The following is a letter to the Today newspaper which was rejected for publication by the paper.
See Leong Kit
I refer to “Overuse of antibiotics leads to the rise of drug-resistant TB in China“ and “Superbug-gene found in New Delhi water raises fear of global spread“ in your TODAY April 8 edition.
Once thought eradicated, tuberculosis has made a worldwide comeback with the worrying emergence of Multidrug-Resitant Tuberculosis (MDR-TB) and Extensively Drug-Resistant Tuberculosis (XDR-TB), both of which are very difficult to treat.
The World Health Organisation has indicated that China, India, Indonesia, Philippines and Vietnam to be hotbeds of TB infection. The majority of our immigrants and migrant workers come from these countries.
Our Health Ministry’s statistics showed that around 1,500 new cases of TB each year were detected among Singaporeans and permanent residents. Foreigners account for another 550 new cases each year.
Even more worrying is the increasing number of TB patients here who fail to complete their treatment. This will lead to further spread of TB and the rise of drug-resistant strains of the TB bacteria.
TB is a highly contagious airborne disease that can be easily contracted in crowded places such as schools, universities, army camps, offices, buses and trains.
While TB affects mostly the lungs, it can spread to other organs such as the brain, heart, bones and even the womb of female victims.
No longer a disease confined to the elderly, TB is now afflicting younger Singaporeans, such as a 21-year old National Serviceman, a 30-year old teacher and a 40-year old managing director.
Amongst last year’s new cases, there were 153 Singapore-born TB victims under the age of 30, of which 12 victims were under 9 years of age.
The writing is on the wall. In 2005, our public were mostly unaware of the following two TB incidents in our schools.
In one case, a primary school teacher with a persistent cough was diagnosed with TB.
Of the at-risk 38 students and 12 teachers sent for TB screening, five students and three teachers were found to have picked up her TB infection.
In the other case, a Chinese national secondary student was found to have TB. Of the 70 students and 10 teachers screened, five were found to have been infected with TB.
As a tiny densely-populated island with hot humid climate, Singapore is particularly vulnerable to the spread of infectious diseases, such as TB, SARS, H1N1, Bird Flu.
Our fight against public health threats must lie in constant vigilance, coupled with a transparent approach and pro-active preventive measures.
There is no room for the type of complacency and too-late reactive measures that we have seen in the Mas Selamat escape debacle.
Concerned Singaporeans certainly expect our Health Ministry to issue a timely and credible public assurance on such important public health issues.
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We eveb import foreign diseases. Great!!!
Too many immigrants in singapore
They may bring in unknown diseases
Then all of singapore will get into trouble and death !!
I am totally disappointed with our lack of health screening at Singapore port of entries. No screening e.g. (SARS) dectectors to detect passsenger arrival from airport, road and sea. I am a frequent traveler in North & Sout Asia. Hong Kong is a very good example that have detectors in place all these while since day one SARs out break.
The govt are taking chances and i do not understand why no precautions are given to Singaporeans as Singapore is a well known place for medical tourism for South East Asia.
It will be a disaster for a tiny densely-populated island with hot humid climate, Singapore is particularly vulnerable to the spread of infectious diseases.
While the author has focused TB, the rise of antibiotic-resistant bacteria has been unchecked, worldwide. MRSA, VRE and a whole host of not-so-benign bugs. Common causes leading to this problem are cavalier dispensation of antibiotics and the incomplete courses of drugs. These are not totally manageable by MOH or any other health agency.
Am adding my comment to posit that Today has not published this letter because it will achieve much and it appears to imply the responsibility lies with MOH to control TB. This is not possible. The way going forward is through public education and even through that, the control is limited.
Let’s not take every opportunity to lambast the government.
Let me try this again, too many typos.
—-
While the author has focused on TB, the rise of antibiotic-resistant bacteria has been unchecked globally. MRSA, VRE and a whole host of not-so-benign bugs are rampant and untreatable in many countries. Common causes leading to this problem are cavalier dispensation of antibiotics and patients not completing the course of antibiotics. These are not totally manageable by MOH or any other health agency.
Am adding my comment to posit that Today has not published this letter because it will achieve little (and may even attract unfair flak) and it appears to imply the responsibility lies with MOH to control TB. This is not possible. The way going forward is through public education and even through that, the control is limited.
Let’s not take every opportunity to lambast the government.
@ Cest La Vie
I don’t think the author was trying to “lambast” the government. As he had written, he was seeking assurance from MOH wrt this issue.
What I don’t understand is why was the Chinese secondary student found to have TB? In a lot of first-world countries, immigrants (except for short-term stay) are required to submit chest X ray to check on TB. That is the case for say, university admission and long-term (more than 6 months) stay.
