Roll Call on 29 April 2009

We have just completed our emergency roll call to particularly update the department on the situation connected to the Swine Flu pandemic.

Traige Station will be set up from tomorrow April 30 at 8am and temperature screening will be put in place at the same time. Temperature taking are to be carried out twice a day from tomorrow onwards.

HIS, like all the other departments in the hospital, is required to nominate helpers to cater to this need. HIS Manager Christopher Teo has nominated everyone in the department to assist should the need arises.

The first group of HIS staff that has been earmarked to service this are the Loose Filing and Processing teams. Non-critical work will be cut-back or shut down.
IDHIS staff will support CDC.

TTSH CEO Dr Lim Suet Wun will be conducting a series of townhall talks the whole of tomorrow and all staff are to attend one of the sessions. The townhall talk is targeted at addressing the Swine Flu Epidemic hitting the shores of Mexico and America.


Other measures to be put in place are:

1. GSS and Night porters to wear masks during their rounds of duties.
2. Action plan for front counter staff still pending confirmation from HR.
3. Staff on medical leave are to provide the list of relevant information to HR.
4. Everyone is to go see a doctor when sick.
5. Team support for absentees is essential.
6. Infection control like hand washing is our responsibility.
From now till June, HR will be tracking all leave. Department's leave forecast is to be submitted to HR. Staff are advised to delay or postpone travel plans

FLU - The Fight Belongs To Each Of Us

FLU - a little word with such a strong impact when left unchecked. We have recently been taken back to those dark days in 2003, when the SARS virus struck so many of us and affected our lives in so many ways, some of which never to be to the same as they were before.

We knew some of those who had succumbed to it. We have worked alongside them here in Tan Tock Seng Hospital. We were in the thick-and-thin of it all, from the battles within the hospital to the battles against the public, who had shunned us for the simple reason that we were employees of THE hospital, where all the action took place.

Listening to the recent reports of the Swine Flu outbreak brings back floods of memories and I feel this is the right time to bring across some simple messages and practices that will go a long way to protecting ourselves and our loved ones.

For those who were here when SARS took us by surprise, we know the importance of protection. For those who have joined us after SARS, it is hope that the importance of such practices and safeguards are not lost on them. They are the only protection we have.

No one can promise you that you will never get hit with another cold or suffer another bout of flu, but you can increase your odds of staying well with some simple strategies.

While contracting a simple cold will not kill you, they can weaken your immune system to the extent that it allows other more serious germs into your body. Consider the number of times your cold has turned into bronchitis or a sinus infection. On average, an adult suffers two colds a year. Now think, that's a lot of opportunities for some serious illness, don't you think?

Here are some tips which may go along way to help you keep flu at bay.

1. Wash Your Hands and wash them as often as possible. This can cut down respiratory illnesses by up to 50 percent.

2. Dry Your Hands In Public Toilets because a shockingly large percentage of people fail to wash their hands after using them. And guess what? Every single one of them touches the door handle on the way out. So, please use a paper towel to turn off the tap. Use another paper towel to dry your hands, and, another to open the door.

3. Get A Flu Shot Every Year. It is the best prevention strategy for influenza. This is particularly important for people at risk of serious complications that may result from flu. This includes you and I, those in the healthcare settings, those with chronic conditions such as diabetes, asthma, kidney problems or heart disease, people aged 65 and above and pregnant women. People whose immune system is considerably weakened should also consult with their doctors about getting the flu shot.

4. Carry Hand Sanitiser With You. Colds are typically passed not from coughing or kissing, although these are two modes of transmission, but from hand-to-hand or hand-to-object contact, since most cold viruses can live for hours on objects. You then put your hand in or near your mouth or nose, and voila! You're sick! Carry hand sanitiser with you so that you can clean your hands anytime.

5. Change Your Toothbrush Every Three Months because your toothbrush can be a breeding ground for germs. It is a good idea to replace it after you've had a cold or flu to prevent re-infection.

6. Put A Box Of Tissue Wherever People Sit so that when anyone who has to cough or sneeze or blow his nose will do so in a manner that will least likely spread germs. Do not let aesthetics thwart you.

7. Use Your Knuckles To Rub Your Eyes as they are less likely to be contaminated with viruses than your fingertips. This is particularly important given the fact that an average person rubs his eyes between 20 to 50 times a day.

