Thursday, May 5, 2011

Questions on support mechanism for caregivers of the mentally ill always go unanswered: A plea to Prime Minister Lee Hsien Loong


Our Prime Minister has assured all Singaporeans that every segment of our society will be taken care of. But I am still not convinced, given the lack of support that people with mental illness and their caregivers face everyday in their lives.

As a run up to the General Elections 2011, The New Paper ran a series of interviews with the Cabinet Ministers. Readers were invited to query the Cabinet Ministers on a whole range of issues affecting their lives. This was for the series, “ASK THE MINISTER”. More than 2 weeks ago, I posed a question to the MCYS Minister, Dr Vivian Balakrishnan through The New Paper on the support system which caregivers like myself desperately need.

This was my question to Dr Vivian Balakrishnan:

“People with mental illness and their caregivers face huge challenges in their lives: stigma, financial and social support, employability, housing difficulties, crisis intervention and high rate of relapses. Yet the support structure for these marginalized citizens here in Singapore is very weak. Caregivers who are taking care of their loved ones stricken with mental illness often suffer burnout, as I have. What plans do you have to improve the support mechanism for caregivers of the mentally ill so that they can lead a much easier life, given that we make a lot of sacrifices?”


The journalist, one Ms Tay Shian received it and called me to confirm my age & some other details. As expected, my question went unplublished and unanswered. Even the more than the 100 letters that I have written to the press pleading for support for the mentally ill and their caregivers go unanswered. The MCYS Minister answered all other questions, but conveniently chose not to address mine. Why is this so?

Our suicide rates have gone up, and will continue to go up. If you read today's New Paper, you will read yet another report of how a lady wanted to commit suicide because of a failed relationship.

In yesterday's Straits Times Forum Page (ST, Wed 4th May 2011), a caregiver, Madam J Bhaskaran is disturbed by the lack of support in securing help for her stricken relative. Her letter, “In a bind over care for mentally disabled sibling”, strikes a chord with me.

I am at wits end trying to secure support for my beloved wife, Doris whom I love so dearly. Though the journey in taking care of her all by myself is extremely arduous and painful, I have not chosen to given up on her. But it will make my journey so much easier if the Singapore Government gives us the vital support that we so badly need.

In Parliament, a few months ago, Health Minister Khaw Boon Wan replied to a suggestion by an MP - I believe it was Assoc Prof Fatimah Lateef, with regards to a caregivers allowance for people like us. I did in fact raise this issue to the press prior to what the MP suggested. My suggestion, as usual went unanswered. The replied given by Mr Khaw in Parliament to MP Assoc Prof Fatimah Lateef's suggestion was highly insensitive and very hurtful. He said that “giving a caregivers allowance will cheapen the sacrifices caregivers make.”

So, I would ask the Health Minister in what way does giving a caregiver allowance cheapen the caregiver journey? I, like many other caregivers, have made huge sacrifices in looking after our stricken ones. I gave my $2,400 job 9 years ago so that I can give love and care to my wife 24/7. She has 7 chronic illnesses and is at fall risks because of her advanced arthritis condition. In any event, providing such an allowance will raise caregiving to a higher level because many caregivers cannot take the stress of caring for their stricken ones and they choose to place them in homes or put them in IMH. So, let's be sensitive to the feelings of caregivers like us who are prepared to walk the journey despite facing huge adversities in our lonely lives.

My wife who has battled schizophrenia for 40 years has suffered a serious relapse of her mental illness and I am made to suffer all alone. The relapse was triggered by the immense pain she has been enduring from her advanced arthritis condition and due to the lack of support that she so badly needs. The costs is very high: emotional, physical and financial. This is now her 12th relapse.

Doris has multiple chronic illnesses and you can read about it further on my blog. One person that really cared for her is her psychiatrist, Dr Eu, Senior Consultant at IMH. He went out of his way and made special arrangements to see my wife - at the 11th hour. Dr Eu felt my pain as he saw me break down and try to hide my tears. He came out of his clinic and helped me to walk my wife into his room because my wife was feeling giddy and her knees are weak. I was deeply touched by his compassion for another human being.