I would like to know if such long-term immigrants (e.g. domestic helpers, foreign students and S pass holders) are similarly screened?
Dear Ordinary SG,
You are correct, perhaps I have over-extrapolated the issue on government criticism but that is the general propensity.
I tend to think that if short term visitors to Singapore are not screened, it doesn’t matter if you screen those staying around on a more permanent basis. The transmission mechanism for TB or most other infectious diseases make no distinction between period of stay. We can screen the long term stayers but the temporary ones can just as well upset the applecart.
With that in mind, it is in my opinion that screening or not makes little difference. Perhaps a little but am sure into the realm of diminishing economics.
I dont believe no extra new germs or virus strains has been introduced to the population.
This is based on commonsense.
I dont believe 15 April 2011
I dont believe no extra new germs or virus strains has been introduced to the population.
…………
common sense? i just came back from paradise cebu resorts…more than 10% of the locals already caught the cough /flu viruses…
so don’t ASSUMED when you don’t ventured out of kiasu singapoor…
you don’t know..1st 2 act as though you are dr khaw the superman?
part II addon
yes the presymtoms is liked TB…
i know because my former teacher died from TB…
If you work in the Middle East, the first thing they do is herd you to medical centres to screen you.
Regardless if you are a top CEO or labourer, everyone has to jam into packed medical centres where you are medically screened before you can start work.
TB is one of the disease checked for and it is well documented that many Indian sub-continent workers fail the test.
import some more la. not only take our children’s places in schools but infect them with new diseases too.
Cest La Vie
Let’s not take every opportunity to lambast the government.
………..
ok girl you are the boss…
p.s. why on earth do you pay a monthly ramsome levies to the goverment ministry?
just for them to earn their 8 months bonuses perhaps?
you meant if/when the TB flus start spreadin only the poor die 1st?
and do you think where would leekingyou/sons inc be?
in cebu watchin the barpoles dancin perhaps?
where were you when SARs was spreadin?
in vancouver perhaps?
Die! Die! Now we are not just overcrowded in our public hospitals, public transport,
public housing, public parks etc etc our lives are in danger too!
This PAP policy of bringing in over a million migrant workers are killing Singaporeans! This is going overboard!
It leaves us to kick out the PAP or local born Singaporeans will be extinct fast!
this is a most timely and relevant article.
thnak-you.
i just like to highlight that many of our ‘ELITE-HAWKERS’ have taken after our elites’ conduct .
many fo these treat their long-time customers as if they are fools.
they hire brigades of PRCs etc to run their ‘famous’ stalls while they vanish somewhere to make more money,i presume.
not only are we paying more for our food but the food is served by cheap labour and not the famous expert hawkers themselves and so taste inferior even to other less famed stalls.
on top of that,i notice that as the standard of the food go done,so does the level of hygiene.
i guess that;s partly why we see singaporeans couging or sneezing everywhere like there is a perpetual epidemic of sorts 365 days a year?
could our helath authorties allot more frequent and stringent inspections on these hawkers and food-courts to uphold the minimum hygiene standards.
Chikunygaya Virus carried by Indians to Singapore and spread by the Culex mosquito caused an outbreak in Serangoon and Mandai area several years ago…..and this virus ishere to stay.
Now TB and superbugs….why do I have to pay taxes to pay my Minister of Halth up to $4,000,000 per year? ……
It really is scary that the PAP is gambling with the health of Singaporeans…
DEar iBELIEVEDontbeliveisbrainDEAD,
Its not difficult to see you have an axe to grind with the ruling party but let’s stick to the issue at hand, shall we? The 8 months bonus and other related self-enrichment measures for themselves are beyond the scope of this article. How much more taxes, or as you call ‘em monthly ramsome levies [sic] if ICA screens everything coming into Singapore? How much more MRT fare would you like to pay if we, as some have suggested, erect barriers along every single track exposed to passengers? You think we should erect barriers next to all the roads too? I understand what you’re saying but living carries its own risk. If one is risk averse, perhaps staying in all day would be best.
@ Cest La Vie: I am glad that you admit there is a general propensity to be over-sensitive when PAP policies are critised.
As for your assertion that it does not matter if long-term visitors/immigrants are screened, this cannot be true. Commonsense tells us that if a short-term visitor will infect fewer people than long-term stayers, simply because the length of exposure is longer. Moreover, long-term stayers are more involved in communities e.g. attending schools which means that the likelihood of infecting others increases disproportionately.
I suggest you check with PAP’s Penang-born, paid $8-only-for-cardiac-bypass Khaw Boon Kwan, why other first-world countries screen for TB among long-term visitors, but Singapore does not.
Of cos today wont publish.
The FW issue is less of a problem to the PAP.
The main problem is that the so-called FTs are also infected.
