We refer to the report on live-in caregivers (“Elderly sick turn to foreign, live-in caregivers”; Dec 27, 2016).

We recognise the work done by foreign caregivers in caring for patients in their own homes, which supports ageing in place.

However, we would like to clarify that these nurses are not registered with the Singapore Nursing Board and are not on our register of qualified nurses in Singapore.

Families requiring nursing procedures for seniors at home can get in touch with the Agency for Integrated Care’s Singapore Silver Line on 1800-650-6060 to be referred to an appropriate home nursing provider.

Families can also check with the provider on whether their nurses are registered with the Singapore Nursing Board.

Tan Soh Chin (Ms),

Registrar

Singapore Nursing Board

This article was first published on Jan 03, 2017.
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Six years ago, Damien Foong was born at the stroke of midnight at Mount Alvernia Hospital while revellers all over Singapore rang in the new year with fireworks, making him one of the first four babies born in 2011.

Today will be another first for Damien – he will be starting Primary 1 at Kuo Chuan Presbyterian Primary School in Bishan.

Yesterday, his father, IT manager Donovan Foong, 46, prepared Damien for his first day at school by taking him for a haircut, buying school supplies and packing his bag.

Mr Foong said he is confident that Damien can adapt to school fast.

“Psychologically, I think he is ready. He is an outgoing boy and tends to make many friends.”

Read Also: Dramatic birth for first Singapore baby of 2017

Still, he is slightly worried that Damien, who turned six on Sunday, might face problems when it comes to academics since he is the youngest among his peers.

Under the Compulsory Education Act, children born between Jan 2, 2010, and Jan 1, 2011, both dates inclusive, have to enter Primary 1 this year.

In contrast, Damien is not worried.

“I am excited about school and want to make new friends.”

Prime Minister Lee Hsien Loong yesterday posted an Instagram message for students who are starting school: “For those starting in a new school, be yourself, get to know your classmates and teachers, and enjoy your new adventure.

“For those returning to school, I wish you an inspiring year of discovery and learning.”

This article was first published on January 3, 2017.
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Whoever said you can’t teach an old dog new tricks has never met 10-year-old Butter.

In the past six months, the mixed breed canine has learnt to raise the alarm whenever Ms Stella Chew’s blood sugar levels fall to a critical low – even if its owner does not notice it herself.

Ms Chew, 37, began researching online and training Butter as a diabetic alert dog when she was diagnosed with Type 1 diabetes last June.

Now, the financial technology consultant is helping to train the dogs of other diabetics free of charge, so as to help them better cope with the chronic illness.

Many people with diabetes – especially Type 1 diabetics, whose bodies are unable to produce insulin – are prone to hypoglycaemia, when blood sugar levels become too low.

“You start to tremble or become incoherent, and your body tends to go into panic mode,” Ms Chew said.

“One time, it happened when I was sleeping and I was struggling to get up and broke out in a cold sweat.”

But now, Butter, trained to pick up the smell of someone having low blood sugar levels, acts as an early warning system, alerting Ms Chew with a lick or nudge before the symptoms start.

The dog has even nudged her awake at night when she was fast asleep and had no idea her blood sugar levels were low.

While diabetic alert dogs are not uncommon overseas, especially in the United States, they are almost unheard of in Singapore.

They also tend to be expensive, costing several thousand dollars.

Rather than buying a dog, Ms Chew trains people’s dogs or works with them to pick a suitable dog from a shelter.

Such a canine must be intelligent, have a “natural confidence and sense of responsibility” and, of course, a sharp nose.

She learnt to train Butter with help from people on online forums.

She would freeze saliva samples when she is in a hypoglycaemic state and later thaw them for Butter to sniff and get acquainted with the smell.

Ms Chew is now working with four people, and hopes they will pass on the knowledge when their dogs have mastered the skill.

One of them is Irish national Caitriona Evans, who heard about what Ms Chew was doing through KK Women’s and Children’s Hospital, where her 13-year-old daughter, Caoimhe, was going for treatment.

She and Ms Chew visited a local shelter, and she adopted a dog which had been abused.

The dog has since “progressed tremendously” and is starting scent training to pick up the smell of someone having a hypoglycaemic episode, Mrs Evans said.

She said of her daughter: “With the dog, she’ll be able to live alone – and if it doesn’t work out, the dog will still be part of the family.”

