the local birds decide to upgrade their tiny little habitat to bigger rainforests in say Malaysia or Indonesia?

The sad truth is that we're not looking at some avian brain-drain but that those missing are now probably dead and gone forever.

The main culprits are poaching and loss of habitat says Birdlife International.

Kim Seng on a specific example, the Straw-Headed Bulbul of Singapore.

"We don't think poaching is the main threat. Habitat lost is a more serious threat to this bird. If you look at the straw-headed bulbul in Singapore. 50% are in the island of Pulau Ubin. The rest are scattered through out the main island. But if you look at the protected area system in Singapore, Pulau Ubin is actually just a nature area in Singapore. It is not a nature reserve. So if we can Pulau Ubin a nature reserve, that will help protect the straw-headed bulbul in the long term so that it will be able to persist in the sustainable future."

For migratory birds, Singapore is the last feeding ground before the big flight to Australia.

Kim Seng explains the significance of Singapore that few outside of the Nature Society know.

"For migratory birds, they have specific points where they breed and spend the winter. But in between they need places to stop, to rest, as well as to re-fuel. So if those places disappear and there is a long distance between the stopovers. Chances are a lot of birds will die because they don't have the energy to reach the next breeding stop. Singapore is important because based on our surveys, most of the migratory birds spend some time with us before they fly on. So if these sites are destroyed, they will not find an alternative site to re-fuel. And a lot will die. One of the reasons is that these birds stop-over based on instinct, based on a map in the mind. So even if there are alternative sites where they could feed, they may not fly there because they are pre-programmed."

And a lot of birds will die.

Kim Seng says some 3 to 5 million birds fly from Siberia to Australia through Asia.

Some wise sage once said, it's only the things that are gone that one cherished.

Don't wait till the birds stop singing before stronger actions are taken says Kim Seng and his like-minded ilk.

Birds are tied to us in more ways than simply just the environment.

"Birds are part and parcel of our culture whether it is Japanese or African or Southeast Asian. It's always been part of our culture. To lose the birds would be akin to losing part of our cultural heritage. Another is that birds are excellent indicators of our natural environment. If we don't see or hear the birds in our neighbourhood, then something must be seriously wrong. This was actually the case in the 1960s. The discovery was made by the famous environmentalist, Rachel Carson, and her excellent book, Silent Space."

The book is an act of love.

It hopes to convince you, the average Joe, and more importantly, the policy makers who can take the necessary actions.

If you want to find out about the dire straits of our avian buddies, buy the book.

You can get more information by calling Nature Society at 6741-2036.

This is Chong Ching Liang for Newsradio 938.

=====================================

Related Links:

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

Nature Society of Singapore
http://nss.org.sg/
Birdlife International
http://www.birdlife.org/

OTGV #45 - Disability Sports

2005-12-19T17:52:00.000+08:00

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.

=====================================

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

2005-12-19T17:29:00.000+08:00

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.

==================

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.

=====================================

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

2005-12-19T16:57:00.000+08:00

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.

=============================

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.

===============================

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

OTGV #42 - Diabetes

2005-10-31T15:51:00.000+08:00

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.

========================

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.

===============================

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

2005-10-31T15:23:00.000+08:00

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.

==============================

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.

===============================

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

2005-10-27T17:44:00.000+08:00

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.

===============================

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/

OTGV #39 - Work Health

2005-09-26T16:15:00.000+08:00

Broadcast Date: 13/10/03

Is the slightest increase of body warmth a raging fever in the morning of a workday?

Is going to work each day feeling like going back to school after a long holiday?

And after work, do you come home grouchy and fight with your family?

A yes answer to any of these questions and you may be suffering from job-related stress.

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

Last week the Health Promotion Board handed out its kudos to employers who actively work to encourage their employees to adopt healthy lifestyles.

However, as the cliché goes, it is a changed world.

There's no longer lifetime employment, in fact retrenchments always seem to hover round the corner, and workers can't even expect annual wage increments anymore.

This seems like a New Economy concoction that's guaranteed to affect workers' emotional and psychological well being.

Yet this issue is not entirely looked into.

The Health Promotion Board has a whole department dedicated to Work Health Promotion or W-H-P.

It has done sterling work in getting private and public sector companies to start health promotion activities at the work place.

However, W-H-P still hasn't moved into the area of looking into promoting better psychological health for workers.

And it is something that will need time to develop says W-H-P's manager, Mabel Chia-Yarrall.

"I think that will be evolving because as with Work Place Health, it started way back in the late 80s, so it is now in the 2000, it’s evolved and it has come a long way."

In Singapore, sometimes there's an assumption that a physically healthy person is BEST able to deal with stress.

Is this true though?

U-S's National Institute for Occupational Safety and Health or NIOSH tries to explain how stress can have a direct link to physical illness in its web-site.

NIOSH explains that stress creates something called the fight-or-flight syndrome in us.

This means an alarm is set off in the brain, which then responds by releasing various hormones preparing the body for defensive action.

Prolonged stress means that the body is placed constantly on the edge resulting in symptoms such as clenched teeth, an accelerated heart rate or blood pressure.

This may ultimately result in more wear-and-tear leading to chronic illnesses and lower resistance against infections.

The Journal of Occupational and Environmental Medicine reported that health care expenditures are nearly 50% greater for workers who report high levels of stress.

Mabel Chia-Yarrall says a recent international study suggests this may be true.

"Over 40 percent of workers feel they can't cope at their work. The ones who have no control at their work. They are more likely to have heart disease. It's not a cause-and-effect kind of thing but it contributes to the likelihood of having heart disease."

Singapore employers lag far behind their European or North American counterparts in looking after their employees' psychological health.

President of Motorola Singapore, Jeffrey Tan, suggests maybe the Asian culture is to be blamed.
"Within an Asian culture sometimes Asians tends to be a little more reticent and unwilling to speak up. But I think as a corporation we have been very successful in that regard; in terms of getting people to come out and say well, there really is no repercussion in this. We just want to be able to understand what are the challenges you face and to collectively work together in that regard."

Motorola like many of the western multi-national companies, have set in place an Employee Assistance Programme, or E-A-P.

An E-A-P uses a psychologist outside the company hierarchy who'll hear out an employee's personal or work-related problem.

The beauty of this process is it's conducted under strict confidentiality so there's no fear of repercussion when a worker seeks help.

This additional "listening ear" is sometimes an unavoidable alternative says Jeffrey Tan.

"Sometimes there are issues that will require a professional counsellor and we do have an Employee Assistance Programme which is part and parcel of the overall human resource support. And when necessary, we will get people to come in to help."

HPB's Mabel Chia Yarrall on the need to provide such a service.

"It's an important area to address and the EAP is an excellent programme to look at that because staff can go and confide to other people. But if you don't have a formal programme you could also identify some mentors. Not necessary their supervisors. It could be the canteen lady, it could be someone, you know who is not holding an official status. And someone whom staffs feel they can go to talk about family, their health or their workplace."

NISOH says a recent survey found that 77% of employers using EAPs experienced improved work productivity and reduced MCs by between 25% and 50%.

The local companies do try.

Changi General Hospital has an internal helpline though it doesn't have external counselors to ensure confidentiality says C-E-O T. K. Udairam.

"We have stress management programme ran by our psychologists and therapists. We have also got another programme for managing stressful situations that they have. So we have a whole group of 60-70 in the hospital, we have trained them and they basically have become buddies to people who are under stress."

Any move to enhance workers health must take a holistic approach.

Singaporean employers have done very well in the promotion of physical health.

But in this age of retrenchment paranoia and pay reduction frustration,

should more be done?

This is Chong Ching Liang for Newsradio 938.

===================================

Related Links:

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

Health Promotion Board
http://www.hpb.gov.sg/

National Institute for Occupational Safety and Health
http://www.cdc.gov/niosh/homepage.html

Journal of Occupational and Environmental Medicine
http://www.joem.org/

OTGV #38 - EHI-SARS

2005-09-26T15:47:00.000+08:00

Broadcast Date: 29/09/03

Singapore was rocked by a SARS scare this month as a researcher was found to have the SARS coronavirus in his body.

The researcher is a post-doctoral student who worked at both the National University of Singapore and the Environment Health Institute laboratories.

The Health Ministry convened a review panel of overseas and local expert to audit the bio-safety practices of the labs working with the SARS virus.

Chong Ching Liang looks at what was uncovered in this week's On The Grapevine.

========================

The Environment Health Institute or EHI laboratories are rated at bio-safety level 3 or BSL-3.

This means that it can handle highly infectious diseases.

Yet a visiting researcher from the NUS caught something there and ended being the latest addition to Singapore's health statistics.

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

It is a huge bullet dodged.

Singapore could have the misfortune of accidentally starting another SARS outbreak through EHI's contaminated virus samples.

Acting Health Minister Khaw Boon Wan considers Singapore lucky that only one person is infected and that he didn't infect anyone else.

"And in this instance, I think luckily it is a minor trip. It is like a small earthquake. Richter scale 2.0. It alerts us to the possible fault lines. Important thing is to learn from this and tighten up procedures so that in future we can one prevent possibility of a real serious earthquake of Richter scale 7.1 or if bad luck something happen, we know how to respond to that. On hindsight looking at this development of the incident I would consider ourselves lucky."

And the incident revealed the fault-lines well.

The first fault lay with the researcher and his supervisor says the Head of the review panel, Dr Antony Della Porta of the World Health Organisation.

"He was working with someone who supervised him and I think the situation was that they rushed and they didn't put the appropriate protective equipment on."

But it extends further.

When the SARS outbreak happened, the EHI was recruited to join in the fight against SARS.

This generated certain complications says the Institute's head, Dr Ooi Eng Eong.

"On hindsight of course we could have put in better system in place. We anticipated the volume of the work would be low and the bulk of the work will be on dengue. We never anticipated to have to deal with SARS. And so on hindsight, yeah we could have done certain things better. And so we are going to take the opportunity and from here on to take stock of our situation, review our procedures, do our protocols, put in system in place and prevent this from ever happening again."

Dr Della Porta says Singapore and its public sector labs have varying standards making safety practices confusing to visiting researchers.

He says the fault-line extends from the individual to the laboratory, and to the lack of appropriate governing public policies on bio-safety.

"It's obvious that the lab put in enormous efforts and put in fantastic efforts during the SARS outbreak but it led to some inconsistencies where the lab was not really prepared to handle organisms at that level. And so to some extent, this incident occurred because of that. But it also occurs because Singapore doesn't have a set of legislative standards for biological safety, and that was one of our strongest recommendations, that that be introduced."

Dr Della Porta explained how the SARS bug may have contaminated the other virus samples.

"We can come up with many hypotheses. Obviously they are working in the same biologically safety cabinet. In theory they have decontaminated between handling the different viruses. If for example a plate or something to contaminated, say some weeks or months before hand, and you were to use that to grow the next stocks, that stock will have a low level of contamination. The next time you use that stocks, it will actually grow up more viruses."

He also took pains to explain that it wasn't the entire EHI laboratory being infectious.

One reason why the latest patient got infected was that he failed to wear the appropriate safety attire while he handled the SARS-contaminated West Nile virus.

In theory even if the researcher didn't catch the SARS bug, he could also come down with the West Nile virus.

Dr Della Porta says there may be new infection if appropriate actions aren't taken.

"I don't think it happen just at the one time. And that's why we are not sure which stocks could have the virus in and which of them might not so we suggest that the prudent and safe to do was to get rid of all stocks and start fresh."

Dr Ooi says his Institute accepts the review panel's call.

"First thing that we are going to do now is to go back and destroy all the virus. We are going to clean the BSL-3 lab and resume work in the BSL-2 lab. Fortunately, a lot of the important projects like the diagnostic test all that have been completed. We know at what level of the virus it can pick up and we know the anti-body tests how well it can perform. So a lot of the critical information on the diagnosis and patient information is already there. So in that sense I don't think it will affect the way we respond to outbreaks. Hopefully we will never see one more."

Analyst with GK Goh Research, Mr Song Seng Wun says this incident isn't likely to impede Singapore's aspiration to be a biomedical hub.

"The point to bear in mind really is that the biomedical clusters here are endowed mainly by the big MNCs from all over the world and some of the biggest names like for instance Schering-Plough who has an integrated society up in Tuas, runs their own labs for instance. They are an international company I would argue, I would even suggest that the standards that they maintain in the Singapore labs will be no different from what they maintained elsewhere as well. So I don't think this latest incident in the government-run labs will have any implications as far as these companies are concerned."

Mr Khaw Boon Wan has assured that existing gaps in bio-safety measures will be plugged.

The research on SARS may have encountered a small hiccup but it will continue.

Until the EHI has upgraded its safety practices, the research center won't be able to continue to grow the SARS virus.

But the Singapore General Hospital's laboratory still can.

No expert thinks Singapore is less capable to deal with the next SARS outbreak.

The fight goes on.

This is Chong Ching Liang for Newsradio 938.

===================================

Related Links:

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

National University of Singapore
http://nus.edu.sg

Ministry for the Environment's Environment Health Institute web-page
http://app.nea.gov.sg/cms/htdocs/category_sub.asp?cid=130

World Health Organisation
http://who.int/

GK Goh and Associates
http://www.gkgoh.com.sg/

OTGV #37 - Balaji's Concerns

2005-09-26T15:28:00.000+08:00

Broadcast Date: 22/09/03

In a recent talk to tertiary students, Minister of State for Health and Transport Balaji Sadasivan spoke about the various threats to Singapore’s security.

Chong Ching Liang, who was at the Singapore Institute of International Affairs-organised event, brings you the highlights.

=========================

It was a student seminar on international affairs.

But perhaps in current times, the focus of the day was on the negative aspects of international affairs.

The students were exposed to the pessimism of a world re-shaped by globalization.

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

The Guest of Honour for the seminar was Dr Balaji Sadasivan the Minister of State for Health and Transport.

He started off by highlighting how globalization might have changed the world for the worse.

"This seminar title "borderless threats, boundless enemies" aptly describes the security challenges of today. In the past, the threat to a country came across its borders. Your borders are finite and you only have a limited number of neighbours. But today with globalisation, with air travel, international communications, every country in the world is your neighbour. And every country where there is a conflict, that conflict can come over and affect the security of your country. A good example is the Middle-east conflict and the terrorism it generates has an impact on us and the security in Singapore today."

Globalization and the Internet may have benefited research and communications but this benefit also extends to people seeking to topple the current world order.

