Tuesday, November 19, 2013

Raymond Anthony Fernando’s two letters to the press on improvements to healthcare & a safer environment

Two of my letters appear in the press today–one to MediaCorp’s TODAY Newspaper on how we can help maids and familes live in a safer environment; and the other on how we can improve or mental health care system. These are efforts to improve systems here and need to be taken in the right context.

Letter 1 - To prevent tragedy, provide better support for maids

The report, “Maid detained after teenager found dead in flat” (Nov 15), may signal a worrying trend, given that there have been several cases of maids implicated in harming their employers’ families.
We must do all we can to help maids, who leave their families behind to earn a living. If not, we would eventually be unable to bring them to our shores.
Also, members of a family who lose a loved one cruelly can fall into depression. It is not easy to cope with grief.

Many of our maids come from developing countries. They may be unable to adjust so quickly to our lifestyle and the demands of looking after our children, which many Singaporeans and foreigners depend on maids to do, as they work long, draining hours.

As a precautionary measure and to make our homes a safer place, maid agency staff should make periodic visits to see how the maid is coping. The staff must also be trained in basic mental healthcare, so that they are able to pick up warning signs that maids may display.

Maid agencies should also be given the telephone numbers of helplines, so domestic workers could secure help as and when needed.

Employers who are worried that their maids are distressed could be given the option to send them for counselling. This is to pre-empt any tragedy from taking place and help both maid and employer live in a safer environment. It should be taken in the right context.

Ultimately, let us strive to make Singapore the best home to live, work and play, not only for ourselves, but also those who give us the support we need.
Raymond Anthony Fernando

Often it is not that our citizens do not want to take care of their health, it is sometimes beyond their control, so we need to be sensitive to those with special needs. I have suggested in my letter to the press – given below, for collaborations between doctors. MOH could undertake this as a Quality Control Circle (QCC) or WIT (Working Improvement Team) project. Ultimately, if this proves successful, there can be improvements in the bed crunch, reduction of patient loads at clinics/hospitals, and the turnover rate for doctors and nurses will be reduced.  There can also be a reduction in costs ­–both on the part of Government spending on health care; and for the consumer.  Although it will take effort and resources to undertake these collaborations, I believe it’s a good investment and it should be taken positively.   We must look 5, 10 years down the road – more so with a rapid ageing population coming on-stream.

Recently, I’ve been having severe pain in my left arm – something like electric current running to this arm, and the doctor advised me to get it checked as I could be having nerve problems.

My wife is seeing a total of 7 doctors; has an average of 8 medical appointments in a month and takes 54.5 tablets a day, and I’m suffering from severe exhaustion.
As caregivers, we do our utmost to support our loved ones, but often we have to pay a heavy price. And it’s not that I have not been pleading for caregiver support. A good mental health care system must look into the welfare of caregivers who make huge sacrifices to support their charges. Do we have that here?

I’m also helping my twin brother who has a wife and a 3-year-old son. All have mental illness, and I’ve made this known to Dr Vivian Balakrishan. 

We need politicians –– ministers, MPs who feel for our marginalized citizens and show empathy.

I will never understand why it is so daunting to secure caregiver support. Yesterday, a teacher and her husband wrote to the Straits Times saying how they have bee struggling to take care of their two  autistic sons, and mentioned that her husband now has 4th stage cancer.

Thank you.


Raymond Anthony Fernando

(2) Letter to The Straits Times:  Help those who cannot help being sick

My letter to The Straits Times on the above matter is published in the Straits Times, today, Tuesday 19th November 2013.

Although some chronic illnesses can be prevented with a healthy diet and exercise, there will always be people who cannot prevent illnesses from disrupting their lives.

Studies have revealed that the prevalence of diabetes and its risk factors is much higher among patients with serious mental illnesses.

Schizophrenia and some other mental disorders, such as bipolar disorder and depression, arise when there are chemical imbalances in the brain.

Research also reveals that the cause of some mental disorders like schizophrenia is genetic.  If the condition does not affect one generation, it may hit the next. This is the case with my wife, whose parents did not have schizophrenia but her grandmother did.

It is also a known fact that all medication have side effects.

During my wife’s visits to the polyclinic and Tan Tock Seng Hospital, the doctors discovered that her sodium level was low, leaving her at risk of getting fits.  According to the doctors, this was caused by some of the psychiatric drugs she has to take every day.

Yet, my wife has no choice but to consume her medication.

The solution is for the Ministry of Health to intensify research and get specialists, general practitioners and psychiatrists to collaborate better, so that those with illnesses they have no control over will not have to see more doctors than necessary.

If this proves successful, it would help ease the current bed crunch and patient load at clinics and hospitals.

We must remember that no one chooses to stay unhealthy.

Raymond Anthony Fernando

This is also an interesting letter from another ST reader –Ms Li Dan Yue, who responded to my earlier letter to the press where I asked for grants to be given to patients and caregivers to tell their stories. It’s some consolation that my message is getting across to some kind souls who feel for us.  This is what makes for an inclusive society.

New perspective of the mentally ill
This letter on the above matter was published in The Straits Times on Tuesday 19th November 2013.
I read with interest Mr Raymond Anthony Fernando's letter ("Help the mentally ill tell their stories"; Forum Online, last Tuesday).
In 2009, I worked for a year as an advice and welfare services volunteer in London, helping people to fill in welfare benefits forms.
Among my clients were those with bipolar disorder. Whenever I had to work with them, the staff would tell me to sit close to their cubicles so I could run and call for help if necessary. Hence, I thought these people were dangerous. How wrong I was.
I once met a woman with the condition. At first glance, she did not seem different from any other person and sat through a three-hour interview with me and answered half the questionnaire in a logical and clear manner.
Later, she revealed she had bipolar disorder that was controlled by medication. She said that when the effects wore off, she would have to take a new dose or isolate herself so she did not hurt her five-year-old son or other people.
She said people would usually stare at her strangely when they saw her taking her medication.
At the end of the interview, she expressed her gratitude towards me for not treating her differently.
Mental illness is still very much a taboo subject in our society today. I admit that I used to judge people with mental illness, but my year of working as a volunteer has given me a whole new perspective of them.
Li Dan Yue (Ms)


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