FT policy is a PAP religious doctrine.
Reducing the so-called FTs is a big no-no unless GCT is infected by an FT.
Cest La Vie
if ICA screens everything coming into Singapore?
……………………………….
so its all bout money$$$$$$$$$$
right?
the locals are xpendable..the ministers/prataa presidente can continued to get million$/month(combined)
prayed to GOD that you are infected with the new tb virus when your maid start coughin(remember the filipino 1/2way house where many of them are infected with tb virus)…
hav a good cough
than come back to discuss…
ole by the way..did you or your masters in istana arranged a standby airlift or seekin for an overseas invitations..now is the time…bon voyage….
Dear Ordinary SG,
Commonsense is not usually common nor correct but am not suggesting anything more than that.
It is commonly known in epidemiology that there is a window period where the host is infectious (while showing no outward signs of infection) and it eventually leads to a sick host seeking medical help. This is probably the stage where the TB carriers are showing up.
There is no distinction there between a short or long term stayer. A short term visitor can be carrying the pathogen along for the ride, stay for a week or two and become infectious. A longer term stayer could similarly have been screened a month ago in his/her country, cleared the screening, contracted the disease and become infectious overseas. The permutations are uncountable, I won’t over elaborate the cracks here, information abounds on cyberspace.
I understand your point about screening longer term stayers, it should theoretically reduce the incidence of disease carriers. But I’ve earlier pointed out that the infection mechanism is not that straightforward. The way to nip this is to screen every entry in Singapore upon arrival (which even then, a carrier may not show any signs at the earliest stage of infection). Are Singaporeans prepared to stand and wait behind long queues at immigration points for screening, especially after a 12-hour flight, just to return home?
Here’s a treat, you don’t need to simulate an actual screening at Changi or Woodlands or Tuas or HarbourFront to appreciate the shortcomings of total screening at entry checkpoints. The great US of A, under the Transport Security Administration, have done full screening on passengers taking a flight. Ask anyone going through one of these how they enjoyed the process.
All I am saying is that full dependence on screening to halt disease entry is effective only to a certain point.
iBELIEVEDontbeliveisbrainDEAD,
You are getting your political inclinations and science mixed up beyond the point of rational discussion.
Just for the record, am not pro PAP. Policy issues on housing, high cost of living and the entire laundry list of matters the government could have done better irks me as much as it does you. But I do not allow this dissatisfaction to cloud my vision. A spade is a spade…what we are discussing is an issue of science, not politics.
You sound bitter. Perhaps you should consider emigrating instead of complaining and infecting those around you with your disenchantment.
Cest La Vie
You sound bitter. Perhaps you should consider emigrating
……………..
you frickin SELLFISH IDIOT SHOLE…
i already immigrate.. i already hold the british PR…
so YOUR issus is if YOU/your pap masters cannot changed the systems..its automatically singapoorium faults…
i prayed that you get the TB virus…
and when i asked you
WHERE WERE YOU durin the SAR virus…
you had yet to answer me…
@Cest la Vie
The diagnosis of TB can be made via several ways, including chest x-Ray, sputum analysis and tuberculin skin test. Disease progression in affected individuals is not important as active and past TB often shows up in chest x-rays. X-Ray is a cost-effective tool and is routinely used in first world countries.
And Cest la Vie, please do not muddy the issues here by asking if SINGAPOREANS are prepared to stand and wait at immigration points for hours. We are SINGAPOREANS and SINGAPORE is our home, TB or no TB. The issue here is the hordes of foreigners from third world countries that are hotbeds for TB but are not screened at point of entry, and therefore importing TB.
If MOM can think of buying $500 designer chairs for use, the comfortably seated bums should reconsider its entry criteria wrt health requirements. We are talking about exposing Singaporeans to unnecessary health risks simply because PAP wants to bring in a lot of foreigners quickly in slip-shod bureaucratic practise.
MOH will never look into this matters seriously If the vitims are we ordinary folks .
Only when KBW , WKS , LHL , MBT , TCH and so on affect with TB , then they will taken action .
In short , The Shit is not on thier head so far .
Ordinary SG,
An X-ray is not a safe way of diagnosing TB, definitely not worth the risk as the primary method of chest examination. X-rays are just unsafe, period. Subjecting your body to x-rays takes its toll, cellular damage leads to further complications later in life. Not everyone is as cavalier towards x-rays as you are.
The context is on TB and by extension, other infectious diseases. Foreigners, third world countries or not, are all potential carriers of TB and diseases. If immigrations were to screen for every potential infectious disease, we are gonna be in the queue for a long time. Practicality is one consideration, Singaporeans coming home or not.