But while terrorism using conventional bombs may be on everyone's mind, Dr Balaji touched on what he considered the more lethal threats facing the world today.

"I consider the most lethal forms of borderless threats: infectious disease and bio-terrorism. A single atypical pneumonia carrier in the province of Guang Dong was all it took to spark off the outbreak of SARS worldwide. The SARS incident has also brought to the foreground the need to adequately prepared against the threat of bio-terrorism. Defence against bio-terrorism has been on the top agenda since the anthrax attacks following 911. But the SARS outbreak and its impact on such a global scale has been a rude awakening for many countries and exposed the inadequacies of their emergency preparedness."

SARS is a disease that evolved from nature and as a result the outbreak had an idiosyncratic behaviour that epidemiologists worldwide could detect and subsequently subvert its spread.

Dr Balaji told the students that a bio-terrorist attack may come with synchronized attacks in different parts of the world or in a country.

This makes policing and containment ever more challenging.

The current New Economy has also been called the Age of Biotechnology.

Biotech firms are supposed to provide the push for the next phase of the global economic evolution.

But the proliferation of biotechnological research also has its downside said Dr Balaji.

"The possibility of bio-terrorism attacks is more probable than what is commonly believed. Biological weapons are sometimes called the "poor man's atom bomb" because it is relatively cheaper to administer than conventional or nuclear weapons. Some experts have estimated it to costs only about one dollar per square kilometer of disruption. With bio-technology on the rise, discoveries in life sciences may further increase the potency and diversity of bio-weapons. It is also becoming difficult to distinguish between legitimate research in biotechnology and ill-intended research in bio-weapons."

Half of Dr Balaji's 20-minute speech was on infectious diseases and bio-terrorism, the other half was on conventional terrorism.

No wonder when it came to the turn of the students to speak most asked him about threats and challenges posed by terrorism and regional conflicts.

The first question asked.

"I am Kelvin from Anderson JC. Sir you have pointed out the bio-terrorism can inflict more damage as it can be synchronized. However during the infection outbreaks of SARS we have lives lost so how can we keep the damage low when an unexpected virus attacks synchronized by terrorists have occurred?"

Dr Balaji's answer to Kelvin's worry.

"You must have sufficient intelligence to pre-empt it to make sure they don't even cross the border into Singapore. And second you must have adequate surveillance we have put into place. System to monitor what is happening so that if there is some unusual pattern then you immediately know something is wrong and investigate because it is easier to contain an outbreak when it is small than when it becomes widespread."

But this answer doesn't seem to assuage the students’ worries.

All who spoke seem fixated on the issue of violent conflict.

The last question of the day to Dr Balaji was on what he considered to be his main concerns.

His reply wasn't anywhere near terrorism at all, which might have surprised the students though it shouldn't have.

"Empower youth to deal with the current situation. If I were a young person today in the current situation, my biggest concern would be employment and career prospects. And how you empower young people to deal with that."

That was the only time economic challenges was raised in the half an hour that students had in their question and answer with the Minister of State.

Globalisation - seen in its most violent and sensational incarnation.

Ironic, in world made so much smaller by air-travel and the Internet, the ties that bind are seen as ties that constrict and force conflict, and not a forger of friendship.

This is Chong Ching Liang for Newsradio 938.

================================

Related Links:

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

Singapore Institute of International Affairs
http://www.siiaonline.org/

OTGV #36 - Blood

2005-08-31T15:53:00.000+08:00

Broadcast Date: 25/08/03

Singapore lags significantly behind other developed countries in terms of blood donations.

A new effort called Centre for Transfusion Medicine or C-T-M at the Health Sciences Authority has launched a initiative to drive up the number of blood donors.

Health Sciences Authority11 Outram RoadSingapore 169078

Director of Medical Services Tan Chorh Chuan says the new system aims to provide a more seamless and less disruptive means for existing or potential blood donors.

"The DonorCare@HSA system is a new IT initiative which has been developed to provide blood donors with a new dimension of service. Using Donorcare@HSA, blood donors will be able to interact more efficiently with the Bloodbank@HSA thru the internet. It is hope that blood donors will find this new resource useful and that it will also encourage new donors to come forward."

The drive to get new blood donors is crucial.

Blood banks all over the world are facing the problem of not having enough donors.

Professor Tan again.

"Despite all the technological advances in medicine, blood obtained from human donations is essential treatment modality for numerous acute and chronic disease conditions. WHO has estimated that 75 million blood donations are collected worldwide. Unfortunately, it is also estimated that 17% of the world's population has access to 60% of this global blood supply, and that 80% of the population has access to only 20% of the supply of safe blood."

And this is the reason why no country can depend on imported blood, since everyone else is facing shortages.

Dr Soe Nyunt, Acting Director of Health Sector Development at the WHO Regional Office of the Western Pacific, says individual countries must be responsible.

"Blood transfusion has been recognised as a key part of modern health care. It is the responsibility of the national blood programme both to provide an adequate supply of blood for all patients requiring transfusion and ensure the quality of blood and blood products for clinical use."

It's always been a mystery why people don't come forward to donate blood.

When the SQ-006 incident happened, queues formed outside C-T-M, and likewise, crowds converged at blood donation centres across the U-S after September 11 attacks.

But such altruism mysteriously vanished during non-crises times.

Prof Tan says the onus is on blood donation centers to win over new blood donors.

"Many factors deter people who maybe motivated to come forward to donate blood; be it fear of needles, insufficient time, lack of knowledge about blood donation, or a previously unhappy blood donation experience. Blood transfusion services must therefore learn to improve the quality of their relationship and interaction with their blood donors, and develop a customer orientation in their philosophy and processes. Customer orientation is the desire to build and maintain lasting and mutually beneficial relationship with carefully selected customers -- in this case, altruistic, well motivated and commited blood donors."

Director of Centre for Transfusion Medicine, Diana Teo explains how the newly launched DonorCare@HSA will help get more donors thru the door.

Dr Teo highlights another time-saving feature.

"Blood donors can now make donations on-line. For busy people in Singapore who may not have a lot of time to spare, this will allow them to make appointments and to make it more predictable so when they come to the blood bank, they know can donate blood at that time. Don't have to call in. If you have internet access, you can just click, make your appointment. One day, two day before we'll remind you in case you forgot there's an appointment."

And the system will remind you either via e-mail or s-m-s one to three days before the actual appointment.

Booking the appointment is as easy as a couple of mouse clicks.

Of course, if you are on the wrong side of the IT divide, you can still donate blood via the walk-in system.

However, you won't have the benefit of time savings should you turn up on a day with a particularly large crowd of would-be donors.

Dr Teo says the DonorCare@HSA system allows a two-way communication so that both the donor and the Centre can benefit.

"The advantage again of having an interface with our owners on-line is that we can regularly conduct opinion polls for our donors on-line. We can regularly gain their feedback. A lot of people now use internet and e-mails for feedback. So rather than having them to type an e-mails, we may conduct polls like 'do you think this will be useful?', 'do you think this will be convenient for you?' This is actually a new way of communication."

Some people may have no problems with donating a little blood but they are too lazy to go all the way down to Outram Road where C-T-M is situated.

This is the reason why there're mobile blood banks and with DonorCare@HSA, this information is available within the website.

Presently, most donors visit the Blood Bank during lunch time or after-office-hours.

Dr Teo on possible future upgrades down the road that may allow her Centre to adjust the opening hours.

"If it is very successful, we can allow it, for example, we might find that if people who really want to make appointments at certain hours, we may consider. Right now if you have late hours, you absolutely cannot predict whether anyone's going to come in or it's going to be very crowded."

Want to donate blood but are too concerned about time to make a trip down to Outram?

Save some time by fixing an appointment first the DonorCare web-page in www.hsa.gov.sg

This is Chong Ching Liang at Newsradio 938.

================================

Related Links:

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

Centre for Transfutional Medicine, Health Science Authority
http://www.hsa.gov.sg/html/ctm/about_ctm.html

OTGV #35 - S'pore's Wealth

2005-08-31T15:43:00.000+08:00

Broadcast Date: 11/08/03

How do you measure a country's health?

In dollars, in economic growth, in crime rates and other social statistics or just simply, in its people?

People, the one renewable resource that makes or breaks a nation.

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

When one generation gets tired, old and perhaps, cynical, another takes over the main task of nation building.

The back waves pushing the front waves as described in one Chinese idiom.

Perhaps, the definitive gauge on the health of a nation is the young, the yet-to-develop resource of a country.

But Young Singaporeans have been getting a bit of a flak these days.

They are gauged to be self-centred, judged to quit Singapore more willingly.

Is it true?

Well, Minister in the Prime Minister Office and Labour Chief Lim Boon Heng finds hope in a survey about Singaporeans and their ties to Singapore.

"Do you believe that Singapore has a future? [children: YES!] Well yesterday, there was a report, they survey Singaporeans and found that 77% of Singaporeans are sure that Singaporeans have a good future. And young people have more confidence than the older ones."

Mr Lim thinks it isn't a youth-induced naiveté.

"But it's not just youthful exuberance or being wise to the ways of the world, but I think the young has reasons to be confident. The majority of our young will enter the market with some kind of skills."

But it is simply beyond a mere equipping the young with the tools to make a living in the New Economy.

A worker who's mobile will move on to greener pastures.

The intangibles, the immeasurable factors that constitute a strong sense of social responsibility is what binds young Singaporeans to their country.

As an example, let's look at young Singaporeans training to be nurses.

Nursing is the new glamour job after SARS.

Nanyang Polytechnic nursing student, Chwee Ngoh.

"Actually at the moment they gave me some very positive and negative remarks. They were like saying 'see, you really have to really be at the frontline lor, you have to really reach out for them. Can you really do it or not?' Then on another hand, they would be like 'Yeah lor, its very good lor, its like very few people can do this.' Because nursing is a profession where everybody can't do it. Only people who are special then can take up this career lor."

And being nurses have certain rewards.

Nurses are most sought worldwide due to endemic shortages of such professionals in developed economies.

United Kingdom and the United States have both been accused of "poaching" nurses from developing nations in desperate need of bettering their healthcare system.

So choices and inducement are aplenty for younger Singaporean nurses to "quit" Singapore.

That they don't will depend very much on their ties to Singapore and their ideals.

Idealism isn't short for N-Y-P student Serena.

"My reason for coming into nursing is, firstly, my mother is a nurse and I am inspired by her. And thru her I could see the nature of nursing which is very noble and you can make a great difference to other people's lives."

Neither is it for her schoolmate, Chwee Ngoh who has to conquer parental disapproval to make it to the nursing programme.

"I actually registered for the joint-admission exercise, I didn't put nursing as the first choice. And that's because a lot of friends and relatives they really dissuade me. Mostly it's because my parents they don't like lor. It's like when your parents don't like, it is better to listen to them. Then so I reluctantly chose another course, business, in Ngee Ann Poly, then after that I was thinking of taking nursing as a part time course, then I really think thru again. If I take it as a part time course then I might just as well as changed it now. Although it was over the period of appeal, I came all the way and I thank NYP a lot for taking me as a student."

Localised idealism, a desire to help society is what will bind them to Singapore.

Nurses can leave Singapore anytime after they are qualified because there is a global demand for them.

A crucial sign of Singapore’s health is that not many of the younger nurses leave.

Another young Singaporean Ivah Ee aspires to be a special education teacher.

An unconventional career goal, but one that projects voluminous optimism for Singapore.

Ivah on what fuels her atypical aspirations.

"Because I find that in Singapore, I find that our society is very different from overseas. The way Singaporeans are brought up is, they tend to shun this kind of kids. I actually saw this thing happening at the bus-stop. It so happens the kid who has Downs' Syndrome is my neighbour. He kind of like wanted to play with this girl while waiting for the bus. So he was like smiling at the girl and the girl mother was like pulling her away saying 'no you cannot play, you can't like smile'. Can't even smile or look at the person."

A sense of social injustice shapes her future.

"That was what instigate me to go into special education because I think it's something Singapore lacks."

Because That Is What Singapore LACKS.

Isn't this statement wonderful?

Battling social injustices without a crippling sense of cynicism that will see some throw in the towel.

This is Chong Ching Liang for Newsradio 938.

==========================

Related Links:

Newsradio 938 (now 938Live)

http://www.938live.sg/

Nanyang Polytechnic Nursing Programme
http://www.nyp.edu.sg/SHS/shs_nursenet.html

OTGV #34 - SARS Memories

2005-08-31T15:19:00.000+08:00

Broadcast Date: 28/07/03

To the rest of Singapore, the SARS deaths were for a time, target of a morbid fascination of how high the SARS death toll could climb.

But to the families who have to cope with the loss of their loved ones, the pain's onset is sudden, the void immeasurable.

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

The SARS Commemoration night was meant to be a nation's salute to the SARS victims and their families.

But only three families who lost their loved ones to SARS showed up.

Most want to move on and deal with their grief privately without the glare of the media.

"Life still goes on and.... I think everybody will continue to do and.... just let her leave in peace lah."

Singapore too hopes to move on and put a closure to the SARS chapter in its history.

Unfortunately, the victims' families journey is far from over says social worker Timothy Koh.

"There's a lot of unanswered questions. There's still having to go thru some discrimination, some of them may have lost their jobs as a result of SARS. A lot of them have to find ways to pick the pieces back together. There's still a lot of emotional issues with maybe lost relationships, for some who have lost their loved ones. grief issues and many other financial issues. Its far from over for a lot of them."

Prime Minister Goh Chok Tong sends his condolences and hopes a nation's sympathy will help ease the pain of those with fallen loved ones.

"To the grieving families, I offer the nation's deepest sympathies. I know that my words cannot fill the void in your heart, or the emptiness in your home. But I hope that you take some comfort in knowing that you are not alone in your grief. The nation shares your sorrow."

The commemoration ceremony was to remember not to mourn.

The National Health Group and the Tan Tock Seng team produced a video for the Health Ministry to help Singaporeans see the human face behind the SARS statistics.

A colleague remembers nurse Hamidah for her optimism and the thumb-up signs she flashed even when she was very ill.

"She speaks her mind, very straightforward and I think, one thing that I really learnt about her is if only you know and you would like her. When she is pretty sick, in ICU, so we have a glass-door, she used to no matter how sick you just have to knock on the door and she opens her eyes she will say like this to you."

Outgoing Health Minister Lim Hng Kiang had led the most remarkable of fights against SARS.

His ministry's containment measures stopped SARS in its tracks.