There is no accurate way to predict when someone might have a hypoglycaemic episode, said Dr Ben Ng, an endocrinologist at Arden Endocrinology Specialist Clinic.

Instead, many people rely on warning signs such as sudden drowsiness or trembling hands.

They also plan ahead – packing sweet food with them if they are going to exercise, for example, which can cause blood sugar levels to drop and trigger an episode.

But people may not react in time, said Dr Ng.

“Hypoglycaemia can come on very suddenly and be dangerous, so any effort to reduce the number of episodes a person might have is a good idea,” he added.

linettel@sph.com.sg

This article was first published on January 3, 2017.
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Last month, news of Deputy Speaker of Parliament Charles Chong undergoing a liver transplant took many people by surprise.

Three years ago, the MP for Punggol East, 63, was diagnosed with a severe form of non-alcoholic fatty liver disease (NAFLD) – steatohepatitis – but did not make it public.

While NAFLD is an unfamiliar term to most people, a recently released study by SingHealth doctors found that its incidence is rising in Singapore, and could well be affecting half of the adults here.

This could put more people at risk of liver failure or cancer, the main causes of which are hepatitis or heavy alcohol use.

But the damage caused by NAFLD is similar.

Professor Pierce Chow, the lead doctor in the study, said it suggested that the rate here could be higher than the Asian average of about 30 per cent of adults.

While the causes of the disease are not clear, people with NAFLD tend to have hypertension and high cholesterol levels – the same risks for heart disease, diabetes and obesity.

The study looked at Singapore General Hospital patients who had surgery to remove their gall bladder, a pear-shaped organ that sits next to the liver, for the periods 2001 to 2004 and 2011 to 2014.

From the pre-operative scans of the earlier group of 127 patients, 40 per cent had NAFLD. Ten years later, 57 per cent of the 99 patients had it.

More patients in the latter group also had high levels of cholesterol – 46 per cent versus 19 per cent.

Almost half of the patients in both groups had high blood pressure.

The study, published online on Dec 20 prior to a print version by the Singapore Medical Journal, said it was “a significant increase” and that intervention is needed to prevent NAFLD’s progression to more advanced liver disease such as liver cirrhosis (hardening) and hepatocellular carcinoma (liver cancer).

Prof Chow said fatty liver disease is a growing concern in many developed countries that face increasing obesity.

In the United States, NAFLD is the third most common cause of liver cancer after hepatitis and alcoholic liver disease.

Because it has no symptoms, NAFLD is rarely discovered until much damage has been done.

Researchers also found that the more obese the person, the higher the risk of having a fatty liver. Indians also appear to be at higher risk.

According to the National University Hospital, which carries out the bulk of liver transplants here, “common causes of liver failure include hepatitis B, cirrhosis, cancer and autoimmune disease”.

There are about 60 people waiting for a liver transplant, about five times the number 10 years ago.

Last year, 38 people had such transplants.

salma@sph.com.sg

This article was first published on January 3, 2017.
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Brunei’s Attorney-General’s Chambers has engaged Senior Counsel Hri Kumar Nair from Singapore to help with a complex corruption case that involves a Malaysian mastermind, officials from Brunei Shell Petroleum (BSP) and more than B$5 million (S$5 million) overall.

Mr Nair led a team from Drew & Napier, including Mr Navin S. Thevar and Mr Edwin Soh, in the case against Sabeli Ismail, 56, a senior official with BSP who had worked for the company for more than 34 years.

The law firm’s chief executive, Senior Counsel Davinder Singh, had acted on behalf of Brunei’s Attorney-General in August in a related trial.

The case was “part and parcel” of continuing efforts to weed out corrupt elements and practices in BSP, noted the presiding judge.

Last October, Sabeli pleaded guilty to six graft charges, with an additional five taken into consideration, all of which occurred in 2008.

He had created work orders for the purchase of various items from Musfada Enterprise for which he received B$30,250 (S$30,250) in total and caused B$51,200 loss to BSP.

Five charges, related to him pocketing another B$21,500, were taken into account.

He was convicted and jailed for four years concurrently on each charge last month, fined B$30,250 and ordered to pay B$50,000 in costs.

In judgment grounds last month, Brunei’s chief magistrate Muhammed Faisal Pehin Dato Kefli underlined “the importance of the oil and gas industry to Brunei’s economy and the status of BSP as a public body within that industry”.

