KATHMANDU: Rebuilding community facilities like schools and setting up health posts was a key focus of the Singapore Red Cross (SRC) in their efforts to help Nepal, after a 7.8-magnitude earthquake devastated the country in 2015.

But more than two years on, the contribution made by the SRC and their network of more than 15 partners has gone beyond simple rebuilding efforts. The partners – 9 of which are Singapore-based – showcased their work at an SRC exhibition held in Kathmandu on Thursday (May 4) attended by Senior Minister of State for Foreign Affairs and Defence Maliki Osman.

These are three of their stories.

SAVING THOSE WHO SAVED HIS LIFE: MANASLU FOUNDATION’S NIGEL KOW 

For 27 year-old Nigel Kow, it all started with the desire to save the lives of those who saved him.

It was 2014, and the then-third year university undergraduate was leading a climbing expedition to Nepal. In the process of going down a steep cliff, his rope snagged on a rock and his body smashed into the rock surface.

The next morning, he woke up to find himself paralysed from the waist down.

“My mountain guides were so worried for me, so they called in a helicopter and dug out the landing pad,” he recalled. “They saved my life.”

Six months later, the earthquake hit. And despite being in the midst of his final exams and having only S$11 in his bank account, Nigel did not think twice. 

“I found out that the guides’ villages were at the epicentre of the quake,” he said. “And I asked myself, if someone saved my life and now their livelihoods are destroyed, am I going to just take the easy way out and say, let me find someone who can help you?

“I asked my guides, do you want me to come down? And I made myself available.”

He approached friends from his church and school, and together managed to raise about S$8,000 which he used to buy and distribute basic essentials to the guides’ villages – which could only be reached after a one-day off-road bus journey and a three-day trek through mountainous terrain.

In delivering the aid, he made numerous trips to and from Nepal while juggling his studies in chemical engineering at the National University of Singapore. In the process, he also started the Manaslu Foundation together with the mountain guides who saved his life. The foundation is a non-profit organisation focusing on earthquake relief and regeneration efforts in Nepal’s Gorkha district, at the earthquake’s epicentre.

The Manaslu Foundation helped to rebuild and equip five schools and a health post in Manaslu, and Nigel’s next project is to equip the schools with WiFi towers.

“I went in totally blind and knowing nothing,” he said. “I had to learn everything through experiencing it myself, or by asking my guys. That’s why all this would really not have been possible without them.”

Nigel has come a long way from when he first started out. And a big lesson learnt, he said, is that there is no substitute for being on the ground, and seeing the needs of the people first-hand. 

“I could have taken the easy way out, and just transferred money to them,” he said. “But by me literally walking to the village, I can see what they really need.

“It means I can talk to the locals, see the situation there, and feel their heartbeat.”

MAKING GIVERS, NOT RECEIVERS: TOUCH INTERNATIONAL’S SHAWN LIM, EUGENE SEOW AND ERNEST HO

There was no shortage of local volunteers in Nepal when the earthquake first hit, according to TOUCH International’s Shawn Lim. Better still, he said, that they knew the ground and could handle the country’s mountainous terrain.

But the problem, according to Shawn, who was part of TOUCH International’s advance team to Nepal in 2015, lay in managing the volunteers.

“Our partners had a base of one or two thousand volunteers, and everyone was so eager to help their own people,” he recalled. “But they were really disorganised.

“They weren’t even tracking where they sent their volunteers, so there were duplicates, and resources that were unaccounted for.”

TOUCH International had come to Nepal with the purpose of finding out what the needs on the ground were, and meeting them. At the start, this included helping to provide basic essentials like clean water and temporary zinc shelters. But Shawn added that small but significant changes could also be made: helping the partners come up with a system to track relief supplies, roster volunteers and organise an SMS reporting system for the volunteers.

“It may be second nature to us in Singapore, but not necessarily so for them, especially in a crisis situation where people panic,” he explained.

The organisation was also able to tap on their years of experience – whether in responding to natural disasters or in their work in Singapore – to offer more value-added help.

One of their ongoing projects is the rebuilding of an elderly nursing home in Kathmandu. But TOUCH International’s CEO Eugene Seow said the team saw an additional opportunity.

“We didn’t just want to rebuild the infrastructure, but also to change the programme of the place,” he said. “So for example, it could be more than just a nursing home, but a senior activity centre, similar to what we have been running in Singapore.”