Dr Eu is trying her on a new drug - “QUETIAPINE 100MG”. Will it work? I really don't know. But I hope so, otherwise hospitalization is inevitable. My wife is extremely frightened and cannot be left alone until she is stabilized. She is like a frightened rabbit. It is extremely pitiful to see her in that condition. Does the Singapore Government understand what I am, and have gone through, bearing in mind that for 37 years I have travelled this journey all alone?

I have seen and read reports of Cabinet Ministers crying publicly: Lim Boon Heng, Lim Swee Say, and most recently, Khaw Boon Wan. But do you all understand that for 37 years I have on so many occasions shed tears and cried myself to sleep as I see my wife suffer horrifically from the ravages of schizophrenia?

I hope that my candid and true life story will inspire, motivate and touch you, because if it does not, than I don't know what will. To build a first class Singapore Government, surely our marginalised communities must find a place in our society.

And as Our Archbishop, Nicholas Chia rightly points out in his pastoral letter to Catholics on the coming GE, “ We must also ensure that the poor, the elderly and the marginalised in our society are cared for .”


Thank you.


Sincerely,


Raymond Anthony Fernando























Saturday, April 30, 2011

Patient with disabilities denied proper medical treatment; sole caregiver suffering burnout

30th April 2011
Introduction

In a rally speech on Friday night - 29th April 2011, Prime Minister Lee Hsien Loong assured all Singaporeans that the government will take care of all Singaporeans, including the low- and middle income groups.

The Prime Minister and his government has also given the assurance, many times, that no Singaporean will be denied proper medical treatment even if they cannot pay for it. But my wife, Doris Lau Siew Lang was denied proper medical treatment at a restructured hospital when she so badly and urgently needed it.

I would like to share this recent heart-breaking incident about my wife as the pain in my heart is unbearable and I am suffering all alone. I can no longer remain silent and the only way to ease my suffering is to write about it. Hopefully, it will touch some peoples' hearts (including the Govt.) and they will come forward and help in whatever way they can so I can lead an easier life in taking care of my beloved wife whom I love dearly. For I have not chosen to give up on my wife even though my 37 years journey in caring for her has been extremely arduous.

Background of my wife's condition

Doris suffers from several chronic illnesses that includes schizophrenia & depression, advanced arthritis, incontinence, stomach polyps, diabetes & high cholesterol. In addition she has to see a heart specialist and an eye doctor. Doris is seeing seven doctors in all. This month alone I had to bring her for 7 medical appointments at hospitals & clinics. Which caregiver would not suffer burnout? Which patient who has to take 45 tablets a day to manage her multiple illnesses wouldn't wear out? Every time Doris has to go for her arthritis treatment, we have spend half a day at the hospital because the results for her blood tests at the lab takes 3 sold hours. I can never understand why this is so. Can't the hospital be more efficient?

Support system for caregivers

It has been an extremely difficult journey for me to care for my wife all alone because our caregivers support system is very weak. Many a time when Doris suffers a relapse, I have to bear the tremendous emotional pain all alone.

My wife and I are Catholics, but we cannnot get the support from our very own Catholic organizations. I have approached the Catholic Welfare Services(CWS) to help us(meals & accommodation) but they say they can't do anything. I asked the CWS to find me a place where I can place my wife in situations where the environment is not conducive(noise pollution) to her mental state; such as when there is upgrading in our estates, be it for the Lift Upgrading Programme(LUP) or Home Improvement Programme (HIP). Or in cases when I have to sell my books and leave her all alone at home. Doris is at fall risks because of her severe arthritis condition. But the CWS have told me to call up all the 30 Catholic churches to find out if there are any places in their churches that can accommodate her. No day care centre in Singapore will take in my wife- even for a few hours. It's been exhausting trying to secure proper cooked meals & support for my wife. For day care centres visits- Rejected. The reason: People with mental illness cannot go to their centres. Is MCYS doing anything about this?

Multiple chronic illnesses due to cheaper drugs
My wife's advance arthritis condition is causing her immense pain and misery, leaving her vulnerable to falling into relapses of schizophrenia and depression – a chronic illness which she has battled for 40 years. Every arthritis drug that is being tested on her is causing more and more side effects.

The specialist at a restructured hospital treating her for her advance arthritis condition has suggested that my wife try out another type of injection that might help to reduce the inflammation and pain of her advance arthritis condition: The Intramuscular Gold Injection. But I am not keen to allow my wife to go on this recommended injection as the side effects are many including itchy skin rashes, ulcers in the mouth and blood and protein in her urine – to name a few.