8. Sneeze And Cough Into Your Arm Or Tissue. Whoever told us to cover our mouths when we cough or sneeze got it wrong. That just puts the germs right on our hands, where you can spread them to objects and other people. Cough and sneeze into your elbow if a tissue is not handy.

9. At First Hint Of A Cold, launch yourself into the following preventive blitz:

a. Suck on a zinc gluconate lozenge until it melts away and continue to suck on one every few hours.
b. Cook up a pot of chicken soup.
c. Roast garlic in the oven, drizzling some olive oil over the whole coves and wrapping it with baking foil.

It is everybody's responsibility to take care of one another. Let us be pro-active in this aspect of flu prevention and arm ourselves with these simple protective measures. What's more - it may just win you the Subaru Impreza - as part of the hospital drive to promote hand hygiene.

What You Need To Know About Swine Flu

What Is Swine Flu? Like humans, pigs get the flu. Four different type A swine flu strains commonly circulate among pigs. Most recent swine flu viruses have belonged to the H1N1 and H3N2 subtypes. Pigs typically get sick but usually don't die from swine flu.

The new swine flu virus infecting humans is very unusual. It's somehow acquired genes from swine, bird, and human flu bugs. And it's also got genes from Eurasian swine flu viruses that aren't supposed to be in North America.

Do Humans Get Swine Flu?
Normally, swine flu bugs don't infect people. Historically, there's a case every year or two in the U.S. among people who have contact with live pigs.
The new swine flu virus is different. It's not yet clear that it's here to stay. But it is infecting humans, and that has world health officials keeping a close eye on it.

What Are the Symptoms of Swine Flu?
Swine flu symptoms are similar to regular flu symptoms and include cough, sore throat, fever, chills, headache, and fatigue. Some patients have also reported nausea and diarrhea. There is no easy way to distinguish swine flu from other types of flu or other germs. It takes a lab test to tell whether it's swine flu.

Can Swine Flu Spread From Person to Person?
The U.S. residents infected with swine flu virus had no direct contact with pigs. The CDC says it's likely that the infections represent widely separated cycles of human-to-human infections.

I Got a Flu Shot. Am I Protected Against Swine Flu?
No. There is currently no swine flu vaccine.

It's possible that the seasonal flu vaccine might provide partial protection against H3N2 swine flu bugs. But the strain that appeared in California is the H1N1 swine flu strain. It is very different from the H1N1 human flu strain included in the seasonal flu vaccine.

It's not known whether previous infection with human type A H1N1 flu might provide partial protection against the type A H1N1 swine flu in the current outbreak.

How Serious Is the Public Health Threat of a Swine Flu Epidemic?
Any flu epidemic is worrisome, especially when a new strain of flu bug is involved. Influenza A viruses new to the human population that are able to efficiently transmit from person to person and cause illness may represent a pandemic threat.

It's worrisome that, unlike seasonal flu, the swine flu outbreak in Mexico is attacking healthy young people. That's a hallmark of pandemic flu bugs.

But it takes more than a new virus spreading among humans to make a pandemic. The virus has to be able to spread efficiently from one person to another, and transmission has to be sustained over time. In addition, the virus has to spread geographically.

Is There a Treatment for Swine Flu?
Yes. While the swine flu bug is resistant to older flu medicines, it remains sensitive to Tamiflu and to Relenza.

Can You Get Swine Flu by Eating Pork? No. You can only catch swine flu from being around an infected pig -- or, if it's the new swine flu virus, from an infected person.

Unconventional treatment of diarrhoea by Juliana Lim

When someone gets diarrhoea, sometimes the solution is so easy, we
wonder why anyone has to suffer.

The secret is in rice water. This is already known in this region. Ask your maids -- Sri Lankan,

Indonesian, Filipina and they would know about it.

(My mother) knew about it. When Dr Albert Winsemius came to Singapore for a farewell and thank you dinner in his honour, he brought along his wife Aly and his granddaughter, Jolijn. Both women came down with very bad gastroenteritis. They saw the doctor who gave them medication. It was slow to work.

Mother boiled some rice in lots of water and went to their hotel with two 1.5L bottles of rice water.

I cringed in shame at the offer of this folk remedy, which seemed so primitive to me. Never heard of this cure before. To my surprise, it worked, and they were even able to go out for dinner the next day. Both were exclaiming how the rice water did the trick of making them well again. Well, lucky it worked, I thought to myselff.