On the commemoration day, Mr Lim apologised to the families for the pains caused by these policies.

"All of us are saddened by the loss of lives in this outbreak. To the friends, relatives and families of the deceased, we regret the pain and grief that you had to go through in the face of restrictions even in the final moments with them."

SARS victims in their death bed haven't the comfort of loved ones for fear that they'll catch the disease.

The victims cross from the living realm alone as he lies in an isolation room.

"Dear uncle, you left without families or friends to comfort you in your last moments here. You left without farewells, nor prayers, memorials to bless your soul. A sojourn that you have planned to see God's holy shrine in India when you turned 63, but alas, you left with dreams unfulfilled. Just a month shy of 63. We miss your smile, mourn your untimely death, but like the unseen breeze, you remain in our hearts."

But each individual death contains moments that will be indelibly etched in memories of the grieving families.

Here they are:

A son's farewell to his father through a phone line.

"When I got there, blood pressure was zero. Heart I supposed has stopped already lah. But the ECG was still beating away. I picked up the intercom and I told him, dad this your son, Gerard here, I said, you can go. Don't hang on for nothing. Just go. You know, just go and meet the lord. And I put down the phone, I went back to the glass-panel in front of the ICU suite, and it went to zero."

A wife's gift to her husband to be a better father.

"She wanted actually my son to be, yeah to be successful in his life. I will work towards it .... she is my inspiration and she will be my inspiration even though she won't be around."

An inspiration to a colleague.

"She put up a good fight. Yeah, for herself and for her family. Nurses will remember her for her dedication ... for her fighting spirit."

The children's loss.

"When mama is not working and she will bring us to Orchard Rd and buy for us clothes and toys. My mom bought these toys for me last year and I will treasure it."

The dawning realisation and pain of returning to normal life without a treasured friend, or relative.

A SARS victim's family member on the change in his life.

"I will take one day at a time. When you reach the bridge then you cross."

A son's lament and hope at the final moment.

"He's taken away so quickly and so abruptly, you know, I have no chance for a final father-son goodbye. How I cope with it basically just come down to faith. Faith of knowing that maybe someday I will see him again."

Singapore's leaders tell us that SARS united a whole country.

And it has.

But the families would rather have their loved ones back as they strive to pick up the pieces.

This is Chong Ching Liang with Newsradio 938.

==========================

Related Links:

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

Ministry of Health
http://www.moh.gov.sg/corp/sars/index.html

National Healthcare Group
http://www.nhg.com.sg/index2.htm

Tan Tock Seng Hospital
http://www.ttsh.com.sg/asp/index.asp

OTGV #33 - Law-Med Debate

2005-08-31T14:50:00.000+08:00

Broadcast Date: 21/07/03

What do lawyers and doctors do when they want to get more familiar with each other?

They have a debate!

Chong Ching Liang attended the first-ever Law-Medical debate and found that it was a more comical than cerebral affair.

===========================

One of the biggest red herrings of the year for the media was an innocuous invite to a debate on whether lawyers make better politicians than doctors.

As it turned out, the motion and the location of the debate in Parliament House, were the only things that were serious.

Hi, I'm Chong Ching Liang. Come share my enjoyment in re-visiting the first-ever Law-Medical Debate on this week's On the Grapevine.

Lawyers and doctors are people from professions that by nature, are meticulous and fastidious.

So there was little doubt that the combative lawyers would leave nothing to chance.

Their first speaker, Christopher Ong on his team's secret weapon to gain victory.

"Before I actually move on to the definition is the... well, more or less or white attire that the male members of the lawyer team has adopted. When we got together, we turn our minds to important strategic issues such as what to wear. And, what we settle on is that the team that wear all-white in this parliament normally wins the debate. [laughters]"

That, and a supreme sense of self-awareness.

"We know where we are coming from. When it comes to politics, we are certainly the better team for the simple reasons that we ... don't ... have.. ETHICS! Whereas these.. [laughters] whereas these noble SARS fighters over hear [laughter] don't stand a chance in the game of politics. These doctors even have, as part of their profession something called the Hippocratic Oath which is to do no harm. We have on our side of the floor we have what you would call, the Hypocritical Oath."

The first speaker from the medical team, Dr Lee Chung Horn, unfazed by the crowd pleasing routine that had preceded him, gamely tried to wrestle some seriousness back into the debate.

"Our stand is simply this, we do not believe that lawyers make better politicians than doctors. To win tonight's debate, ladies and gentlemen, the proposition has to establish superiority that clearly one profession is more gifted than the other, for politics!"

But the lawyers would not be so easily subdued!

Adrian Tan says his task isn't to establish superiority, not at all!

"We are here to say that we are inferior to them. In every moral respect! [Laughters] And that is why our last speaker IS, Mr Chelva Rajah! [laughters] I challenge you to find among the medical community, ANYONE with the moral calibre [Laughters] of the learned gentleman."

In fact, tongue firmly in-cheek, it is this inferiority in character that would make lawyers better politicians!

"To sum up what we have been saying before. We are very good at covering our asses. [laughters] And doctors are very poor at that.... in fact all they do is uncover our asses.[laughters]"

But undaunted, the medical side's Dr Sreedharan tried another tack to engage his opponent, ridicule and shame...

"Actually I left the first minute for rebuttals but no real points were made. In order to make a rebuttal [laughters] so I am sorry about that. Yeah"

He gamely soldiered on bringing up examples of medical doctors made good in the global political world such as Drs Gro Harlem Brundtland and Mahathir Mohamed.

The lawyers came back with their femme-fatale, Leong Wai Kum, who illustrated the quintessential lawyering skill of winning over a jury.

"Now it may well be that it is not our training whether as lawyers or doctors that will make us better politicians. I think it may well be our gender that make us better politicians. [laughter] I mean my dear honorable FEMALE judges. [laughters]"

Momentarily seduced by the limelight, Professor Leong went on a 3 minute spiel on the benefits of being female.

But despite meandering, she brought out her point.

"I think I have the connection -- Our government, in its infinite wisdom has really dealt the medical profession, a rather bad hand. Because of course we know, for ever so long, medical faculty in NUS has not been allowed to take their fair share of women. Honourable members of the judges, I repeat, we have more women, women are better in every thing. Obviously! It's lawyers that make better politicians in Singapore.[laughters]"

By now, the doctors had given up on their hope of ever having a serious debate.

Such emotional duress forged an unexpected comedic gem in their third speaker Dr Umapathi.

"Let me start off with a story. The story about Humpty Dumpty. You know, the silly egg that sat on the wall, fell off and all the kingsmen couldn't put him together again. Of course this is a very old story. Kingsmen in old English is actually politicians. So among the Kingsmen were lawyer-politicians, and doctor-politicians. Of course the majority were SAF scholars! [laughters]"

Using this story, he illustrated what separated lawyers from doctors in the profession of politics.

"What do you think the lawyer-politicians' first instinctive response. What... is... the .. liability? [laughters] Who's liable for this. Is it the parents of the egg, who didn't supervise the egg? Is it the local council that didn't put up signs and railings and then the egg fall off? Now what do you think the doctor-politician is going to do? Of course the first is going to do is "mouth-to-shell" resuscitation. After which, his first response would be what went wrong? What would be a happy egg get up on the wall. Was he suicidal? [laughters] Is he another victim of the Singapore education system?! [Laughters]"

So who won in the end?

The judges gave the prize to the lawyers.

But most in the audience didn't care about the victory as they were left in stitches.

If this much laughter and harmless rip-roaring self-deprecation dominated world politics, maybe conflicts would be obsolete.

This is Chong Ching Liang for Newsradio 938.

==========================
Related Links:

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

Law Society Society
http://www.lawsociety.org.sg/

Singapore Medical Association
http://www.sma.org.sg/

OTGV #32 - Ladan&Ladeh Sum-Up

2005-08-31T14:14:00.000+08:00

Broadcast Date: 14/07/03

This week's On the Grapevine takes a last look at the brave challenge that failed Singapore's quest to help Ladan and Ladeh fulfill their wish to be separate.

===============================

What a difference a week makes.

As last Sunday faded into Monday, the country was still starry-eyed with hope.

Hope that the operation Ladan and Laleh Bijani will be successful.

Last Monday, trepidation might have crept in perhaps but never sadness or even despair.

Hi I am Chong Ching Liang and this weeks On the Grapevine takes a retrospective look at the emotions of the past week.

"Both of the flowers are very fragile especially Laleh, in our poetry is very shaky even if there is very small wind. Ladan is also a very fragile flower. Today these two flowers do not exist anymore."

Pictures from BBCnews.com

That was the Iranian Ambassador to Jakarta, Shaban Shahidi Moadab.

His poetic words brought added poignancy to the loss of hopes once held.

Hopes that weren't just held by the twins or their family, but by the peoples of Iran, Singapore and to a certain extent, the world.

When Nepalese twins Ganga and Jamuna came to Singapore for their separation operation, they are mere babes, unable to speak a single word.

Ladan and Laleh, on the other hand, were twenty-nine year olds, articulate and Ladan was, in particular, vivacious.

They communicated their dreams to the whole world, about how they searched for a means to see each other's face without a mirror.

Laleh wanted to be a journalist not a lawyer, though she is a law graduate like Ladan because they couldn't take separate courses.

They touched the hearts of two nations because of their humanity and their zest and yearning for a normal life.

Letter from irantimes.com

It's arguable that perhaps they affected Singaporeans more than Ganga and Jamuna ever did.

Mr Shaban Shahidi again.

"I believe they're are not just two flowers but they are two swallows who flew from Iran to come to Singapore. Their destiny tied them together. For 29 years, they said yes to that but finally they decided to challenge and in this challenge, science and medicine came to the rescue. The name of the operation is Hope. The challenge is lost but the hope will continue."

Well-wishers stayed at Raffles Hospital hoping that the best outcome will occur.

But as news broke last Tuesday that Ladan had passed on, many like this Singaporean mother broke down.

"I have been reading, following the news and my heart actually go out to the two of them. [sobs] you know every time I hear of these two... it breaks my heart. [sobs] You know its difficult for these two survive, I know. When I was having my lunch, someone was signalling to me that one of them actually one of them, you know, didn't make it so ... you know my heart just went down. I just couldn't hold back my tears. [sobs]"

When Laleh died some 90 minutes later, all hopes that at least one of the remarkable Iranian twin would make it were dashed

The loss was hard to accept as an Iranian well-wisher put it.

"Its very bad. Very bad. I believe when you heard, you also shock. It's not really a small things, yeah? Its very difficult, not easy to accept they're gone. It's not easier yeah, for all of us. It's not something we expect to be 100 percent to go through. Of course we lose someone, somebody in this life. She is supposed to live like us and... sorry."

Around the world, the breathless expectancy gave way to a post-mortem of moral analysis.

Those in support praised the Singaporean team for their bravery in undertaking an ethically and technically challenging operation.

Dr Leslie Cannold, a Fellow at the University of Melbourne's Centre for Applied Philosophy and Public Ethics said the operation was not a mistake.

"The medical issues are relatively clear in this case because what you are dealing with are two competent adult. And so if the twins wanted to be separated they therefore took on, made an autonomous choice of what they wanted. And therefore they took on the responsibility, understanding that they have been in fact been denied several times by other doctors to have the operation. That's called informed consent."

In the other camp, Dr Richard Nicholson, the editor of the Bulletin of Medical Ethics said it wasn’t enough to just say the twins understood the risk and had given their informed consent to go ahead with the operation.

"Well, the doctor’s duty is not to ask everything the patient asks for even if the patients do understand the full risks involved. And with both twins sadly dead, there’s really no way of know whether they did understand fully the risks or whether even if they were given a realistic assessment of the risks by the medical team. But regardless of what information they did have or understand, there's still a duty on doctors not to go ahead with procedures that are incredibly risky unless it's an alternative to inevitable deaths."

The outcome of the world's first separation procedure to liberate two adult twins joined at the head ended in double tragedy.

But while post-mortem criticism exists, Dr Cannold maintained the decision to operate was laudable.

"It doesn't make any sense to suggest that this sort of things oughtn't to be done by doctors because they have never been done before. Logic will of course tell that there's always a first time for every thing and medical science would be at a standstill unless doctors are willing to take risks."

Perhaps, the most clear sighted of all comments was uttered by the Iranian Ambassador to Indonesia, Shaban Shahidi.

"I would like to say that Laleh and Ladan are not just two patients but they were ambassador of peace, ambassador of friendship. By using Ladeh and Ladan, I believe that the solidarity between Singaporean people and Iranian people, not only Singapore and Iran but this part of the world and Iran. And this will continue."

After the ravages of war and SARS, it is heartwarming that an effort to give two high intelligent individuals a normal life should unite the world -- in a brief moment of positive prayers that dreams might come true.

Lets hope that as days fade into weeks and memories of the twins start to wane,

the goodwill struck between Singapore and Iran will endure as Mr Shaban Shahidi hoped.

This is Chong Ching Liang for Newsradio 938.

==========================
Related Links:

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

University of Melbourne's Centre for Applied Philosophy and Public Ethics
http://www.cappe.edu.au/

Bulletin of Medical Ethics
http://www.bullmedeth.info/index.html

Raffles Hospital
http://www.raffleshospital.com/

OTGV #31 - Ride for Life

2005-08-31T14:00:00.000+08:00

Broadcast Date: 02/06/03

INTRO:

AIDS has never received quite the same global cooperation as another global disease, SARS. Help for AIDS patients often came from AIDS activists rather than the government. In this week's On the Grapevine, Chong Ching Liang looks at a recent fundraising event, Ride for Life at what it aims to do to help AIDS patients.

=====================================

SARS may go, AIDS to stay.

That's the intriguing tagline that came with an e-mail that I received on the Ride for Life fundraising event.

It's true, SARS is in the limelight now, but may fade away as the disease tapers off.

AIDS on the other hand, is often swept under the old metaphorical carpet -- Not seen but still there.

Hi Welcome to On the Grapevine with me Chong Ching Liang as I look at a biennial event that strives to raise funds for AIDS as well as to raise awareness about the disease.

Chair of this year's organising committee for Ride for Life, Professor George Bishop explains the significance of AIDS awareness.

"The importance of events like Riding for Life is that it reminds people that AIDS is a health problem. I mean AIDS has literally affected 10s of millions of people worldwide. Singapore has been quite fortunate in that the number of people with HIV is relatively low in Singapore but it is still a major health problem. And it is a problem that is preventable, and it is a problem that we can do something about."