“Intergenerational volunteers can also come in, and the stronger elderly can take part in senior activities,” he added. The team is also exploring the possibility of opening a childcare centre next to the nursing home, and having a staff exchange, where staff from the nursing home come to Singapore to see how a senior activity centre works.

Underlying all this, said Eugene, is the team’s focus: to make givers, rather than receivers.

“We want them to go away knowing that after encountering us, they are confident that have been enabled and empowered to do things for themselves,” he explained.

“That has always been the heart of what we do at TOUCH, where we leave behind a community of people who are able to help others.”

HELPING CHILDREN CREATIVELY: AWFUL GRACE’S CHRISTINE TAN

Beyond basic essentials like food and water, another immediate need facing quake survivors in Nepal was trauma counselling. And as a trained counsellor in Singapore, Christine Tan, the founder of Awful Grace, hoped to fill that need in a particularly creative way: art therapy.

In 2015, she teamed up with another organisation named The Red Pencil to bring two art therapists to Nepal to help children – a group she said was particularly vulnerable.

 “Sometimes children don’t have the words to express what they’ve gone through, especially because of the language difficulty,” she said. “And we found that it all came out through the drawings.

“We would have children drawing things like people hiding under tables, things that express their experience in the quake. From there, we could talk to them about their drawing, and identify which children needed more help.”

Her team also trained local volunteers in art therapy and trauma counselling.

As Christine was initially with Prison Fellowship Singapore, she focused on what she described as the “hidden communities”: families and children of those in prison. But last year, she decided to strike out on her own and start Awful Grace so she could expand her reach to help those in the villages these families and children came from.

“Increasingly I was starting to feel that even though these prisoners’ children needed help, there were so many other needs outside as well, so I wanted to do more,” she explained.

Awful Grace also organised a mobile medical and dental clinic and did health screening for the children. But Christine said they had to go beyond meeting the basic needs in the community, and move into sustainable community development.

To that end, she’s trying out a new project after seeing a similar model at a rehabilitation centre she visited: enabling families to run their own goat farms.  

“We identified 60 families in total over 3 years, and we bring them to the rehab centre where they learn how to look after and breed goats and cows,” she explained. “At the end of the training, we will give them a pair of goats and cows and they can start breeding, and after 18 to 24 months, they will return two goats back to us.

“I realised that in order to address the health needs, we need to lift them out of poverty,” she added. “We want to be able to help them help themselves, so the community can be a steward to those around them.”

SINGAPORE: For almost a year now, Nanyang Girls High (NYGH) students have been starting school at 8.15am – a good 45 minutes later than most secondary schools.

And the results have been telling.

The school in Bukit Timah has been taking part in ground-breaking sleep studies conducted by Duke-NUS Medical School researchers – whose studies have shown that 80 per cent of teens here don’t get enough sleep, which affects their health, grades and cognitive abilities. 

It was what the teachers of NYGH had been suspecting all along.

Mrs Ho-Sam Choon Juen, NYGH dean of student systems and info management, said: “For a long time, we’d known that our girls were not sleeping enough because of their academic and extra-curricular demands.

“Some of the teachers’ observations were that they (the students) looked tired and sleepy in class.”

And so, in the second semester of 2016, the school delayed its start time so that students could get proper sleep – tweaking how it ran its curriculum so that they wouldn’t have to end school later.

There is scientific reasoning behind letting teens sleep in later, according to principal investigator Professor Michael Chee.

“Your biological clock shifts when you go into your teen years, you start having a preferred sleep time that’s about one hour later. And this tends to shift back when you reach young adulthood,” said Prof Chee, who is also director of the Centre for Cognitive Neuroscience at Duke-NUS.

So it’s the teen years that are very critical. And this is why we believe that if we start school later, it should be primarily directed at secondary schools.

GIRLS MORE ENERGISED FOR THE DAY

And at Nanyang Girls, 45 minutes has made all the difference, for the students and teachers.

NYGH chemistry teacher Mr Muhammad Imran has noticed a distinct change in the students. The school environment has also become more vibrant in the morning.

“I think that’s because everyone is already more energetic when school starts,” he said, noting that there were fewer sleepyheads in class.

WATCH: How the school did it (4:31)

“The girls might not be necessarily excited about the lesson but at least they’re excited even before the lesson starts – and that makes it a lot easier for everyone, not just the teachers but for students to be more comfortable,” Mr Imran added.