I was discussing this some years back with Kim Ng, the ex-matron of KK Hospital. She said, yes, that is what Professor Wong Hock Boon, the notable paediatrician teaches. I was shocked and made some comment how could he? It was common knowledge so what had he to do with it?

Many months later, I regretted laughing at it. Dr Christina Shanta
Emmanuel, who is the CEO of...uh, which group I have forgotten. Either
National Health Group, or Polyclinics, or whatever.. regarded me
seriously when I brought up the topic like it was good fun. She said
that Prof Wong Hock Boon had presented a paper on it. At some
conference. After he had done clinical trials.

Then his results were published in the Lancet, the Medical Journal all
doctors read. In fact, said Shanta, he was credited for saving the lives
of 2 million African babies by this method.

Ah, so! I am impressed.

It is rice water and not rice, that does the trick. I have found it
effective again and again. You take a handful of rice and boil it in a large saucepan with lots of water. Like three or four large glasses. Then you cool that and drink the water. If you are in a hurry to relieve the ailing person, take the saucepan off the fire and dunk it in a frying pan or basin of cool water with ice cubes if necessary.

This gives the patient a chance to drink the rice water sooner and cure himself or herself sooner.

When drinking the rice water, make sure there is lots of it. You have to
tell the patient that enough water must go in to line your guts from
throat to other end, all 10 to 12 metres of it. If you take rice, it
stays in the stomach. If you take broth, some of it may go into the
small intestine.

But if you take rice water, it will carry rice grains to every inch of
your small and large intestine to the end where the problem is.
How does it work? Even Prof Wong Hock Boon doesn't know.

Read the attached file. Or go to
http://rehydrate.org/dd/dd06.htm#page2

CONGRATS! Suryani, On The Birth Of Your Baby Girl

We received news this morning that our beloved friend and colleague, Suryani Binte Taib, gave birth to a healthy baby girl last evening at Kandang Kerbau Children and Women's Hospital.

Little Junior is the latest addition to Suryani's other six children. She weighs 3.255kg at birth and was delivered at 9.20pm on 21 April 2009. Mommy is now admitted at Ward 81, Bed 16.

On behalf of everyone in HIS, I would like to congratulate you on the fruition of this wonderful journey of life. To the little girl we say "Welcome to the world". We wish both mother and child the best of health and a wonderful life ahead.

World Voice Day

Did you know there is a day in the annual calendar known as 'WORLD VOICE DAY'? I didn't. It was after I came across an article in Mediacorp's TODAY newspaper that I realized there is such a day. And you know what else I discovered? That our healthcare professionals have been marking this day since 2002. How's that for news!

Anyway, leaving the surprise factor aside, World Voice Day was on April 16 and this year's theme is 'Invest In Your Voice'.

When you think about it, your voice is a really critical tool of communication but most people tend not to give it much thought unless they use it professionally on a day to day basis. Or perhaps, until they start to lose their voice or get it all hoarse and scratchy.

This year's theme is a good one because it draws your attention to the need to take some time to listen to our voice instead of other's for a change. Of course, paying attention to our voice is something we should do everyday, especially since our vocal cords can be damaged so easily.

Dr Paul Mok, a Voice Specialist from Alexandra Hospital remarked that "people don’t realize that our vocal cords can vibrate many times in a single second. The more we shout, strain or abuse the voice, the faster the vocal cords will slam against each other, resulting in a swollen and inflamed throat".

He also said, "Most times, if you lose your voice, it will come back within 48 to 72 hours. But if the problem that causes the voice to degenerate continues, there is no chance for recovery and irreversible changes can happen to the vocal folds such as scarring, permanently dilated blood vessels and so on".

Sounds scary, bit it is something we can avoid. After all, the problem does not lie in how much we talk, but the way we talk and whether we practice good vocal habits. This is good news for heavy users of the voice such as those who love singing and talking like singers, teachers, actors and lawyers.

For them, speech therapist Kristen Linnemeyer, also from Alexandra Hospital, recommends doing frequent vocal exercises such as the tongue trill or lip roll as effective ways to warm up the voice and keep it in good condition. Relaxing the neck muscles and physical massaging of the throat is also a good exercise.

"Most importantly", she added, "you have to be in tune with your voice, how it sounds and how it feels. Most people get into trouble with their voice when they try to force and overcome what's naturally going on".