Fellow committee member Sukri Kadola on what exactly is the Ride for Life and what it hopes to achieve.

"It does 2 things. First, it promotes AIDS awareness, second it is to promote healthy lifestyle. The event Riding for Life was first held in 1999 and this is a long distance cycling event in which Singaporeans take part in a one week cycling marathon thru peninsula Malaysia. This year's ride will begin in KL and include stops in Termeloh, Kuantan, Alam Shah, Seremban, Batu Pahat and JB before arriving back to Singapore."

This is the third time the biennial Ride For Life has been convened.

Sukri on the event's past fundraising efforts.

"The first two rides in 1991 and 2000, we raised about 100K dollars and we had used this funds for the AIDS patients so that they can afford to pay the expensive medical bills. The average of what an AIDS patient will spend on medication can run up to a thousand to 1800. So these funds that we raised will help to a certain extent the expensive medical fees for treatment in HIV and AIDS."

This helping hand is greatly appreciated by AIDS patients here.

Unlike countries in Africa or other developing nations, Singaporeans affected by AIDS don't have access to cheap generic AIDS medication.

AIDS stricken Singaporeans have to bear the high medical costs of buying from drugs produced by giant pharmaceuticals.

Professor George Bishop again.

"Yes that is a real problem! One of the things that we've been particularly concerned with is the accessibility of medication for people with AIDS since there's no government subsidy for people with AIDS. Essentially it falls to NGOs like Action For AIDS to provide that kind of subsidy. So part of what we are doing with Riding for Life is raising money for the AIDS medication fund that's run by Action for AIDS so that people with AIDS can be subsidised in terms of their medicine. I mean they can get some help even if they can't get it from government agencies."

But beyond mere economics, the issue is really about generating awareness of a disease that people tend to ignore.

"There's a great deal of stigma against people with AIDS because AIDS is associated with sexuality and associated with behaviours that's often stigmatised. People don't really want to talk about it. It is a stigma that's really isn't justified and I think it is important to bring that to people's attention. It's important to be reminded that you know AIDS is a health problem the fact that it is preventable and also to bring to people's awareness what people with AIDS go through what they experience."

Meet Margaret Wong one of the participants of the Ride for Life initiative --

"A little bit about myself. Alright. My age. I am 61 years old and I am a retired primary school teacher. My last school was at Poi Ching Primary where in Toa Payoh and I was teaching Primary Six. My son who is a committee member told me about this event and ever since he told me about this event, I have been attending all training both locally and in Malaysia. The actual ride will be 900 km over a week."

61 years old -- and she decides to pedal 900 kilometres -- why did she to it?

"At first I took it as a challenge. At first I didn't realise that it was so long, I thought it was only KL and back. Alright. But then now they are doing 900 km I was also pretty excited when I heard from my son that we are also raising money for Actions For AIDS. Since I retired I have thought about doing some community work but never got around to doing it. So when I heard about this event I thought it will be exciting to do something for the community like fund raising for AIDS patients so that was my main motivation."

This year's Ride for Life will also see the coming together of Singaporean and Malaysian NGOs.

This is a good sign for someone like Professor Bishop.

"I think it is very hopeful. One of the things that’s important to keep in mind is that AIDS is not a problem that is localised in any one place. AIDS is worldwide and the only way that we can deal with AIDS effectively is on a global basis. It's also important that countries in the same region also work together. It's also important NGOs work together."

Though this year will see less riders due to the economic uncertainty, the group still hopes to raise some 40 thousand dollars.

Some may say this isn't a big sum of money, but this show of support to the AIDS-stricken is, perhaps, immeasurable.

This is Chong Ching Liang for Newsradio 938.

ends/...

==========================
Related Links:
Newsradio938 (now 938Live)
http://www.938live.sg/

Action for Aids
http://www.afa.org.sg/

OTGV #30 - SARS FREE?

2005-07-29T11:45:00.000+08:00

Broadcast Date: 19/05/03

Singaporeans today will wake up to newspaper headlines proclaiming whether Singapore is SARS Free or must it wait another 20 days to achieve this status.

But what does this all mean?

Join Chong Ching Liang in this week's On the Grapevine to find out what being SARS Free means.

=============================

Chances are if you tune in to the radio, watch TV news or read your papers today, Monday the 18th of May, you will see proclamations of whether or not Singapore has achieved the SARS-Free badge.

It is obviously an achievement more valued by the individual countries than by the organisations fighting the global battle against SARS.

For an organisation such as the World Health Organisation or the W-H-O, a SARS Free country is a fluid category since the world isn't SARS Free says its Information Officer Iain Simpson.

"We don't really declare countries SARS Free routinely. We maintain a table where there have been local transmission and there are procedures for which countries are on that or rather which areas are on that and which are not."

More important is whether Singapore ever gets included in the list of countries that the W-H-O warns people to avoid.

Even after the SARS scare at the Pasir Panjang Wholesale Market, Singapore never made it to this list.

W-H-O's Dr Nelgaard on the criteria used to place countries on his organisation's travel advisory.

"I would also like to emphasise also that we will be in contact with the authorities in Singapore before any decision is taken. So it is not a unilateral decision but it is based on criteria that we are currently refining. There are 3 criteria. First one is the size of the outbreak; the second one is the extension of the outbreak beyond the first clear focus of close contacts. And the third one is the export of cases internationally."

Getting the SARS Free nod doesn't translate in a breather for the government or the immigration and health authorities says Mr Simpson's fellow Information Officer, Peter Cordingley.

"Hanoi has been on full alert since it became a SARS free area, and there has been no dropping of the guard, the government authority as well as the WHO team that is there, has actually been stepping up pre-cautions. These things weren't in place from the beginning quite obviously. Some of them got put in place and now even more are being put into place in terms of the airport. There's a long border with, virtually impossible to police that completely but a big effort is now being made to do the best they can."

This need to be constantly vigilant isn't lost on Singaporeans if the feedback from Newsradio's listeners in the TalkBack programme in AM Newstalk is anything to go by.

Mr Lee said being SARS Free is less important than doing the right thing.

"SARS is going to be a long-haul thing and sooner than later I think the whole world will have SARS. Rather than getting worried and all worked up about whether we are going to be SARS Free. What is more important is at the end of the day, people will evaluate how a country view SARS and how we take care of the problem, rather than to say whether we are free or not."

Another caller to Talkback, Johnny, acknowledged the importance of being certified SARS Free but highlighted it's what we do that'll impact us as a nation.

"As far as the May 18th is concerned, from within a Singapore context, it's not a critical day because all the precautions are in place. But I guess to be pragmatic in the sense that Singapore is dependent on the world for business, economy and what have you, achieving the SARS Free status is important for a SARS Free standpoint but within Singapore we should just get on with life as per normal."

W-H-O's Iain Simpson on the main significance to country after it has been judged by to be free of any local transmission by the W-H-O.

"It basically means that Singapore will no longer be asked to conduct exit screening at the airport for people taking flights to make sure there's no export of SARS. Because if there's no local transmission, there's no export of SARS."

Newsradio listener Johnny says whether Singapore can gain economic mileage from being declared "SARS Free" depends on how it maintains its alert against SARS.

"If precautions are in place in relations to the airport, land entry point and sea entry points, that SARS is being checked even after May 18th. If that is well publicise and accepted, that should put Singapore in a very good position."

Fellow caller to AM Newstalk's Talkback segment Mr Lee says Singapore may well have reaped some rewards for its handling of the SARS outbreak here.

"In fact in this bad economic times, this has actually given Singapore a premium, so to speak, over the other countries I mean. People have already holding back investments in China and Taiwan. Things like that. I think as a matter of fact, it is a good thing that has happened."

Yet another caller Mr Pereira thinks that life is returning to normal.

"I gave a Vesak Day talk to about 300 people, and we were expecting a little less than a hundred. Very surprised that everybody turned up. No one was wearing a mask and life was going on as any other Vesak."

But ultimately, until every country in the world is SARS Free or when there's a vaccine or cure found, Singaporean life will be changed.

Health Minister Lim Hng Kiang speaking to reporters about the impact of the Institute of Mental Health SARS-scare.

"Well we can do everything that we do and we will still be facing such situations weeks, months later on. So I think we have to accept the fact that this problem requires utmost vigilance and if there's one breach, one mistake, one mis-diagnosis one carelessness, one selfishness, the problems comes with us. It's not the end of the world. We isolate, we contain, we ring fenced it. It may costs us 15 cases, 10 cases, twenty cases but we will definitely contain it and don't let it spread, provided everybody works with us."

In a world changed by the SARS scourge, any country, SARS Free or not, getting complacent is doing so at its own peril.

This is Chong Ching Liang for Newsradio 938. (now 938Live)

==========================
Related Links:

Newsradio938 (now 938Live)
http://www.938live.sg/

Ministry of Health SARS website
http://www.moh.gov.sg/corp/sars/index.html

World Health Organisation SARS website
http://www.who.int/topics/sars/en/

National Development Ministry's News Release on Pasir Panjang Wholesale Market
http://www.mnd.gov.sg/Newsroom/newsreleases/2003/news280403.htm

OTGV #29 - SARS Contact Tracers

2005-07-29T11:35:00.000+08:00

Broadcast Date: 12/05/03

Intro:

In this week's On The Grapevine, join Chong Ching Liang as he looks at the silent but crucial role that contact tracers play in the fight against SARS.

===========================

SARS is such a new bug that there's no real medical fight against it.

There isn't yet a reliable test kit to detect it.

So the containment of its spread is achieved through very exhaustive detective work.

Aside from the healthcare professionals, another front in the battle fought against SARS is engaged by the contact tracers.

Hi I am Chong Ching Liang and welcome to On the Grapevine as I look at the work done by this group of nearly invisible SARS combatants.

Health Officer Han Wee Kiong sheds some light on the working hours of the contact tracers.

"Basically our shifts breaks into 2, the morning shift is from 8 to 4 pm. The afternoon shift is 2 to 10 pm. Basically we work a lot more than our shift. [Average of how many hours ot?] Two to 4 hours just to get all the contacts in because sometimes the cases were hospitalised and we are unable to call them, So we have to call the family members to get the information and most of the time they are unable to give us the information that we need. So we have to try a lot other means to get the information."

Very often, the work follows the contact tracers home even when the shifts or the over-time has ended.

Mr Han admits to thinking about cases which he couldn't or didn't manage to contact even when he is at home and getting ready for bed.

Minister of State for Education and Manpower Ng Eng Hen says the fight against SARS provides a constantly evolving learning curve for the government.

One of the lessons learnt is that it is not only a medical battle but a logistic battle to allocate resources to help the Health Ministry.

"If you think about it, how have we fought this war? Not with drugs at all. It's not a medical war. It's a logistical war. So putting 9 Div commander contact tracing, what is contact tracing? Asking who you've been in contact, there's nothing medical about it. Doctors are never meant to do that."

Initially, the Health Ministry started with a team of some 20 contact tracers.

This grew to 60 and then 80 in total strength.

The biggest test for the endurance and resourcefulness of the Health Ministry's contact tracers was when the SARS bug escaped the confines of Tan Tock Seng Hospital and spread to the Singapore General Hospital in late March.

Mr Han on the workload then.

"The workload was quite tremendous for our team. Basically we have to investigate about 6 to 7 cases a day. Imagine the number of visitors and the visitors who visit the hospital. We basically have to make quite a number of calls per officers. There were cases where actually the contacts could grow up to one, two hundred. So we've break down to a group of ten, we all have to make about ten calls. If we have more cases, if one person is handling one case, you have to call 50 to a hundred times."

But something else happened that stretched the initial team of contact tracers even more.

The Pasir Panjang Wholesale Market.

The workload became nightmarish with an anticipated list of some two thousand contacts to be traced.

So the government beefed up the stretched resources of the Health Ministry by sending one hundred and sixty MINDEF personnel to help out the contact tracers on the 25th of last month.

Here's one of them.

"I'm Captain Thomas Neo, I am from the Ministry of Defence. I am assisting by operating as one of the four executive officers that's running the shift in the contact tracing team. currently there are two shifts. One shift comprises of 12 teams of approximately ten men so it makes a total of 240 of which 160 men are from the Ministry of Defence whereas the other 60 men are from the Ministry of Health."

Captain Neo on what his team faced when they arrived.

"There were a lot of contacts to be made. The workload then was more. More calls to be made, more people to establish contacts, for us to compile the figures. Per person I would say it'll depending on day to day but on average, we are talking about 50 to 60 depending on the number of cases at hand. Depending on how voluminous the cases have churned out in terms of contacts."

But contact tracing is a skill, each tracer has to ferret out information that the interviewees have either forgotten, can't recollect or willfully tried to keep it from coming out.

Minister of State for Health Balaji Sadasivan on the importance of contact tracing even on the tracking of SARS worldwide.

"Contact tracing is an important medical tool in the control of SARS and the fact that there's a border doesn't reduce it's importance. The reasons why you need to contact trace are if you have SARS you need to catch it from someone. So you want to go back and find the source of the SARS because if the source can be identified, then other people who may have caught SARS can be identified and ring-fenced."

So good contact tracers are essential.

Captain Neo on the training his team received.

"the focus was really what we really deem necessary was to give our guys who are new, hands-on training. That is what we deem as relevant. They were attached to the teams that were already functioning in the MOH. There were attached to them, they had some hands-on training. After 3 days when we deem they are ready to be on their own, before we branch them out as a support to the current batch of people doing contact tracing."

Thrown straight into the deep-end, a lot of the lessons are learnt on the job.

The worse may be over after the extreme case of Pasir Panjang Wholesale Market but at least, Singapore now has a team of two hundred and forty contact tracers to deal with whatever may come.

This is Chong Ching Liang for Newsradio 938. (now 938Live)

==========================
Related Links:

Newsradio938 (now 938Live)
http://www.938live.sg/

Ministry of Health SARS website
http://www.moh.gov.sg/corp/sars/index.html

World Health Organisation SARS website
http://www.who.int/topics/sars/en/

National Development Ministry's News Release on Pasir Panjang Wholesale Market
http://www.mnd.gov.sg/Newsroom/newsreleases/2003/news280403.htm

OTGV #28 - SARS Lessons

2005-07-29T11:23:00.000+08:00

Broadcast Date: 05/05/03

It's nearly two months.

Gradually the initial suffocating fear loosens its grip somewhat as the world learns to deal with a new disease, SARS.

Hi Welcome to On the Grapevine as I take a look back at Singapore's fight against SARS.