Alexandria Egan, 16, thinks an extra half-hour to sleep has been key to getting her through the school day a lot better. Waking up early used to make her feel lethargic throughout the day. Once, she said:

I was in the toilet and I fell asleep. I fell down and hurt myself.

“At the end of the day I would find myself losing focus and not really catching what the teacher was saying. But now, for my last lesson, I’ll still be paying attention,” Alexandria said, adding she also has energy left over for her CCA after classes.

This reaffirms one study by Prof Chee on how teenagers’ cognitive abilities and mood are affected by sleep. He had 60 students take part in an experiment at the Nanyang Girls Boarding School to document the effects of multiple nights of sleep restriction.

“What we’ve been trying to do in these studies is, firstly, to show that even among very high performing students, sleep restriction to five hours in bed over multiple nights – simulating a school week – can degrade performance.

“There are cumulative declines in your vigilance, speed of processing, executive function – all of which are fundamental cognitive processes around which all other bits of cognition are built,” said Prof Chee.

For Vivien Tan, 16, just knowing the extra 45 minutes is there has led to much better-quality sleep. “Previously I’d go to sleep worrying about my assignments the next day,” she said.

“Now I know that I can wake up with a certain amount of time to study before school starts. It has allowed me to relax at night, so I have really good, deep sleep.”

PLANNING SO THAT SCHOOL DOESN’T END LATER

The case for schools in Singapore to start later has surfaced regularly over the years.

But the arguments against it have always included how this would clash with the work schedules of parents, who would be late getting to the office after sending their children to school. Some also worry if their kids would end school later, while others are concerned if there would be a cut in curriculum time.

Indeed, teacher Mr Imran was concerned about whether his students would be stuck in traffic jams with the office-bound crowd.

My second thought was if we start later, does that mean we’re going to end later and everything is just going to be pushed back – and the cycle continues?

“So I would say that initially my thoughts weren’t great. Honestly, I wasn’t enthusiastic about this,” he admitted.

But NYGH decided to take the bold step anyway. As Mrs Ho-Sam said: “It’s really about the students’ well-being.”

To assuage the concerns of the different groups, the school re-designed the timetable structure, re-distributed the curriculum hours, staggered the recess timing, and changed the assembly to a fortnightly session.

It took about half a year of planning before they rolled out the initiative in mid-2016.

Mrs Ho-Sam said: “We made sure that we did not compromise the curriculum hours for each subject, and that the teachers still have sufficient interaction time with the girls during lessons.

It is about effective and clever use of time as well. We managed to start school later by 45 minutes each day without ending the afternoon later for the girls.

This is important, because the girls still have third-language classes, tuition or CCAs to attend after school.

FOR SOME PARENTS, MORE TIME FOR BONDING

Before the school rolled out this initiative, they engaged parents. Some were concerned because they had other children attending schools that started at the regular time.

These parents were assured that if they needed to continue sending their daughters to school at 7.30am, there would be teachers around for their security.  Said Mrs Ho-Sam: “The teachers are not coming later. Only the students report in later. Even the canteen operates at the same time as well.”

She added that the students who come early “can use the time do their work, or even just chill. They feel that the school hours are not as rushed as before”.

It also works out well for the teachers, who can hold their daily meetings in the mornings instead of during recess time which left them with very little break time, Mrs Ho-Sam noted.

Parent Mr Chng Hock Huat was initially sceptical about the school’s move. Already, the father of five was making multiple trips in the morning to send his kids to school, and he was worried about making huge changes to his schedlue.

“But then I remembered how during our school days, if I was allowed to snooze for another 10 minutes, it was really like paradise. So why deprive my daughter of that?” he said.  

Mr Chng said the later start time has resulted in him sharing a closer relationship with his daughter. “Now we have the privilege of having a nice breakfast at our favourite wanton noodle stall at least once a week (before school). My wife and I can chat with our teenage girl. So it’s really wonderful,” he said.

While he acknowledges that it poses some logistical challenges for working parents, it is great that they are given that option.

There will be parents concerned that with one hour less (of curriculum time), something must give. I think we should remind ourselves, school is not a factory. It’s all about doing more with less.

For instance, he said, “the kids can always come earlier to have their discussion group. The notion of giving them this discretionary time is to allow them to make full use of it.”