The other consideration, of course, is cost. Certain ministries may buy expensive chairs, that is their prerogative and there’s nothing any of us can do. There is no strength in argument to say that since they can buy expensive chairs, they can pay for the screening costs. That is not going to happen. You can be cock sure the cost of screening will never be absorbed by the immigrations department. It’ll be borned one way or another by travelers as airport taxes will go up. Hence, there is no merit in dragging in ministers’ 8 month bonuses and other perks they heap on themselves. Its commonly acknowledged that this country’s civil service operates on private sector wages without its correspondent accountability, we all know that. Let’s not expect the government to go out of their way to protect us.
And if you are concerned about latching onto a bug, which you are rightly entitled to, perhaps looking after your health is one area that is solely within your control. As no bug is 100% infectious, maintaining your immune system in tiptop condition has a better chance of keeping the bug at arm’s length than half-baked, reactive measures of screening and what not. Sleeping enough, eating well, exercising, maintaining a balanced mental frame of mind…all these work synergistically to keep you on top of your health. Depending on someone else to look out for you is not what I would do, less so for an elitist government.
This will be my last post. This discourse has been enjoyable but has run its course. Enjoy the weekend.
iBELIEVEDontbeliveisbrainDEAD,
Real class of you. Your missive is so full of mis-assumptions, I am unsure where how to address you. Have a good day ahead.
I have always enjoyed this quote from Robin Williams: “Never pick a fight with an ugly person, they’ve got nothing to lose.”
Kinda had you in mind when the phrase flew across my mind like a news flash ticker.
Cest La Vie 16 April 2011
iBELIEVEDontbeliveisbrainDEAD,
Real class of you. Your missive is so full of mis-assumptions, I am unsure where how to address you. Have a good day ahead.
………..
you says science and politics don’t mixed together?
right?
so why should we pay the pap politicians such high prizes when they cannot even minimised the tb/sar viruses?
the thais did it…the citizens survived the thais crisis without spendin bahts nor a ransome on ALL the sickness and their ministers don’t make bahts on heath in the name of science/educations
and best of all..leekingyou alway proclaimed the thais are full of corruptions within their ministries…
do you see thaksin brin his familly into politics? can you see thaksin stepped down gracefully even after he bein upsurged from his seat as prime minister?
so what is there to MIS-ASSUMED?
ow do you know i am ugly? are you GAY that you self proclaimed to be handsome?
why your nick sound grand make you a smarter person?
The World Health Organisation has indicated that Philippines…blah blah lah…
……………
and did i not posted this remarks below?
just came back from paradise cebu resorts…more than 10% of the locals already caught the cough /flu viruses…
…………
so was i merely bein mislead misassumed or mis-informed?
or maybe i just an idle rumour mongrol perhaps?
………………..
and ere we are another smarta s s posted:
……………..
And if you are concerned about latching onto a bug, which you are rightly entitled to, perhaps looking after your health is one area that is solely within your control. As no bug is 100% infectious, maintaining your immune system in tiptop condition has a better chance of keeping the bug at arm’s length than half-baked, reactive measures of screening and what not. Sleeping enough, eating well, exercising, maintaining a balanced mental frame of mind…all these work synergistically to keep you on top of your health. Depending on someone else to look out for you is not what I would do
………………
so in another words…when you are in the mrt..keep an armed length..ow with a bamboo tekko perhaps? don’t blamed the health ministry nor the manpower ministry..they are too far busy countin levies…
if not the aabove ministries to do somethin…who would do it for us?
Cest La Vie perhaps?
@Cest la Vie
Let me repost my advice to all PAP trolls – please do your masters a favor and check your facts before posting.
Any medical personnel will tell you that long gone are the days when x-rays are considered harmful to the body such that they should be taken only twice a year. Nowadys the amount of radiation emitted by x-rays are lower than the amount one receives during a flight. Moreover x-rays are very cheap. The average mass screening costs less than $15.
So, Cest la Vie, kindly ask MOH and MOM to explain why not all long term immigrants are not required to undergo chest x-rays. Is this oversight due to complacency? Or disregard for citizens’ well-being? Or simply expediency to allow massive importation of foreign workers, TB or no TB?
Vote out PAP. There is no accountability, no transparency.
Cest La Vie, 16 April 2011
maybe you can share some advise on how ordinary folks who are working how to “sleeping enough, eating well, exercising, maintaining a balanced mental frame of mind…all these work synergistically to keep you on top of your health.”
how much sleep is enough, in your opinion? what does it mean to eat well? & what really is a balanced frame of mind?
take your time to reply. people need to know the details to do what you advise. i trust that you live such a life, so at the very least you can share with everyone how you personally do it.
The high density will let these imported disease spread like nobody’s business. SUPER crowded train, one guys cough and sneeze, the rest of us no where to run, all kenna infected. We don’t even have a country-side to run away to.