In the beginning there was SARS and nothing much at all.

There's no information, there's no experience in dealing with an infectious outbreak involving an entirely new disease.

In fact, most ministries, including the Health Ministry, are not prepared at all says Minister of State for Education and Manpower, Ng Eng Hen.

"Indeed any other ministry was not geared to fight this. Even the Ministry of Health. Because this disease, the last time was polio in 1950s. I mean, all our systems were not geared for infectious disease and therefore the set-up of ministerial committee where all the ministers put their resources together."

A lot of the fear is generated by the fact that there is no cure or vaccine against SARS.

There may not be a cure for a very long time if the fight against AIDS is anything to be compared against.

But what's even more crucial is that there isn’t a lab-based diagnostic kit accurate enough to detect the new virus.

This means the fight against SARS so far isn't an entirely medical one says Dr Ng.

Each branch of the government is drawn into battle and their expertise and knowledge challenged.

The learning curve is very steep and quick, assured actions are crucial and absolutely necessary.

National Development Ministry was drawn in by the unexpected closure of the Pasir Panjang Wholesale Market that disrupted Singapore's supply of leafy veggies for a while.

This lesson of having just one distribution centre is swiftly learnt says National Development Minister Mah Bow Tan.

"We are now in the process of building redundancies. In other words, duplicating the facilities that we currently have but we have to be careful that beyond a certain point, the additional points involved will have to be factored in. But yes the answer is we will be building redundancies. The main idea is to protect our sources of supplies to make sure our food supply coming in whether it is fish meat vegetables eggs whatever is safe, is protected."

Pasir Panjang also brought in an interesting lesson for the Health Ministry.

How can a relatively small team of people do contact tracing for an estimated group of some two thousand people and still hope to have the Home Quarantine orders out as soon as possible?

Dr Ng Eng Hen who's also part of the SARS combat Unit says this taught the lesson that getting help to the Health Ministry is very important.

"The second tipping point was allocating resources to MOH because it was not geared up to fight this national crisis. Because if you think about it, how have we fought this war? Not with drugs at all. It's not a medical war, its a logistical war. So putting 9 Div commander contact tracing, what is contact tracing? Asking who you've been in contact, there's nothing medical about it. Doctors are never meant to do that."

But contact tracing by authorities isn't enough.

Singaporeans are urged, begged or even cajoled to be forthcoming and honest about their health status and do self-assessment of their own risks.

In his dialogue session with the grass-roots leaders, Prime Minister Goh Chok Tong was asked if the government should name people who are home quarantined so that his or her neighbours can take the necessary pre-cautions.

Mr Goh turned the question back to the floor.

"Now should we tell the neighbours about the family that's been quarantine? In other words, do you agree that we should in fact be quite open about this? What do you think? Those who support there should be more openness please put up your hand."

Not enough hands up.

So Mr Goh clarifies what he actually means.

"My own view is there's nothing shameful about being quarantined and I will let people know. Mrs Lee was quarantine and we knew. And SM told everybody. So I think if you take that attitude, your neighbours know, well we’re just a little careful that there's somebody being quarantine but there's nothing, really embarrassing about it. So can ask those who support a more open stance, please put up your hands. Those at the top? I think there's a clear majority."

As the PM proves, people will even accept radical measures that may compromise their confidentiality if they can understand why these measures are being undertaken.

Of course they mustn't feel singled out and ostracised by the community.

After all, a person on quarantine isn't even sick so why should they be treated as lepers?

Senior Minister of State for Transport and incoming Acting Minister for Health Khaw Boon Wan says more can be done to the current system to rid it of stigma.

"I also get some anecdotes on why people are reluctant to call 993. Because... ambulance will come and the whole neighbourhood is be shuttered you know, we are trying to look into this whole process, whether we could humanised it. Most of this contacts who developed fever are mobile. There's actually no need to move them in ambulance or whatever. there could be other means. So a few of us have been thinking about how to make it more user friendly. Less frightening to the person and to the whole community. And I have an idea. You could come in one of those beautiful SQ tour coach, you know, and we will send to Tan Tock Seng!"

Mr Goh Chok Tong says it is imperative that all must their part because the best reactive system in the world will crumble to naught if even the most minute population doesn't play ball.

"While we do in controlling the problem, we cannot allow one selfish act, one selfish individual to destroy the lives of all of us. So that is my simple message."

It is still early days yet but the world and Singapore has learnt so much about SARS and so much more.

It's been a quantum leap of experiential learning that may well equip Singaporean leaders and population to deal with the next curve ball nature decides to throw at them in the form of another new infectious disease.

This is Chong Ching Liang for Newsradio 938. (Now 938Live)

==========================
Related Links:

Newsradio938 (now 938Live)
http://www.938live.sg/

Ministry of Health SARS website
http://www.moh.gov.sg/corp/sars/index.html

Hong Kong University SARS Fund website (with links and info)
http://www.hku.hk/sarsfund/

World Health Organisation SARS website
http://www.who.int/topics/sars/en/

National Development Ministry's News Release on Pasir Panjang Wholesale Market
http://www.mnd.gov.sg/Newsroom/newsreleases/2003/news280403.htm

OTGV #27 - SARS Summary

2005-07-29T11:05:00.000+08:00

Broadcast Date: 31/03/03

New disease, new challenges and the government took drastic steps last week to tackle them.

"I have invoked the Infectious Diseases Act and we will be serving notice on all these people and so this will prevent them from interacting with the rest of community and presenting a risk to them."

"Ministry of Education and Ministry of Health have decided to close all primary schools, secondary schools, junior colleges and centralised institutes to Sunday, 6th of April."

Hi Welcome to On the Grapevine with me Chong Ching Liang as I take a look back on a furious week of activities to combat the Severe Acute Respiratory Syndrome or SARS.

The government actions to impose home quarantine and temporary closure of the national schools up to JC level stem from an effort to try and calm frayed public nerves.

Education Minister Teo Chee Hean.

"The advice from the medical profession is that there is no reason to close the schools on purely medical ground. But there has been concerns express by parents and we received this feedback directly from parents directly and also from general practitioners. Basically this move is to reassure parents to give them peace of mind so that know their children are not put at risk."

Why is the public panicking?

First, SARS is a disease that humanity has never seen before.

The World Health Organisation's advisor to the Singapore government Dr Osman Mansoor explains.

"So we are still learning. WHO's role is to coordinate the activities that is going on in different countries and to learn, a lot to learn from Singapore. But WHO does not know what is the right thing to do to control this disease nor would anyone else know. I can tell what we do know; we do know that the transmission appears to be extremely limited. Nearly all the transmission has happen in hospitals when people have become very sick."

With a new disease, information about it is constantly evolving and the public is simply too impatient to wait.

So that's how rumours start.

There are already different versions of SARS-related e-mails that have been snaking into Singaporean computers.

One says SARS only affect the Chinese and another, more damagingly, accused the government of information blackout.

Elisabeth is a 4th or 5th generation recipient of the second type of chain mail.

"When I first read it, regarding a news media blackout, I was thinking to myself, ha ha. So now the truth comes out because last week, there was a speech from Lim Hng Kiang, he did mentioned that we have everything under control, no panic but now suddenly this week things seems to be moving in another direction."

But because it is on something as unknown as SARS, her first thought was to forward the letter on to people she cares about.

So these e-mails become a cyber-virus that's propagated the same way as an uncontrolled flu bug.

Dr Wong Sin Yew, an infectious disease physician in private practice feels the public needs to support the public sector healthcare professionals at this time, and he urges Singaporeans to be cautious when dealing with such alarmist e-mails.

"I have no doubt that everyone is trying to provide as much reaction as possible but I would like the readers and your listeners to concentrate on actually what are the facts. And the facts are MOH, WHO, and many other countries are collaborating to try and find out what the bug is. There are a lot of speculations and I think these speculations do a great disservice to public health policies makers who grapple with a rapidly evolving disease."

So has the government been withholding information?

Health Minister Lim Hng Kiang has been chairing media briefings and personally answering all questions every alternate day or so.

Transparency will help but battling the disease will take a lot of hard work and good solid detective work coupled with sound medical knowledge.

Mr Lim Hng Kiang on how Singapore and Hong Kong worked together to determine the course of infection for Singapore's first three patients.

"Well, we are in contact with the Hong Kong authorities and their hypothesis to us is that the 7 patients who're infected stay on the same floor and they hypothesised that they could have contracted from this Guangzhou doctor who's the source, either while waiting for the lift or inside the lift. Their hypothesis is close direct contact when they were waiting for the elevator or they were inside the elevator itself and the Guangzhou doctor may have sneezed or coughed and that could have pass the droplets to the others. And that's how the infection got started. That's their hypothesis and I don't think anybody can pin-point the cause but because the other hotel workers are not affected, they think that it's a plausible explanation."

But it seems the future is getting a tad brighter.

A team of micro-biologists from Hong Kong University claims the first step to stopping the SARS bug has been reached.

Dr Malik Perius.

"Growing, identifying the virus is very important; you can call it a breakthrough if you like. Of course we are not at the end of the road but I think we have taken a big step along that road. It also opens the door to testing what anti-viral drugs would be effective against this virus to the longer term, developing vaccines. It is a long way to go but I think this is an important first step."

In about a week's time, the schools will be re-opened.

Whether or not the public will accept this will depend on how aware they are of the SARS bug.

So Mr Lim Hng Kiang promised an information blitz before the reopening of schools to educate Singaporeans.

"I think we have to do quite a lot more in the following days to get the public educated, to understand the nature of SARS. We'll be taking out ads; we go and attend talk shows to get the message across in all the different ways."

It will be awhile before the public regains its composure but at least, we can rest assured that scientists worldwide are working hand-in-hand to wipe out the SARS bug.

This is Chong Ching Liang for NewsRadio 938.

==========================
Related Links:

Newsradio938 now 938Live
http://www.938live.sg/

Ministry of Health SARS website
http://www.moh.gov.sg/corp/sars/index.html

Hong Kong University SARS Fund website (with links and info)
http://www.hku.hk/sarsfund/

World Health Organisation SARS website
http://www.who.int/topics/sars/en/

OTGV #26 - Human Organ Transplant Act (HOTA)

2005-05-30T17:39:00.000+08:00

Broadcast Date: 27/01/03

Organ transplant isn't in the realm of science fiction anymore.

In fact, it is done with such regularity around the world that the problem is the shortage of transplant organs.

Last year, the Slim 10 incidents worldwide highlighted the dire need to increase the supply of organs available for transplant.

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

This week I look at the Health Ministry move to re-tool the Human Organ Transplant Act or HOTA.

Minister of State for Health Balaji Sadasivan explains why now.

"The Human Organ Transplant Act was enacted about 15 years ago and it has served us very well with regards to transplantation. It has allowed us to increase transplantation for patients with kidney failures. But over the last 15 years, there have been considerable progress in the field of transplantation surgery, and also the public have understood and have accepted transplantation surgery as a form of treatment."

Under the present HOTA (circa 2003), only the kidneys from accident victims can be used.

With the proposed revision, liver and corneas will be added to the list and in addition, deaths from non-accident causes can also be used.

But this doesn't mean a floodgate will open, allowing all kidney or liver failure patients to get the vital organ they need.

Health Ministry's Director of Medical Services Tan Chorh Chuan.

"What are the things that make someone not suitable as a donor. Generally if their medical condition affect their organs like the liver and the kidneys to the degree that it is not going to be very useful for the transplantation and the other is that say they've got infections because if they have infections, this may carry over to the transplant process. So many of the conditions, the medical situations do not allow these organs to be optimally used for transplantation."

Even with the new revisions, there will be only 12 more donors per year.

12's the average number of brain dead patients from non-accident causes.

So the prioritising of giving younger patients kidneys over the senior citizens may not be changed.

Singapore General Hospital's principal investigator in renal transplantation, Dr Vathsala.

"Well, as you see we have a huge backlog of people who are within the age limit who are actually very, very fit to receive a transplant. We have 666 patients as of now and it will take a lot more kidneys to change the actual criteria. But certainly people will wait shorter periods, we think more people will get transplanted within a year, so that means they wait less. And if they wait less, then they have a reduced burden of dialysis. The debt on dialysis will be lower, so I think there are a lot of advantages."

Dr Prabhakaran of the National University Hospital's Liver Transplant Programme also gives a good prognosis of the proposed changes.

"It gives new hope to more than 12 patients who might get an organ because one liver donor can potentially save two lives. A liver can be split to a child and an adult. So if you have 12 new donors because of the new regulations and assuming that we can only get good livers from only 6 patients Then you can potentially save 12!"

But the revisions to HOTA will not include heart or lungs as the transplantation of these organs are still fairly experimental.

Dr Balaji as to why heart isn't included.

"Why are hearts not included? I think we want to go at a step by step process. we've had only kidneys in HOTA and moving from kidneys to liver is one step. Liver transplantation is much more established than heart transplantation. Possibly at some point in the future, we will have to look at cardiac transplantation."

Organ transplant, like death is often not openly discussed in Singapore.

In fact, one may intentionally shy from such thoughts.

So should the Health Ministry be the one to push across the donations of other organs like hearts and lungs as well?

Health Ministry’s Professor Tan explains why public policy makers need to thread carefully.

"It's trying to put out a balance approach to put out something which we think meets the professional needs because right now ,it's really the kidney failure and liver failure patients who are in a sense the most needy in terms of the numbers and the severity of impact. And also cornea because although it is not life saving, it's sight saving. So really it's trying to strike a balance. Present something that will meet our need and yet in a sense will not put people off."

Last year, Ms Rajah died from liver failure arising from Slim 10.

Dr Balaji explains why distant relatives are subjected to more scrutiny.

"Basically if you are not related, then what is important will be a psychological assessment, make sure you know what you are doing and to make sure you know all the risks that are involved. If that's done and there does not appear to be any financial inducement or organ trading, then the approval will be very quick. But with regulations that we draw up, we hope the process will be much clearer to every one."

The Health Ministry says this additional layer of bureaucracy is necessary because there needs to be checks and balances to prevent organ trading.

What do you think?

Provide your feedback to the Health Ministry in one of its public forum.

The first such forum is on the 29th of this month.

You can also forward your thoughts to Health Ministry via e-mail at MOH_HOTA@moh.gov.sg

or via fax at 6325-1686

This is Chong Ching Liang for Newsradio 938.