BUT CAN THIS BE SUSTAINED?

The catch? Some students are now making use of this extra time to catch up on their work or watch their favourite Youtube shows, said Alexandria.

So are they actually getting more sleep?

Prof Chee’s team tracked about 400 students with time logs and actigraph watches, and surveyed around 100 parents and 60 teachers. They found that the self-reported increase in sleep duration was, on average, around 20 minutes.

“This is on par with studies elsewhere – you get about 50 per cent yield on the gain in sleep,” said Prof Chee.

Whether even this increase in sleep can be sustained is a key question. “Just like with a diet or exercise programme, there’s a honeymoon period that lasts about a year – then after that, you find that unless the person has a substantial change in behaviour that’s internally motivated, you see recidivism into prior behaviour.”

That’s why sleep education is important, he said – as well as the time-use logs, so that students with irregular sleep patterns can eventually be helped with counselling and customised advice.

“Nothing works like success,” said Prof Chee. “If the students, parents and teachers see for themselves the benefits of improving sleep, then you know, we hope that several will come out and serve as advocates or role models for better sleep.”

SHOULD ALL SCHOOLS START LATER?

This is why Prof Chee thinks that it can become possible to roll out this start-late approach to all schools across Singapore.

“I think it’s going to take time but I am optimistic. (Singaporeans) will adjust to what’s good for them, and when they see how well the school does, they will want to follow,” he said.

When contacted, the Ministry of Education said that most schools start their school day at around 7.30am or later. It said that the amount of sleep that students get each night is not just dependent on their waking time but also on their sleeping habits and routine.

The ministry added: “Schools take into consideration their parents’ feedback, transport provisions and traffic situation around their schools to determine their start time.

“Schools are also mindful that starting schools later has an impact on schools’ dismissal time, with lessons continuing during the hotter part of the afternoon.”

SINGAPORE: For almost a year now, Nanyang Girls High (NYGH) students have been starting school at 8.15am – a good 45 minutes later than most secondary schools.

And the results have been telling.

The school in Bukit Timah has been taking part in ground-breaking sleep studies conducted by Duke-NUS Medical School researchers – whose studies have shown that 80 per cent of teens here don’t get enough sleep, which affects their health, grades and cognitive abilities. 

It was what the teachers of NYGH had been suspecting all along.

Mrs Ho-Sam Choon Juen, NYGH dean of student systems and info management, said: “For a long time, we’d known that our girls were not sleeping enough because of their academic and extra-curricular demands.

“Some of the teachers’ observations were that they (the students) looked tired and sleepy in class.”

And so, in the second semester of 2016, the school delayed its start time so that students could get proper sleep – tweaking how it ran its curriculum so that they wouldn’t have to end school later.

There is scientific reasoning behind letting teens sleep in later, according to principal investigator Professor Michael Chee.

“Your biological clock shifts when you go into your teen years, you start having a preferred sleep time that’s about one hour later. And this tends to shift back when you reach young adulthood,” said Prof Chee, who is also director of the Centre for Cognitive Neuroscience at Duke-NUS.

So it’s the teen years that are very critical. And this is why we believe that if we start school later, it should be primarily directed at secondary schools.

GIRLS MORE ENERGISED FOR THE DAY

And at Nanyang Girls, 45 minutes has made all the difference, for the students and teachers.

NYGH chemistry teacher Mr Muhammad Imran has noticed a distinct change in the students. The school environment has also become more vibrant in the morning.

“I think that’s because everyone is already more energetic when school starts,” he said, noting that there were fewer sleepyheads in class.

WATCH: How the school did it (4:31)

“The girls might not be necessarily excited about the lesson but at least they’re excited even before the lesson starts – and that makes it a lot easier for everyone, not just the teachers but for students to be more comfortable,” Mr Imran added.

Alexandria Egan, 16, thinks an extra half-hour to sleep has been key to getting her through the school day a lot better. Waking up early used to make her feel lethargic throughout the day. Once, she said:

I was in the toilet and I fell asleep. I fell down and hurt myself.

“At the end of the day I would find myself losing focus and not really catching what the teacher was saying. But now, for my last lesson, I’ll still be paying attention,” Alexandria said, adding she also has energy left over for her CCA after classes.