When you are already down with the flu and sore throat, there is no instant cure. The body needs time to heal. The key is to rest and drink plenty of fluids and stay away from smoke to avoid inflaming the throat.

Try some of these warm up exercises.

A Low Focussed Breath: http://www.entnet.org/AboutUs/upload/Breath-Relaxation.wmv

A Jaw Release: http://www.entnet.org/AboutUs/upload/Jaw-Release.wmv

A Lip Trill: http://www.entnet.org/AboutUs/upload/-0831836.wmv

A Tongue Trill: http://www.entnet.org/AboutUs/upload/Tongue-Trills.wmv

A Sample Guide: http://www.entnet.org/AboutUs/upload/Two-Octave-Scales.wmv

An Example Of Sirens/Kazoo Buzz: http://www.entnet.org/AboutUs/upload/Siren-Kazoo-Buzz-2.wmv

An Example Of A Cool Down: http://www.entnet.org/AboutUs/upload/Cool-Down.wmv

You can visit this website if you want to know more: http://www.entnet.org/HealthInformation/aboutVoice.cfm

H.I.S. My Care Certified Trainers

March 2009 saw four of our colleagues receiving their certifications to officially certify them as My Care 6S trainers. The four are, Yvonne from CCU, Tzuu Ling from CMU and both Abduh and Schneider from MROps.

They received their certificate at a specially organized ceremony graced by none other than our very own CEO, Dr Lim Suet Wun. Well done gals and guys!

Thomson Road

Thomson Road (Chinese: 汤申路 Tangshen Lu) is a major trunk road linking Singapore's central business district with the northern suburban areas.

Taking its name from John Turnbull Thomson, a Scotsman who was the Government Surveyor and Chief Engineer of the Straits Settlement from 1841 to 1853 and who helped build many roads into the interior of the island beyond the core of the city centre in the south.

Originally known as Seletar Road (the later of which is now the name of a small road off Yio Chu Kang Road in Seletar Hills Estate), it was known to the Chinese as Chia Chui Kang, literally meaning "freshwater stream" in reference to the Kallang River which crosses the road in its upper reaches near the traditional core area of present day Ang Mo Kio.

Thus, it was also known as Ang Kio Tau, meaning "head of the red bridge", the same bridge which may have given Ang Mo Kio its name. It also had a Tamil name, Thanir Pilei Sadakku, literally meaning "water-pipe street".

Today, the road begins at a major road junction with Keng Lee Road, Kampong Java Road, Cavenagh Road and Norfolk Road, and leads northwards through the Novena residential area. It passes by Toa Payoh before continuing on as Upper Thomson Road (汤申路上段 Tangshen Lu Shangduan) at the junction with Braddell Road and Lornie Road.

It skims along the western edge of Bishan and Ang Mo Kio, then cuts through relatively undeveloped areas until it reaches the junction with Mandai Road, where it continues northwards via Sembawang Road.

It is also the site of Saint Joseph Institution International, Ministry of Youth, Singapore Polo Club and many more.

The History of Sentosa Island

Sentosa was once known as Pulau Blakang Mati, which in Malay means the "Island (pulau) of Death (mati) from Behind (blakang)".
The name Blakang Mati is rather old but may not have been founded in the nineteenth century as generally believed. In fact, there exists an island that was identified as Blacan Mati in a 1604 map of Singapore. Other early references to the island of Blakang Mati include Burne Beard Island in Wilde's 1780 MS map, Pulau Niry, Nirifa from 1690 to 1700, and the nineteenth century reference as Pulau Panjang (J.H. Moor). However, early maps did not separate Blakang Mati from the adjacent island of Pulau Brani so it is uncertain to which island the sixteenth century place names referred.

The island has gone through several name changes. Up to 1830, it was called Pulau Panjang ("long island"). In an 1828 sketch of Singapore Island, the island is referred to as Po. Panjang. According to Bennett (1834), the name Blakang Mati was only given to the hill on the island by the Malay villagers on the island. The Malay name for this island is literally translated as "dead back" or "behind the dead"; blakang means "at the back" or "behind"; mati means "dead". It is also called the dead island or the island of the dead.

Different versions of how the island came to acquire such an unpropitious name abound. One account attributed the ominous name to murder and piracy in the island's past. A second claimed that the island is the material paradise of warrior spirits buried at Pulau Brani.