================================
Related Links:

Newsradio938
http://newsradio.mediacorpradio.com

Health Ministry's FAQ on HOTA
http://www.moh.gov.sg/corp/systems/organ/hota/faqs.do

National Kidney Foundation Website on Organ Donation on Laws and Policies
http://www.thegift.org.sg/why_organ_donation/policies_laws.html

National University Hospital Liver Transplant Programme
http://www.nuh.com.sg/sitemap.html

OTGV #25 - Pay for Social Workers

2005-05-30T17:22:00.000+08:00

Broadcast date : 10/02/03

They really are the forgotten professionals.

Well... maybe not forgotten but definitely taken-for-granted.

We are talking about Social Workers.

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

Dr Myrna Blake has been involved in the training of and has been practicing social work for nearly half a century and, she has noticed changes in the profession over the years.

"The whole profile of the client and also, I guess the expectations of social workers. The field of social workers is enormous. We're not just dealing with public assistance. We are talking about human development, in terms of people making the most of what they have. I once gave a talk where I compared social workers to Batman. When they need to be down in the ground in detail, but up in the sky to see a wide breadth. And also to be able to shift from one side to the other."

Most of the time, social workers work very long hours with salaries that dip below that of most other professions.

But they are increasingly being recognised by the government.

Since 1999, outstanding social workers have been rewarded with the Outstanding Social Workers Award or the OSWA.

One of the winners is Esther Koh, a young social worker for whom the OSWA means quite a lot.

"I am very amazed that I received the award. Very honoured and very affirmed and encouraged that as a younger social worker, I won the award."

However, recognition doesn't feed the stomach as some wisecracks say.

So recognition can go only so far to keep good, decent social workers on the job.

The other OSWA winner Maureen Fung says social workers need to be seen as a professional and at the same time have a fairly adequate wage structure to retain good workers.

"How to reconcile that is going to be tough. Yeah? It's going to be needing time and effort on the part of professional bodies as well as relevant authorities that are working with social services, even our funding bodies, to ensure that social workers are adequately paid for us to have them and sustain them in their job. We are not talking about big bucks where profit organisations are concerned, but adequate you know, comparable to you know, what they are paying social workers in the civil service."

Maureen is a career social worker who has spent her entire working life in the Samaritans of Singapore and most recently, the Asian Women Welfare Association.

The National Council of Social Service is the organisation directly involved in regulating the profession of social work.

The NCSS sees itself as being responsible for upgrading the image of social workers .

It is also looking to upgrade the remuneration package for social workers so that the sector can retain its best workers.

Frances Lui Director of Corporate Communications, NCSS

"NCSS is working with the other government agencies to re-look at the salaries structures and also the career structures of a social service professional. Our objective is to ensure that as professionals, their salaries will be pegged and aligned close to what the civil service is getting."

How much will this help?

Well, for one veteran social worker, this little move will go far.

Maureen Fung again.

"With this latest move of raising the salary scheme of social workers. I think this is important. It will draw people who want to enter with that passion but still need to feed a family to come in. We know there are people who love to do it. I have come across male social workers, they are starting a family and it's not adequate. Had they stepped outside it would be more. And we lose them. Yeah? And we do need male social workers as well. Nonetheless, whatever the sex, we ought to be reasonably paid to do the job."

Nominated MP and chairperson of the 2002 OSWA selection Committee Braema Mathi says more can be done to show social workers Singapore does appreciate their work.

"I think these are steps but I still feel that they are small. Good steps but I feel they are a little long in coming I think it will be great to bring the social workers on par as soon as possible. That's the clearest signal that we can send into society that we appreciate the work they do."

But raising the salary structure and implementing a more structured career path may not solve the problem of funding.

Most Voluntary Welfare organisations or VWOs are cash strapped because volunteers run them.

So increasing the size of their payroll won't help them at all.

But to call simply for the government to step in to contribute more funds may not be the answer either.

Dr Myrna Blake paints the dilemma for me.

"There is a real advantage for the voluntary welfare organisation because they have a freedom in being able to develop programmes that they like. If everything was under the control of the government, there will be a little more of control and you know necessarily because of budget. So if you look at the VWO sector, there's a huge range of how each has developed in terms of specialisation and innovative programmes It would be a pity if that was stifled. And yet on the other hand there is this tension of not having money and stuff sometimes and committees having to spend lots of time fund-raising rather than doing the sort of things they should be doing. But I don't know the answer to this. I just can see the dilemma."

The current rate of social workers dropping out is at 10 percent of the cohort.

Maybe it will change with better pay and recognition that social work is a highly skilled profession.

After all, we mustn't take advantage of social workers just because they have a good heart, right?

This is Chong Ching Liang for Newsradio 938.

================================
Related Links:

Newsradio938
http://newsradio.mediacorpradio.com

Singapore Association of Social Worker's Past OSWA Recipients Webpage
http://www.sasw.org.sg/public/aboutsocialwork.htm#Outstanding_Social_Worker_Award_(OSWA)

Samaritans of Singapore
http://www.samaritans.org.sg/

Asian Women Welfare Association
http://www.awwa.org.sg/

National Council of Social Service
http://ncss.org.sg/ncss/index.asp

OTGV #24 – Primary Care Partnership Scheme

2005-05-17T11:59:00.000+08:00

Broadcast Date: 13/01/03

For the aged poor, polyclinics may be the only means to treat their common ailments.

But polyclinics aren't as conveniently located as private clinics.

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

The Health Ministry introduced the Primary Care Partnership Scheme or PCPS for the aged poor last March.

It'll allow them to seek treatment at private clinics at polyclinic prices but not all who are eligible are onboard yet.

Dr Steven Ang has a clinic in the Redhill area where there's a high concentration of the aged poor.

"PCPS scheme was started some time in March or April last year and my clinic has been on the scheme since then. We noticed that for my clinic there hasn't been a big demand for this particularly service. Recently I noticed that the Ministry of Health has launched a campaign to recruit more members for the scheme. We would expect an increase in demand for our services."

Currently, there're about 4,600 elderly folks in the scheme and the Ministry hopes to double this number by year's end.

To this end, it's looking towards a more collaborative approach to recruit more needy elderly for the scheme, says MOH's Deputy Secretary Chang Hwee Nee.

"There have been publicity in the media but it still has not reached out to the elderly. So this is really an effort, a collaboration with Lions Befrienders, in the course of their voluntary work, they have come across these needy elderly and we are very appreciative of them identifying these elderly and bringing them here so that our staff can go the extra mile and help them to fill up the forms."

Last month, about 100 elderly from the Mei Ling and Redhill estates signed up for PCPS.

They were identified and bussed to the Ministry by the Lions Befrienders so that ministry staff could help them fill up the PCPS enrolment forms.

Ms Chang explains the experiential benefits for her colleagues.

"This collaboration with Lions Befrienders will give our officers an opportunity to have personal interaction with the elderly. [It'll] give them a greater appreciation of the needs of the Elderly. And I think they will remember well, the next time they develop a scheme or design an application form, they will make sure that scheme is well-communicated and easily understood, and the application process is citizen-friendly."

Another thing to bear in mind would be the convenience of bringing the registration process to the elderly.

The 100 folks who signed up for PCPS last month live in a common block of flats designated for senior citizens

So, it might have been more convenient if the processing had been done where they lived.

In fact, some of them said there was a slight hiccup with the arrangements that day

"We waited for a long time at Redhill! We waited for almost 2 hours for them to pick us up. No one's there to send us here. Later some one came."

More crucially, some elders avoid Singapore General Hospital and its vicinity for superstitious reasons.

An elderly lady from Redhill explains why some of her neighbours didn't show up.

"Only those of us involved with the Senior Citizen centre are invited. But some people don't want to come. When I asked them to come along, they reacted strongly and say they don't want to come. Superstitious you see, they don't want to be near SGH. I asked them but they shooed me away."

But this doesn't mean that those left behind will be forgotten.

Lions Befrienders' executive, Melissa Rodrigues, says her organisation will follow-up on these cases.

"Most of these Elderly here, they actually belong to our sub-centres. For example the elderly here belong to Mei Ling Street and it is a drop-in centre where the elderly actually live in the block in which our centre is built at. From today's exercise we will actually know who are the elderly that actually slipped through the cracks and we can actually track them and actually talk to them one on one and actually explain to them the benefits of this scheme."

In fact, the elderly might be able to make a more informed decision in a familiar setting.

"Even though they can't make it here or they don't want to come, we can actually do the application at the centre itself. I think they will feel more comfortable talking to the staff whom they know, rather than coming to a strange place, talking to strange people."

Despite the problems, those who signed up for PCPS are pleased, as summarised by this elderly lady from Redhill.

(hokien)
"It's very good and very cheap. The senior citizen centre sent us here to apply for the scheme. We're happy. It's very good for us elderly."

She says prior to PCPS, most of them either goes to the polyclinics or not at all due to the high costs of healthcare involved.

But she sees the potential with PCPS

"There are many private GPs. There's one in Block 86, 70-something. We live in Redhill. There's many. But we've never visited a GP so we don't know if they're part of the scheme. We can go ask. See if there's the PCPS sticker on the GP's window. We won't go in if there's no sticker."

The practitioners also welcome this scheme.

Dr Steven Ang Clinic and Surgery has done its share of philanthropy and this scheme will allow more to be helped, says Dr Ang.

"Well, my clinic is located at Redhill where there is a large population of the Elderly. All along we have been seeing poor patients and we have actually been providing services to them either free of charge or at a great discount. With this scheme, the government actually extends its assistance to this group of people directly. It is a win-win situation for everybody involved."

So, for our elderly poor, the next health visit may be to a private G-P below or near their block instead of the polyclinic in the town centre.

This is Chong Ching Liang for Newsradio 938.

================================
Related Links:

Newsradio938
http://newsradio.mediacorpradio.com

Ministry of Health PCPS Factsheets
http://www.moh.gov.sg/corp/elderlycare/pcps/intro.do

Lions Befrienders
http://www.lionsbefrienders.org.sg/

OTGV #23 - Aids Series 1/5 - On the Homefront

2005-04-08T17:52:00.000+08:00

Broadcast Date: 02/12/02

December first, World AIDs Day.

Not a celebratory date but an important date nonetheless.

It educates and this is this year's UNAIDS campaign message.

"Don't you touch my sister",
"You're not my son anymore".
You've just experienced some of the most painful symptoms of HIV and AIDS. Help us fight fear, shame, ignorance and injustice worldwide.

Live and let live.

The greatest pain of contracting AIDS isn't physiological.

It's the pain of rejection, discrimination, and ostracism.

Hi I am Chong Ching Liang and welcome to the first of an On the Grapevine series on the AIDS pandemic.

AIDS has been a malevolent juggernaut that's not let up despite better knowledge and medication that have surfaced in the last two decades of research.

Action for AIDs' President, Dr Roy Chan provides the grim statistics during the Third Singapore AIDS conference.

"Since we last met two years ago in December of 2000, another two million people have become infected with AIDS, HIV in Asia alone. There are now over 7 million infected persons in the region, it is clear that the epidemic has well and truly taken off and the most severely affected countries in the region are Thailand, Myanmar, Cambodia, and India. But more recently the epidemic has been increasing rapidly in parts of China, Viet Nam and our neighbour, Indonesia. In Singapore in the last two years, 450 or more Singaporeans and PR were diagnosed with HIV and AIDS. This brings the total number of infections to almost 1800 and over 600 have died from AIDS."

Compared to South Africa or perhaps Thailand that's closer to home, it is easy for Singaporean to think that 450 in two years isn't great shakes.

But each digit obscures the human face that it is. Dr Chan again.

"Whilst many have the support of families and friends, others have passed away alone, and have been abandoned. Memories have often been banished from families because of shame and embarrassment. We are very happy that this time there are individuals brave and committed enough to air their fears and hopes. I would like to recall these words of Nelson Mandela at Barcelona AIDS conference in July who in calling greater visibility and positive people says 'you must not be ashamed of speaking out, because when you keep quiet, you are signing your own death warrant.'"

In Singapore where intravenous drug consumption isn't a major problem, the spread of AIDS/HIV through drug addiction is rare.

The more primal urge of sex is the main cause.

"The overwhelming majority was transmitted through sexual intercourse. The majority of infections are seen in heterosexual males with a significant minority among homosexuals and bisexuals. 9 cases out of ten are in males. The proportion of females has not changed much over the years."

Times have changed.

Contracting AIDS is less of a death sentence these days.

"Modern medicine has now rendered AIDS a treatable disease. It is no more the uniformly infections that it was in the 80s and the early 1990s. Anti-HIV drugs can be given, can give infected individuals a very good chance to live long healthy and fulfilling lives."

But these medications aren't cheap and while they keep the infected individuals a more normal life, it doesn’t cure.

Minister of State for Health Balaji Sadasivan warns a dependency on current medical advances won't derail the AIDS pandemic.

"While medical treatment has improved the quality and length of life for HIV-infected persons, it cannot cure HIV disease. Once infected, despite the best and most expensive treatment, the quality of life over time can never be as good as those who are not infected. Despite treatment, a person with the HIV virus still can spread the infection. Since AIDS is almost always spread by careless and irresponsible human behaviour, the key to prevention is to educate people to be careful and responsible."

The costs of a life-saving triple cocktail of anti-retroviral drugs are still formidable for HIV/AIDS patients.

This fact is even more crucial when you consider the Health Ministry study that shows most new cases are blue-collared working class men whose monthly income may be less than a month's prescription costs.

Unfortunately, the Singapore government doesn't provide them for free to all AIDS patients because they are considered non-standard drugs.

But the road isn't closed.

The anti-retro-viral drugs are known to reduce the mother-to-child transmission of the deadly virus during pregnancies.

Dr Balaji says the State do provide when it comes to expectant mothers and their children.

"All the women who are HIV positive, who have to deliver children, have been given the medication because KK Hospital they have special funds that they collected through fund raising projects which they use to give these women so that they get their medication. Likewise, every child in Singapore who has had HIV, all its treatment has been paid for. What is more, KK has got some funds to help their parents. These children fall sick. ETC"

However, the greatest tragedy of it all is that after over two decades, males haven't learnt the prevention and cure for AIDS/HIV isn't too expensive, if they are intent on sowing their wild oats.

Feeling frisky? Got a dollar?

The condom is the surest way to avoid contracting AIDS at an average cost of 1 dollar apiece.

Tune in to the next installment as I look at the global AIDS pandemic.

This is Chong Ching Liang for Newsradio 938.