This reaffirms one study by Prof Chee on how teenagers’ cognitive abilities and mood are affected by sleep. He had 60 students take part in an experiment at the Nanyang Girls Boarding School to document the effects of multiple nights of sleep restriction.

“What we’ve been trying to do in these studies is, firstly, to show that even among very high performing students, sleep restriction to five hours in bed over multiple nights – simulating a school week – can degrade performance.

“There are cumulative declines in your vigilance, speed of processing, executive function – all of which are fundamental cognitive processes around which all other bits of cognition are built,” said Prof Chee.

For Vivien Tan, 16, just knowing the extra 45 minutes is there has led to much better-quality sleep. “Previously I’d go to sleep worrying about my assignments the next day,” she said.

“Now I know that I can wake up with a certain amount of time to study before school starts. It has allowed me to relax at night, so I have really good, deep sleep.”

PLANNING SO THAT SCHOOL DOESN’T END LATER

The case for schools in Singapore to start later has surfaced regularly over the years.

But the arguments against it have always included how this would clash with the work schedules of parents, who would be late getting to the office after sending their children to school. Some also worry if their kids would end school later, while others are concerned if there would be a cut in curriculum time.

Indeed, teacher Mr Imran was concerned about whether his students would be stuck in traffic jams with the office-bound crowd.

My second thought was if we start later, does that mean we’re going to end later and everything is just going to be pushed back – and the cycle continues?

“So I would say that initially my thoughts weren’t great. Honestly, I wasn’t enthusiastic about this,” he admitted.

But NYGH decided to take the bold step anyway. As Mrs Ho-Sam said: “It’s really about the students’ well-being.”

To assuage the concerns of the different groups, the school re-designed the timetable structure, re-distributed the curriculum hours, staggered the recess timing, and changed the assembly to a fortnightly session.

It took about half a year of planning before they rolled out the initiative in mid-2016.

Mrs Ho-Sam said: “We made sure that we did not compromise the curriculum hours for each subject, and that the teachers still have sufficient interaction time with the girls during lessons.

It is about effective and clever use of time as well. We managed to start school later by 45 minutes each day without ending the afternoon later for the girls.

This is important, because the girls still have third-language classes, tuition or CCAs to attend after school.

FOR SOME PARENTS, MORE TIME FOR BONDING

Before the school rolled out this initiative, they engaged parents. Some were concerned because they had other children attending schools that started at the regular time.

These parents were assured that if they needed to continue sending their daughters to school at 7.30am, there would be teachers around for their security.  Said Mrs Ho-Sam: “The teachers are not coming later. Only the students report in later. Even the canteen operates at the same time as well.”

She added that the students who come early “can use the time do their work, or even just chill. They feel that the school hours are not as rushed as before”.

It also works out well for the teachers, who can hold their daily meetings in the mornings instead of during recess time which left them with very little break time, Mrs Ho-Sam noted.

Parent Mr Chng Hock Huat was initially sceptical about the school’s move. Already, the father of five was making multiple trips in the morning to send his kids to school, and he was worried about making huge changes to his schedlue.

“But then I remembered how during our school days, if I was allowed to snooze for another 10 minutes, it was really like paradise. So why deprive my daughter of that?” he said.  

Mr Chng said the later start time has resulted in him sharing a closer relationship with his daughter. “Now we have the privilege of having a nice breakfast at our favourite wanton noodle stall at least once a week (before school). My wife and I can chat with our teenage girl. So it’s really wonderful,” he said.

While he acknowledges that it poses some logistical challenges for working parents, it is great that they are given that option.

There will be parents concerned that with one hour less (of curriculum time), something must give. I think we should remind ourselves, school is not a factory. It’s all about doing more with less.

For instance, he said, “the kids can always come earlier to have their discussion group. The notion of giving them this discretionary time is to allow them to make full use of it.”

BUT CAN THIS BE SUSTAINED?

The catch? Some students are now making use of this extra time to catch up on their work or watch their favourite Youtube shows, said Alexandria.

So are they actually getting more sleep?

Prof Chee’s team tracked about 400 students with time logs and actigraph watches, and surveyed around 100 parents and 60 teachers. They found that the self-reported increase in sleep duration was, on average, around 20 minutes.

“This is on par with studies elsewhere – you get about 50 per cent yield on the gain in sleep,” said Prof Chee.