BSP accounted for more than half of Brunei’s gross domestic product and 90 per cent of its total export earnings, a court had heard in an earlier related case.

Sabeli is the second of eight suspects to be convicted in the complex large-scale graft case being probed by the authorities in Brunei since 2009.

Mr Singh had, last August, prosecuted former BSP employee Aidah Tengah, 44.

She was jailed for three years on appeal for corruptly receiving bribes totalling B$200,200 from David Chong, the manager of Musfada Enterprise, a key BSP contractor.

Musfada supplied items such as oil spill kits, box pallets and safety equipment.

Chong, a Malaysian who orchestrated the bribes paid between 2007 and 2009, was sentenced to six years’ jail in 2013 for his role.

Legal practitioners said the engagement of lawyers from a top Singapore law firm suggested the premium placed on the case by the Brunei government.

Said Association of Criminal Lawyers of Singapore president Sunil Sudheesan: “We should be honoured that Brunei has chosen one of Singapore’s leading private-sector lawyers to prosecute an important case there.

“It is no surprise as Brunei had engaged Mr Singh before and Mr Nair is one of his most esteemed colleagues.”

vijayan@sph.com.sg

This article was first published on Jan 03, 2017.
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About a month before Emily (not her real name) was due to appear in court last November for a maintenance trial, she was shocked when she found that her husband had cancelled her Dependant’s Pass (DP) in the midst of their separation.

After four years of calling Singapore home, the 51-year-old British mother of one faced a four-week deadline to leave the country and her teenage daughter, who has yet to finish school here.

This method of “getting rid” of expatriate spouses by terminating the pass was becoming more common, but for the past half year or so, there have been more cases where the courts prevented this tactic, said lawyers.

They attribute this change to a growing awareness of the predicament of trailing spouses in divorces or separations.

In Emily’s case, after a tense two-week wait, the judge ruled that her British husband was to reinstate her pass for two years, she said.

“I want to stay here for my daughter, who still has 18 months back at school,” said Emily, who lives with her 17-year-old and is looking for a job here. “My husband travels often, and a child needs her mother.”

SIM University senior lecturer Yvonne McNulty said that in her research involving 252 expat spouses going through divorce in Singapore, about 100 either had their DPs cancelled or been threatened with cancellation.

The three-year study ended last year.

She added that with a minimum of three years needed to finalise divorce here, the DP holder is at “a clear disadvantage with the law” if he or she loses the pass in the first month of separation.

But she said that the number of reinstated passes remains a “very small number” and more can be done to stop the cancellation of spouses’ DPs.

When an expat moves here, his or her company sponsors the Employment Pass.

The employer of the expat – who is typically male – then sponsors his wife and children as dependants on his pass, which he can ask to cancel any time.

Divorce cases in Singapore with at least one party of a different nationality rose from 31 per cent of cases filed in 2011 to 40 per cent in 2015.

British permanent resident Catherine Rose Yates, who set up a support group for expats going through separation, said her group has grown from some 250 members in September last year to more than 300 now.

Most members have children, making separation complicated due to care and custody issues, she said.

But she has seen at least three cases in the past two or so months where the courts ordered a spouse’s DP to be reinstated for the duration of the proceedings, she said, “so the other party can have a fair trial”.

Lawyer Yvonne Sweeney, whose expertise includes cross-border divorces, said: “It’s been happening more and more in the past six months.”

Calling such rulings “a significant move” for access to justice, lawyer Franca Ciambella said: “It also makes it a more level playing field as the working spouse can no longer use (the pass) as extra leverage to force the non-working spouse to accede to their demands.”

This will allow the trailing spouse to remain with his or her children as well, and have an option to work here, she added.

Family lawyer Foo Siew Fong said: “The court has always placed the welfare of children as paramount. It is certainly not in the interest and welfare of the children if their mother is forced by circumstances to leave them behind.”

Kate (not her real name), a Kazakhstani who managed to enforce a court order to reinstate her DP last month, said this was important as she could represent herself in court proceedings.

She has a two-year-old son.

The 26-year-old added: “By cancelling my DP and forcing me to leave Singapore, my ex-husband was trying to separate me and my child (using the system).”

byseow@sph.com.sg

This article was first published on Jan 03, 2017.
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