=========================
Related Websites:

Newsradio938
http://newsradio.mediacorpradio.com

Action for Aids
http://www.afa.org.sg

Ministry of Health, Singapore
http://www.moh.gov.sg
http://www.moh.gov.sg/corp/about/newsroom/speeches/details.do?id=29294601

World AIDS Conference 2004
http://www.aids2004.org/

United Nations Programme on HIV/AIDS (UNAIDS)
http://www.unaids.org/en/default.asp

OTGV #22 - Aids Series 2/5 - The World Outside

2005-04-08T17:41:00.000+08:00

Broadcast Date: 09/12/02

The HIV/AIDS infections is now a pandemic and no longer an epidemic.

It now covers almost the entire world, and yet it keeps growing and growing.

According to UNAIDS statistics, the number of people living with AIDs is now at 42 million.

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

Despite having been tracked and studied for nearly two decades, the rate of increase just keep accelerating.

Dr MeeChai Viravaidya is the appointed Ambassador for UN-AIDS.

He has been an incessant presence in the fight against AIDS in Thailand and he paints for us the extent of the growing pandemic.

"AIDS death each year is 3 million and going up. I mean, the whole of Singapore is dying every year. Can you imagine that? The whole of Singapore dies every year! But that's the current situation in many, many parts of the world."

AIDs/HIV threatens not just economically but socially.

Director of HIV/AIDS Research Division, University of Natal, South Africa Alan Whiteside explains.

"AIDS can either be extremely divisive to a nation or it can be a nation-building force. It depends on how the nation responds to it. In the worst situation, what you find is that people are not open about HIV. They know there's a problem in their midst. They don' know the magnitude of their problem. They can see their friends dying and falling ill. They're not entirely sure why. There's no leadership."

Countries must look at AIDS issue as a humanitarian problem, not mere statistics to be cast aside if the infection rate is too small.

President of Action of Action for AIDs, Dr Roy Chan revisits the AIDS situation in Singapore.

"While the absolute numbers in Singapore may not be very high, per capita infection rates tell a different story. When we compare these stories, we find that HIV here is more prevalent than many other developed countries in Europe, in Asia. Our HIV prevalence is 0.146 percent amongst adults compared to 0.12 in Australia, 0.12 in the UK and a much lower rate in Japan. But numbers do not the full story. More important than numbers is the fact that AIDS have now touched the lives of thousands of Singaporeans. We have lost and continue to lose friends, family members, fellow workers and fellow citizens to AIDS."

But the adults aren't the most at risk, warns UN-AIDS' Senior Epidemiologist Bernhard Schwartlander

"AIDS hits young people in ages when they are the most productive. That leads to traumatic impacts on development, on economies and on households in many parts of this world. You can imagine the impact this has on economies for example. In a company, when a quarter, or more than a quarter of the labour force is HIV positive, that company may run into serious trouble in the future."

Sadly and most unfortunately, it is only when the economic costs of AIDS becomes obvious, then will actions be taken.

One of the largest mining companies in South Africa, AngloGold estimates up to 30 percent of its workers.

Faced with this challenge to its future productivity, the company is now dispensing the expensive "triple cocktail" of anti-retroviral drugs to its AIDS infected employees for free.

In Southern Africa, where the AIDS problem is at its most acute, it’s political and business leaders are stirring from their stupor.

Executive Director of UNAIDS, Dr Peter Piot.

"I believe we are now at a turning point in the 20-year history of the AIDS epidemic in Africa. Everywhere I go, I hear the top African leaders speaking out about AIDS as the major threat to the continent’s development. This gives me grounds for hope that in the coming years, we will see stronger, more effective responses to AIDS in many more sub-Saharan African nations."

It's about time, says Dr Meechai.

He says AIDS has the potential to de-stabilise a country.

"In most part of the world, national security issues is are from the inside. HIV/AIDS is already changing not only individual fate but fates of nation. In many African countries, a quarter of the adults is affected. The workforce is being depleted. The most skilled people are dying. Teachers, engineers, doctors, soldiers, the whole works. Probably the next Prime Minister will be younger than William Pitt, younger than 21 because there's nobody older than that."

So far, the focus of the world when it comes to AIDS has been trained at the males.

But as the situation in Southern Africa indicates, it is the females that are increasing carrying the burden of the infection.

But going beyond gender, Asia may soon catch up with Africa in terms of infected individuals.

"AIDS is not a health problem. It’s a development problem, it’s a societal problem. For Singapore , it's a small problem today but for many, many countries, it is bigger than war. Before long we can say there will be more people who died from AIDS than all Asians that have died from wars in the whole history of Asia. That will happen."

The culprit for the spread of the AIDS isn't always an individual's lifestyle, lechery or inclinations.

The most culpable of culprits belongs to those in charge of governance says Dr Meechai.

"Why we have allowed this to happen? It is the lack of political leadership. How many leaders in the world has stood up, understood the fight against AIDS and willing to put up a good show? Some has remain totally silent. And not just the leaders of a country, leaders’ politics, business as a whole begins always with denial and then before actions takes place, so many people has been condemned."

For the anti-AIDS campaigners, the key to fighting the scourge must be transparency at all levels of society.

Only then can education takes place to dispel prejudices and discrimination.

And perhaps only then, true rehabilitation and the search for cure be more meaningful for the infected.
Tune in to the next installment as I look at how the pandemic can be combated.

This is Chong Ching Liang for Newsradio 938.

=========================
Related Websites:

Newsradio938
http://newsradio.mediacorpradio.com

Action for Aids
http://www.afa.org.sg

Ministry of Health, Singapore
http://www.moh.gov.sg
http://www.moh.gov.sg/corp/about/newsroom/speeches/details.do?id=29294601

World AIDS Conference 2004
http://www.aids2004.org/

United Nations Programme on HIV/AIDS (UNAIDS)
http://www.unaids.org/en/default.asp

OTGV #21 - Aids Series 3/5 - Media's role

2005-04-08T17:30:00.000+08:00

Broadcasted on 16/12/02

AIDS can be seen as a disease, a social problem or a public policy planning headache.

In whichever guise, AIDS isn't dirt that can be swept under the metaphorical carpet.

Hi, I am Chong Ching Liang and welcome to On the Grapevine.

There's no carpet big enough for the problem to be swept under.

The plight of the infected has to be brought to light.

Dr MeeChai Viravaidya is the Ambassador for UNAIDS and has been an incessant voice in the fight against AIDS in Thailand.

"We have very little time. The pandemic has leapt upon us with appalling sadness. In 1980, we knew nothing about AIDS, right now, 20 million have died."

For nearly two decades, Dr MeeChai has been educating his fellow Thai on the cheapest and most effective ways to prevent AIDS is the humble condom.

He feels governments should do more even if AIDS isn't a big problem yet.

"Once AIDS takes hold, it explodes. Don't wait for it to happen. Enjoy the luxuries of doing a bit too much, too soon. Enjoy the luxury of that."

The media is one tool where policy planners and governments have tried to harness in their fight against AIDS

When he opened the Third Singapore AIDS conference, Minister of State for Health Balaji Sadasivan took the Singaporean media to task for not doing enough to educate the public on AIDS prevention.

"I was greatly disturbed by a 2 Oct report in the New Paper that highlighted the plight of a young lady who had unprotected sex with a man dying with AIDS because and I quote 'I didn't want him to feel that there's a barrier between us'. In a similar article, a doctor had stated that he had known people who wanted to be HIV positive just to be equal to his or her positive partner. What disturbed me was the article covered in a rather neutral manner. While we empathize with those suffering from HIV/AIDS, we and in particular the Media, must send a clear message to young people that it is not OK to get AIDS."

Dr MeeChai issued a similar call to governments and the media to do more.

"It's now as never before, not only to advocate for the afflicted, and pressed for more effective, more effective treatment but also to turn back the time. There's no cure. There's no vaccine. The only way to end this pandemic is to end new infections. We have to say this loudly and often, and we have to back it up with action, not just with words."

The next world AIDS conference will be held in Thailand and Dr MeeChai wants it to be a major coming-out party

As host, Thailand plans to raise some eyebrows

"When you land on the airport, I hope I can have the airport authorities to have the red ribbon on the tarmac. So every pilot landing, whether you are bringing people to the conference or not, the red ribbon is there. And when you hand in your passport, instead of just smiling stamping, they'll stick a condom in your passport. We will have children marching, the whole of Bangkok will know what's happening, and we will also have our policemen working with us, any parking ticket will also have a condom attached to it. We'll call that our 'cops and rubbers' programme."

The next step is to educate.

Education will break stereotypes, prejudices and most of all myths.

Dr Meechai's team has produced an information booklet that they had mass-distributed in the past.

"Well they were given a book that we produced earlier. Questions and answers on HIV, questions such as can you get AIDS in a swimming pool? Well you can get it anywhere. It not where you are, it's what you do. You can get it on a kitchen table as well. And we trained them so they were aware of AIDS and when people talk to them, [they say] 'yes it's real. and here's a book and you can't get it from kissing. Well, in a way I guess you could but you have to kiss and exchange saliva for 50 litres!"

AIDS is a sensitive topic because it affects cultural sensibilities and dampens the tourist trade

So, statistics may be manipulated to give a false indication of the AIDS problem

"And then one day, yeah just a few, yeah a little bit more. And then they still lie about the figures. Just keep the figures low and the fewer people you tests, the fewer HIV positives. In many counties, the testing is low, that's why the figures is low. But that's not the issue, the issue, and it is the most evil element in government, is denial, because denial means you lose time and you lose lives unnecessarily."

But times are changing.

Political leaders are acknowledging the problem.

In southern Africa where the problem is at its worst, Nelson Mandela has been a tireless campaigner.

"There can be no doubt that humanity faces a major challenge. The severity of the economic impact of the disease, is directly related to the fact that the most infected persons are in the peak productive and reproductive age groups."

Famous movie stars have also joined in the fight.

Elisabeth Taylor in her speech to the UN two years ago petitioned for cheaper drugs for AIDS sufferers.

"When will the world find the human and financial resources to replicate these life saving programmes across the region if not the world? How much longer can we afford to wait? Our hopes for effective treatments are surely closer to us than ever before."

Perhaps star power can open more eyes than dreary educators or politicians.

Only when the veil is lifted can the society see AIDS as a disease that can be controlled.

Here's actor Danny Glover's message.

"I have to say something. If I am disappointed with the take, we go again. Shoot it again. But with AIDS, the movie's over. It's the last show. It's up to you and me. Lend your voice, to break the silence."

Tune in next week for a look at the social implications behind not providing cheap medication.

This is Chong Ching Liang for Newsradio 938.

=========================
Related Websites:

Newsradio938
http://newsradio.mediacorpradio.com

Action for Aids
http://www.afa.org.sg

Ministry of Health, Singapore
http://www.moh.gov.sg
http://www.moh.gov.sg/corp/about/newsroom/speeches/details.do?id=29294601

World AIDS Conference 2004
http://www.aids2004.org/

United Nations Programme on HIV/AIDS (UNAIDS)
http://www.unaids.org/en/default.asp

OTGV #20 - Aids Series 4/5 - The Rationale for Cheap Drugs

2005-04-08T17:10:00.000+08:00

Broadcasted on 23/12/02

AIDS hasn't a cure.

Well, not just yet anyway, but the capacity to fend off the most debilitating effects of the scourge is here.

Unfortunately, most of the afflicted has no access to the much-needed medication because of one thing:

The huge costs.

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

Although Africa has been hogging the headlines when it comes to the AIDS pandemic,

Asia is fast catching up.

Estimates from UN-AIDs projects Asia will lose more lives through AIDS than all of its wars put together.

What puts this in even sharper perspectives is that there is medication to fend off this calamity to humanity.

Veteran actor and AIDs activist, Elisabeth Taylor just developing medicines is useless.

"Our enthusiasm for these drugs should also not distract us from another gloomy reality; that under healthcare systems, the issues of costs and access will mean that these drugs will not be available to those that need them the most. As a result, terrible discrimination will both in the US and elsewhere, between the rich and the poor, the Haves, and the Haves-nots, those that can afford Protease inhibitors, those cannot."

It seems only when the AIDS affect a country's or a multi-national corporation's economic future, then definitive actions will be taken.

AngloGold, one of the largest mining companies in the world, has decided to provide free anti-retro-viral drugs to its workers.

Some 30 percent of its 40 000-strong workforce could be severely weakened.

The alternative of not doing anything for Anglogold, is imponderable as a business entity.

Anglogold has been able to provide the life-saving "triple cocktail" to AIDS patients because South Africa have been granted the right to produce cheap generic "copies" by the pharmaceutical companies.

But such actions are far and few in between because of the strong copyright laws protecting the giant pharmaceuticals.

Elisabeth Taylor made this poignant plea to the UN a couple of years back.

"When will the world find the human and financial resources to replicate these life saving programmes across the region if not the world? How much longer can we afford to wait? Our hopes for effective treatments are surely closer to us than ever before."

Unfortunately, this is something that Singaporean AIDS sufferers cannot look forward to say Action for AIDS or AFA, Benedict Jacob-Thambiah.

"The protection of generic drugs itself is protected by several international agreements for example TRIPPS under the WTO and also under several patent laws. I do not see Singapore allowing the production of generic drugs. One is for the protection of the pharmaceutical companies; second, is the numbers in Singapore are too small for us to actually set up a generic drug production service or a centre. So right now, many patients buy their drugs from Thailand or from, you know, their friends who come from India who made drugs as well. I don't foresee Singapore ever having generic drug production centre."

Singapore has grown to be a world-leading medical hub.

But Ambassador for U-N AIDS, MeeChai Viravaidya says perhaps more can still be done in Singapore to help the AIDs patients.

"On the treatment, yes, you are doing a great deal but the costs is still high. Luckily in Thailand, as of next March, the government, government-owned pharmaceutical organisations would be able to produce cocktails at the price of 75 U-S cents per day so no more than around US$300 the whole year. Sometimes you can't even come out of a Chinese restaurant under that in some cities. We can't export it but if Singaporeans want to come over, no problem. We'll really help you that way."

How expensive is the AIDS medication in Singapore?

Benedict paints the grim picture.

"HIV drugs in Singapore are among the costliest in the world. The drug companies charge Singapore what they charge countries in the North like America and in Europe. They do not realised that the per capita income of Singaporeans on average in comparison to income of people from North America and Europe. They charge Singaporeans the same prices. The cost of medication here can cost anything between 800 dollars a month, 1500 to as much as 2000 depending on the kinds of cocktails you are on. And it also depends on how severely affected you are with the HIV virus. 70 percent of the patients in Singapore are not on medication because they cannot afford HIV drugs."