A third account claims that an outbreak of disease on the island in the late 1840s almost wiped out the original Bugis (The Bugis are the most numerous of the three major linguistic and ethnic groups of South Sulawesi, Indonesia's third largest island) settlers on the island. Dr Robert Little, a British coroner investigating the deaths, stumbled upon what was called Blakang Mati Fever, purportedly a type of fever caused by miasmastic (bad air causing disease) fumes arising from decaying leaves and swampy water on the island. This event led to a controversy in medical circles at that time as to the causes of what was later recognised in 1898 as malaria spread by the Anopheles mosquito. The government's malaria research station was originally located here.
A fourth interpretation is that "dead back island" was so-called because of the lack of fertile soil on the hills.

In 1827, Captain Edward Lake of the Bengal Engineers in his report on public works and fortifications had proposed an alternative name for Blakang Mati as the "Island of St George". However, the island was seen as too unhealthy for habitation and his proposed name was never realised.

In a 1972 contest organised by the Singapore Tourist Promotion Board, the island was renamed Sentosa, a Malay word meaning "peace and tranquility".

Pre 1945
In the nineteenth century, the island was considered important because it protected the passage into Keppel Harbour. Plans to fortify the island as part of the defence plan for Singapore were drawn up as early as 1827, but few fortifications actually materialised until the 1880s, when the rapid growth of the harbour led to concern over the protection of coal stocks against enemy attack. The forts built on the island were Fort Siloso, Fort Serapong, Fort Connaught and the Mount Imbiah Battery.

The western end of Pulau Blakang Mati, the place where Fort Siloso is now, used to be called sarang rimau (the tiger's den). Salusuh is a kind of herb used as a remedy in childbirth, but there is no explanation of how the fort came to be so-called, the orang laut of Kampong Kopit only knowing the place by the name of sarang rimau. By the 1930s, the island was heavily fortified and a crucial component of Fortress Singapore, and the base of the Royal Artillery.

During the Second World War, the island was a British military fortress. The British set up artillery guns in Fort Siloso that were then pointed to the south, facing the sea in expectation of a seaward Japanese assault. However, the Japanese eventually invaded and captured Singapore from the north, after having done the same to Malaya (now known as West or Peninsular Malaysia). Following the surrender of the Allied Forces on February 15, 1942, the island became a prisoner of war camp, housing Australian and British prisoners of the Japanese.

During the Japanese Occupation, under the Sook Ching Operation, Chinese men who were suspected, often arbitrarily, of being involved in anti-Japanese activities were brutally killed. The beach at Pulau Blakang Mati was one of the killing fields.
1945-1972
After the Japanese surrender in 1945 and the return of Singapore to British rule, the island became the base of the locally enlisted First Singapore Regiment of the Royal Artillery (1st SRRA) in 1947. Other locally enlisted men from Singapore were sent to the island for basic military training before being sent to other units of the British Army in Singapore.

Ten years later, the 1st SRRA was disbanded and its guns dismantled. The coast artillary was replaced with Gurkha infantry units, first the 2/7th Duke of Edinburgh's own Gurkha Rifles and later the 2/10th Princess Mary's own Gurkha Rifles. Fort Siloso and Fort Serapong became a Catholic retreat and a Protestant church house respectively. Fort Connaught was left in ruins.

In the early 1960s, during the Indonesian Confrontation, the 2/10th unit defended the island against Indonesian saboteurs. With the end of the Confrontation in 1966 and the withdrawal of the Gurkha units from the island, the British handed over Sentosa to the Aingapore Armed Forces of the newly independent Government of Singapore in 1967.

In 1967, Pulau Blakang Mati became the base for the Singapore Naval Volunteer Force, which relocated there from its old base at Telok Ayer Basin. The School of Maritime Training was also set up there, as was the first Naval Medical Centre.

In the 1970s, the government decided to develop the island into a holiday resort for local visitors and tourists.

In 1974 the Singapore Cable Car system was built, linking Sentosa to Mount Faber. A series of attractions were subsequently opened for visitors including Fort Siloso, Surrender Chamber wax museum, Musical Fountain, and the Underwater World. The causeway bridge was opened in 1992 connecting Sentosa to the mainland.The Sentosa Monorail system was opened in 1982 to transport visitors to various stations located around the island. On 16 March 2005, the monorail service was discontinued to make way for the new Sentosa Express, which commenced operations on 15 January 2007.