Whether even this increase in sleep can be sustained is a key question. “Just like with a diet or exercise programme, there’s a honeymoon period that lasts about a year – then after that, you find that unless the person has a substantial change in behaviour that’s internally motivated, you see recidivism into prior behaviour.”

That’s why sleep education is important, he said – as well as the time-use logs, so that students with irregular sleep patterns can eventually be helped with counselling and customised advice.

“Nothing works like success,” said Prof Chee. “If the students, parents and teachers see for themselves the benefits of improving sleep, then you know, we hope that several will come out and serve as advocates or role models for better sleep.”

SHOULD ALL SCHOOLS START LATER?

This is why Prof Chee thinks that it can become possible to roll out this start-late approach to all schools across Singapore.

“I think it’s going to take time but I am optimistic. (Singaporeans) will adjust to what’s good for them, and when they see how well the school does, they will want to follow,” he said.

When contacted, the Ministry of Education said that most schools start their school day at around 7.30am or later. It said that the amount of sleep that students get each night is not just dependent on their waking time but also on their sleeping habits and routine.

The ministry added: “Schools take into consideration their parents’ feedback, transport provisions and traffic situation around their schools to determine their start time.

“Schools are also mindful that starting schools later has an impact on schools’ dismissal time, with lessons continuing during the hotter part of the afternoon.”

SINGAPORE: In the recent Committee of Supply 2017 debates in Parliament, Senior Minister of State for Health Chee Hong Tat spoke of increasing capacity in the palliative care sector so that “more Singaporeans with terminal illnesses can benefit from palliative care services”.

As more resources and manpower are channelled to this healthcare sector, I sense more Singaporeans asking what palliative care is and how it can benefit patients and their families. More frankly, is it possible for someone to still live a good life when he or she has a terminal illness?

As a palliative care doctor, I often hear patients and their family members say “Doctor, you must do everything”, when they receive dreaded news that the patient’s medical condition is terminal. This is understandable: Families and friends all want the best medical treatment for their loved ones, no matter what the financial costs are, so that he or she can live a little longer and spend more time with them.

The patients themselves have future plans and long-term goals that did not factor in a terminal illness cutting their time short, and want to live a little longer.

A little longer so that a mother can see her child grow up and graduate from school. A little longer so that a father can see his daughter get married. A little longer so that a grandfather-to-be can witness the birth of his first grandchild.

Indeed, medical technology can sometimes offer options to prolong a person’s life and address health problems directly. A surgical procedure can remove a brain tumour for instance. However, the risk to the patient is the possibility of losing some capabilities depending on which functions are controlled by the part of the brain closest to the tumour.

For example, removing the brain tumour may mean losing the ability to speak. In other cases, a longer lifespan may come at the cost of being bedbound and needing assistance with daily living activities for the entire length of a person’s life, with the person consequently losing a sense of autonomy and independence.

There are always trade-offs.

“NOT SIMPLY WHETHER TO LIVE OR DIE BUT WHAT KIND OF LIFE IS WORTH LIVING”

“At those critical junctures, the question is not simply whether to live or die but what kind of life is worth living,” said Dr Paul Kalanithi, a neurosurgeon at Stanford University. Paul was diagnosed with lung cancer and wrote the book When Breath Becomes Air, which became a New York Times bestseller. He passed away in March 2015 at the age of 37.

In his book, Paul shared his experience of persevering with his neurosurgical training and having a baby while undergoing treatment for cancer. His wife Lucy Kalanithi said: “Even while terminally ill, Paul was fully alive; despite physical collapse, he remained vigorous, open, full of hope not for an unlikely cure but for days that were full of purpose and meaning.”

The Kalanithis’ story show us how we can live well in the face of terminal illness. For it depends on which values we hold dear, which shape our priorities and the choices we make.

Some may want to pursue medical treatment so that they can fulfil specific life goals before time runs out, despite the financial and personal costs. Others may want to stop work in order to spend time with family or reconnect with their own spirituality.

A terminal illness may even bring renewed energy and a sense of urgency to work on a meaningful project. For Dr Paul Kalanithi, his terminal illness led to him completing his neurosurgical residency training despite long hours at work. It also led to him and his wife having a baby even though “saying goodbye to your child would make your death more painful”.

WHAT MAKES LIFE WORTH LIVING? WHAT MAKES A TREATMENT WORTH TRYING?

Regardless of our individual goals, holistic care for people facing terminal illnesses will have to include not only medical treatment that improves the biological health of a person including chemotherapy and various surgical procedures, but also palliative care.