If you analyse the Health Ministry's AIDS statistics, most of the infected belong to the lower economic classes, i.e. the blue collared workers.

Therefore it's no wonder that 70 percent of them are without medication since their wages will be much lower than the costs of treatment.

To compound things, the AIDS medication cannot be subsidised by the government since they are not on the schedule of standard drugs.

However, Minister of State for Health Balaji Sadasivan says there'll be help for those most in need.

Expectant HIV-positive mothers are given the anti-retro-viral drugs as some studies have shown that it will significantly reduce the transmission to the unborn baby.

"All the women who are HIV positive, who have to deliver children, have been given the medication because KK Hospital they have special funds that they collected through fund raising projects which they use to give these women so that they get their medication. Likewise, every child in Singapore who has had HIV, all its treatment has been paid for. What is more, KK has got some funds to help their parents. These children fall sick. ETC"

In summary, here's where Singapore's is:

The AIDS patients wish and hope that the government could do more to help reduce the costs of treatment,

the AIDS activists wish that cheaper medicine will lead to a much lower infection rate because more HIV- patients will come out of the closet for treatment and counseling.

And this may in turn contribute to the government's wish to eradicate AIDs in Singapore.

This is Chong Ching Liang for Newsradio 938.

=========================
Related Websites:

Newsradio938
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Action for Aids
http://www.afa.org.sg

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

OTGV #19 - Aids Series 5/5 - Voices

2005-04-08T17:04:00.000+08:00

Broadcast Date: 30/12/02

Their voices are silent.

Even if they speak, sometimes, family members don't hear.

And when they are gone, families sometimes force themselves to forget.

These are the voices of the HIV positives.

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

I spoke with Royston Tan, the director of the remarkable film, 48 on AIDs, on why he decide to do this project.

[There're really of a lot of the misunderstood theories of this disease. [It is] Something that I have always been wanting to explore. The opportunity came when Channel NewsAsia approach me to do a special documentary for the 20th anniversary of AIDs. Well I think it was overwhelming for me because I didn't really know what I was getting into. This is definitely one of the most challenging projects that I have ever done because people are not so open about this topic and there were people who shun me because they knew I was in contact with the AIDS patients so they didn't want to talk to me. That three months in the production was a lonely journey for me but I really enjoy the whole process because I think personally for myself, I have misunderstood a lot of things about this disease and I have got a clearer picture [now] and that helped me a lot. I hope it is for the viewers who had seen this film. So Royston, tell me, what is the one big thing that you have gained from this remarkable endeavour? When I am in contact with the AIDs patients, I felt the way they live their lives; they cherish every moment they have. All the little things like the sound of raindrops and the colours of the grass and things like that. And that is something that I have never appreciated and it makes appreciate things even more now.]

48 on AIDS was shown on Channel NewsAsia on World Aids Day at the beginning of this month.

Here are the voices of the afflicted, beginning with two young boys who symbolise the innocents who’re swept into the AIDS maelstrom.

[Twinkle twinkle little star, how I wonder what you are.][I think for most of us AIDS is still very distant, very unknown you know. It's a disease that happens to other people or other countries but you know when it strikes home, then you think of it very differently. And when you have knowledge of someone, whom you knew, who is so full of life, so talented, who actually succumbed to it, then you feel the full impact. You know, the pain, and ... and the sense of loss and my greatest wish if I can ever make a wish is that I never again have to know of any other who's succumb to this disease.][I never know that I would become a transgender okay? Or I will become a sex worker and caught HIV. Okay, so now I feel like, maybe it's still a dream. Maybe one day I'll wake up and it's not real. I never feel sorry for being HIV now because that changes my life from a sex worker to a skilled worker. So that's something that I never thought I can be.] [You appreciate all these little things because somehow having this is sort of an awakening I guess like 'Hey!' you know you gotta open your eyes and don't take things for granted anymore and every little things is so meaningful like just turning on the tap and watching the water flow through, taking a shower and all these types of things. I always like to pass on a very positive type of thinking to show them that it's not a death sentence after all and with the will and a lot of positive thinking, life just goes on.] [To me, I feel even if you've contracted the disease, its better not to know because more often than not, if it turns out that if you do then it changes your whole perspective on life. It's like the same as... same reason why people don't want to know about their future lah.] [I don't think that I will live beyond the age of 55 because by then, I think I should have AIDS and I am sure that ten years down the road, on this day, will be lighting a candle for me because I am not here any more.] [I do have friends who are gays and I ....] [To those who thinks that AIDs is a moral disease, it may surprise you to find that the husband didn't contract the virus by fooling around but the entire family, husband, wife and child all have HIV. And how do you look them in the eyes and say you did something wrong and being punished for it?] [People themselves cannot change the perception. We have to tell them how. So we have to give a face to AIDs. Today people only see when they hear AIDS, to see drug addicts, a dirty, smelly very sick drug addict but they don't see the loving husband, the mother, the little child who are suffering from AIDs. We are using...]

This brings us to the end of On the Grapevine's 5-part look at AIDS and the lives it touches.

This is Chong Ching Liang for Newsradio 938.

====================

Newsradio
http://newsradio.mediacorpradio.com/

Action for Aids
http://afa.org.sg

OTGV #18 - Jets & Flats

2005-03-31T14:34:00.000+08:00

Broadcasted on 25/11/02

Singapore used to have civilian airports right in middle of the island.

As the population grew, the airport gets displaced by residential areas, from Kallang to Paya Lebar then finally to Changi.

However, there are some airports which can't be easily moved for national security reasons -- these are the military airports.

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

"I'm sitting in a park off Jurong St 65, under normal circumstances a very quiet, peaceful place where you can scarcely hear the noise of traffic. Occasionally, you can hear the sound of children playing, laughing."

But this remarkable peace is sometimes interrupted according to a couple of residents who spoke.

"It's very noisy because the very sound you know. Sometimes go up no noisy. Sometimes go very low right? That time very noisy. Saturday, Sunday only the children are home, that people no work. That time flight also going very low lah. That time very noisy. Some people take rest in the afternoon. That time also very problem you know."
"The jet planes sometimes disturb the surroundings. My small brother sleeps ah, they have to wake up when they hear the jet planes. Very noisy ah. It's very loud lah. Like so loud that even when baby sleeping still can wake up. It often happens. er, one week five times. [So is there anyway you all can stop the noise from coming to your house?] I think not possible lah."

An Australian acoustic designer Michael Dowsett is amazed that residential flats are built in areas like Jurong West or Paya Lebar at all.

"to be completely blunt and honest, from a planning point of view, the apartment should not have been build there is the simple answer. And in fact, planning control really should exist that really prevent all control of non-compatible land use. And in fact, a number of countries do have that kind of experience of that kind of legislation in place. In fact, in Australia there is an Australian standard that specifies design around the airport where you cannot build residential dwellings. if you are inside certain noise contour, you are forbidden basically to build a residential dwelling area. [9 mins 55 secs] If you are within the zone, you can build but with special acoustic treatment."

Non-compatible land use.

But in land-scarce Singapore, such luxuries are not available.

To be fair, the landing and take off path of the Tengah Air Base F-16s didn't always go over the Jurong West estates.

The jets used to go the other way until Malaysia closed the airspace.

So now we have a slight problem of unsold flats in Jurong West HDB precincts.

The flats are remarkably designed, some with wonderful balconies and huge windows.

But for Michael Dowsett, this constitute a design problem that increases sound.

"It is possible to design in appropriate noise controls depending on the noise source. In this rather extreme case of the F-16s, it really means that the apartments need to be air-conditioned. You can’t have natural ventilation and good acoustic performances. in that situation with the aircraft noise, it really should be brick house concrete or double brick really to sort of get a higher level of treatment. The maximum that you can really get from the double glass that we talk about is a 50 decibels reduction. That’s sort of the limiting factor."

So I ask John Ting, President of Singapore Institute of Architects if Singapore architects design blindly without taking into account the overall environment.

"I am glad you [brought] up this point because we have to get a good balance of the openness in the housing unit to the outside so get air flow and light coming through. At the same time as you said you want the ambient place to be comfortable even for noise level. now you can solve that problem through design also. If you design the balcony probably, you can actually deflect some of the sound out of the unit."

How bad is the noise?

So I visited one of the flats and sample the phenomenon of the passing jets.

"[Sound of TV sets on in the living room.] This is the ambient sound of the home with the TV set on. This is the sound of the jets flying pass the home.[Sound of jets over the TV sound and the ambient sound]"

But there may be some aural reprieve.

The Member of Parliament for the area, Minister of State for Defence, Cedric Foo says there's a possibility of using double glazed windows to shut out the sound.

Of course, to that effectively, it means a fully air-conditioned unit, something that will wreaked havoc with the wallet in such tough recessionary times.

Architect John Ting says one must strike a compromise.

"Of course in the hospital we do that because the room is air-conditioned. Now in the residential unit, you can design the balcony in such a way to deflect some of the noise out instead of reflecting them into the unit. Secondly, if you don't want to close the windows all the time, you can introduce fabrics, thick curtains that are maybe eye-level height so that you still get air coming in, and light coming in but the noise is cut down. Thirdly of course, like you said, we can introduce double glazing into all housing units also so that you can choose to open the window partially and cut down the noise by closing some of the windows."

But it is not that the residents in Jurong West or Paya Lebar are constantly petitioning the government to shut down Tengah or Paya Lebar air base.

While they may be irate about the noise but they are aware of the essential role the F-16 fighters play in protecting the country.

For this, Mr Cedric Foo is grateful that they recognised that the planes are not like a bunch of kids playing football into the middle of the night.

Perhaps, the architects and builders of Singaporean homes must help to solve this problem by introducing appropriate design controls at the pre-construction stage,

and not wait till complaints or sluggish sales come about before thinking about highly expensive retrofitting with sound-proofing materials.

This is Chong Ching Liang for Newsradio 938.

===========================

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OTGV #17 - White Noises

2005-03-31T14:20:00.000+08:00

Broadcasted on 18/11/02

Singapore has over 6 thousand people packed into one square kilometre.

So the lack of personal space and its attendant effects such as noise is something that all Singaporeans grow up with.

Hi, I am Chong Ching Liang and this is On the Grapevine.

This week I discuss with two practitioner on acoustic design in residential developments.

An acoustic engineer, Michael Dowsett explains why neighbourly relations may be impacted if there isn't good acoustic design in modern highrise homes.

"Neighbours aren’t conducive to your requests to please keep the noise down, and we all know what it’s like trying to sleep when there’s a party going on next door. And the fuse gets shorter and shorter and you know, I think that you could certainly say that there’s an increase in annoyance due to the noise can lead to violence and more outbursts and a greater level of dis-satisfaction due to your neighbours."

In these days of high-powered home entertainment systems, President of the Singapore Institute of Architect, John Ting, concurs.

"I think it is an important element because as you pack more people into a smaller area, social interactions will be affected by the noise created by the residents. Put it this way lah, a good of ambient noise is good but you need to control the level and also the intermittent levels created by the hifi sets, or televisions, or mechanism that actually generate loud noise."

Ironically, the advances in building technology has exacerbated the problem of noise.

"Now in the old days, we used to use bricks for partition wall and of course in the old days, people use simple hifi sets. Now with new technologies coming along, people are moving towards pre-fabrication, hollow block walls for example in the construction of the building units. At the same time, sound system are getting a lot more developed now so there will be an increase in the level of noise transfer between housing units."

In developed western countries, there's now a demand for good acoustic design for residential units to prevent excessive noise transfer says Michael.

"as purchasers become more sophisticated, become more aware, become more educated on what they need to consider when they are making a purchase, they need to consider all these factors. It’s like as part of a checklist you know: does it have a kindergarten nearby, does the school bus stop, you know you add is the acoustic performance acceptable? Am I going to grow crazy listening to my neighbour watching his tv at 9 o’clock in the morning. So it depends on the factors that are driving this equation and I think until the developers and designers can see that there is a downside to not performing the acoustic of the performance, they will continue to save money by just installing only what they need to install."

In Singapore, acoustic design are missing in the bulk of the most prestigious private residential developments.

John Ting thinks there may be a cultural reason behind this lack of demand.

"Asians being Asians, culturally we are more tolerant to ambient noise, more tolerant to a high level of noise compared to the westerner. Singapore, for example, the general rule of thumb is that traffic noise and the noise coming in from the outside of the housing estate should be below 60 decibels."

Sometimes the market demand for good acoustic design manifests itself in the form of civil lawsuits.

Michael Dowsett again.

"in Australia for instance it’s more and more apparent to developers and designers, the importance of acoustic treatment. There’s been a number of court cases particularly in Sydney, where residents have actually taken their developers to courts for sub-standard acoustic performance of their dwellings. And that has resulted in certainly greater awareness from developers and in fact providing acoustic performances which is greater than the minimum requirements specified in the building code."

In Singapore, public planning has taken note of the need to reduce the ambient noise levels even though good acoustic treatment hasn't made it to most building designs yet.

John Ting again

"From [a] planning perspective, the HDB also the S-I-A, the professional people are aware of this and as such there are certain planning parametres. We can use the set--back from teh road as one mechanism. Further you are set back from the road the less noise that comes into the unit. One very good thing that we can use which is ecologically very sensitive and friendly is using nature to our advantage by planting thick foliage between the road and the housing unit because the nature the leaves and the trees actually break down the sound waves so that the sound when they comes through the foliage, they actually become muted."

Both experts agree that proper sound proofing at the design stage is important as retrofitting an apartment can prove to be even more costly.

But ultimately, as architect John Ting explains, the definition of what is an appropriate noise level is to be set by the society.

"It's a question of where we draw the line that society at this level we can all agree at this level we can all tolerate. Beyond that let's do something about it. Rather than no white noise at all or don't control it at all. No white noise we probably go abit insane and berzerk you know, because human beings are social animals, need a bit of noise to keep us all more or less in touch with society. But the question is where we draw the line that is reasonable for everybody to say that 'Yes, that's a good level that we can live with and that's a good level that can still allow us to do a lot of things at home without making too much noise."

Tune in to the next programme as I find out if good sound design can tuned out the excessive noise levels of screaming F-16s in a place like Jurong West.

This is Chong Ching Liang for Newsradio 938.

===========================

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Newsradio938
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