But what is palliative care? According to the Centre of Advance Palliative Care in the US, palliative care is defined as “an extra layer of support” to “improve the quality of life for both the patient and the family” that is “appropriate at any age and at any stage in a serious illness and can be provided along with curative treatment”.

Palliative care is a growing healthcare field internationally, as both public awareness and dedicated resources in this area increase. In Singapore, as the capacity, accessibility and quality of palliative care improve, we will hopefully increasingly be able to live well and lead better lives in the face of terminal illness.

One important aspect of living well is having meaningful relationships with our loved ones. Chief executive of Assisi Hospice Choo Shiu Ling said: “Advanced dementia and life-threatening conditions impact patients and their caregivers more significantly as they not only have to deal with disease symptoms, but also the loss of personhood, life aspirations and cherished interactions with their families.”

It is useful therefore that palliative care aims to foster meaningful interactions with loved ones through better management of pain and discomfort that accompanies symptoms such as breathlessness, as well as better emotional support for caregivers and patients. This second part is just as important as the first.

For it includes having serious conversations between doctors and patients and their families on what the treatment options are and the trade-offs involved in prolonging a person’s lifespan, which may bring more suffering after a painful procedure or because of medication side-effects. Ultimately, these necessary but difficult discussions help patients decide for themselves what makes life worth living and what makes a treatment worth trying.

Such serious conversations that reaches into the depths of a terminally ill patient’s hopes and fears can in turn help doctors formulate a treatment plan that is in line with the patient’s values and has the best chance of helping patients achieve their goals. So palliative care can help patients make the most of life even in terminal illness.

To me, when we are able to live well, then we can honestly say that we have well-being.

This well-being stems from knowing that we have not wasted our lives but have used it for good, that we have spent quality time connecting with loved ones and that at the end of the day, with a life well-lived, we find peace within ourselves.

Dr Grace Yang Meijuan is a consultant at the National Cancer Centre of Singapore’s Division of Palliative Medicine.

SINGAPORE: Lee Kuan Yew School of Public Policy Associate Dean Donald Low apologised yet again to Home Affairs and Law Minister K Shanmugam on Wednesday (May 10) for a Facebook post on the minister’s comments that penalties for crime must reflect public opinion, calling his initial apology on the issue “insincere”.

In an exclusive interview with TODAY last month, Mr Shanmugam said that the Government must pay heed to how society feels about the punishment meted out in criminal cases. “But it doesn’t mean automatically you agree with it. You must assess it, whether it is also fair. So there are two parts to it – one, whether it is fair; two, what does the public believe is right.”

Mr Low shared the TODAY article on his Facebook page that same day, stating that “making laws on the basis of public opinion is populism by another name”.

Mr Shanmugam soon responded, saying the economist had “seriously misconstrued” what he had said.

A day later, Mr Low apologised in a second post, saying that his initial comments were “mostly a reaction” to the headline of the TODAY article which he thought did not represent Mr Shanmugam’s position accurately. “I had read the piece in full, but didn’t give your comments sufficient attention in my post. I apologise for that,” wrote Mr Low.

The academic’s third public post on the issue comes about two weeks after his last comment.

“I have spent several days reflecting on my conduct, in putting up a commentary that was neither accurate nor honest,” he wrote. 

“I attributed to him views the very opposite of what he held, and then criticised him in a sneering tone.”

Mr Low also called his initial apology a “non-apology” that was “insincere and self-exculpatory”.

“I tried to claim I was commenting on the headline and not his remarks, when my comments clearly showed otherwise. [When I sent the apology, to make my apology appear true, I also deleted some comments I had made in my FB, which showed that I was in fact commenting on his remarks].”

He said he had written again to the minister to convey his “unreserved apology”. 

“I had misrepresented your views in the TODAY article, and had presented them in a careless, thoughtless and flippant way. To make things worse, my apology was self-exculpatory. I accept that my criticism of your views was untruthful, unfair and unsubstantiated. I have let the LKY School down. But above all I’m sorry for my original post; it was impulsive and reckless,” the reproduced letter to the minister read. 

Mr Low also said that when he was out of a job in 2012, it was Mr Shanmugam who gave him a recommendation for his current position.

“I decided that I should come clean about someone who had in fact helped me, and I should set out the facts in public.”