The only solution is to do another Total Knee Replacement, which is going to cost me $8,000 a 50% rise from $4,000 previously. Doris needs cataract operations (both eyes). Each operation (per eye) is going to cost me $800- $1,000- an increase of another 50%- previously $400 per eye. Little wonder that Singaporeans have valid reasons about rising medical costs.

Go to the A& E for treatment if arthritis pain is unbearable Attempts to reach out to the specialist during periods when my wife is in severe pain of her arthritis is not possible because the doctor has suggested that I bring my wife to the A & E department if my wife cannot bear the pain. What is the point of bringing her to the A&E Department when we have to end up waiting hours on ends, pay $90 and then be told to go back to to see the specialist on another given date? In what way does this solve the problem? Why add more stress on my wife when she is on heavy medication? Moreover the Ministry of Health is discouraging people from visiting the A & E Department. The specialists there are unwilling to see my wife even though Doris suffers unbearable pain because of the hospital's workload. To make matters worse the Patient Services staff who is handling my feedback became defensive and told me that if necessary the A& E doctors can ward my wife in the hospital. Why would I want my wife to be hospitalised when she already has spent a large part of her life in hospital – Warded IMH 11 times in IMH times during our 37 years marriage?

Unemployed Caregiver foots out $1,000
I could not bear to see my wife in pain so I hade no choice but to bring Doris to see a surgeon in a private clinic last week. He gave Doris a Synvisc injection that costs $1,000, but it will reduce her pain and misery for several months. To see the specialist at the restructured hospital for this same type of injection would mean that I would have to wait and wait. But this Synvisc injection would have only cost me about $400 if Doris was given the jab at the restructured hospital. Mind you, I don't have a full-time job. Nobody knows the suffering and hardships that caregivers like us go through to see their stricken ones suffering. For the last few nights, I cry myself to sleep.

Onslaught of mental illness- schizophrenia 
My wife was denied proper and immediate attention because of system problems in the hospital and because doctors there do not want to do a little extra work. The Synsvic injection apparently came too late. As a result Doris is now falling into a serious relapse of schizophrenia. It is extremely pitiful to see her suffer the ravages of schizophrenia. It is only a matter of time because she is hospitalised and when that happens, Doris will have to undergo ECT(Electric Convulsive Therapy). ECT is mild current applied to the brain. Have you seen a patient go through ECT?  I have. It will tear your heart & mind apart.

Symptoms of Doris' relapse of schizophrenia: Doris is extremely frightened, appears lost, cannot concentrate, very depressed, has loss of appetite,fearful, nervous, severely constipated (connected to the mind), and has difficulty sleeping.

If Doris has to be warded in IMH, it will be the 12th time and it is going to cost me at least $5,000. Needless to say the costs for me is very high: emotional , physical & financial. As her caregiver, I will have to suffer all alone for one solid year when she relapses.

To deprive a mentally ill patient who is struggling with a whole range of chronic illnesses of the support that she urgently needs, is sinful and inhuman.

For sure, love is the most beautiful virtue in the world. But love can also be very painful when I see my beloved Doris suffer so much, and I become helpless from the lack of support, the prejudices she faces because of her schizophrenia and the  poor welfare for her. But I know for sure when Doris passes on and goes to heaven, the Lord will always protect her and give her relentless love. In heaven, her life will not be compromised because of multiple chronic illnesses and she will never face any discimination and prejudice.

During the 70s' when my wife had a working career, she did a lot of charity & social work, despite being stricken with schizophrenia and depression at the tender age of 17. Doris visited the homes for the aged, spent time with old folks, the handicapped and comforted all these citizens. I accompanied my wife and also took part in these actvities- encouraged by the love that my wife gave to these less fortunate citizens. As a secretary, she contributed much to the economy. 

For my part, influenced by my wife's caring nature, I have been vounteering my services to IMH regularly. Recently I was also requested by the Community Psychiatry Dept. of IMH to edit some stories written by recovered patients for a publication. I readily agreed despite having to look after Doris 24/7.

Now when we need support, this is how we are treated.

To my readers, please pray for Doris. She is a beautiful human being and does not deserve to be treated in this manner. No human being does. And Doris needs friends who can care for her and give her love because we are living in a very unkind society! A place in which the mentally ill have no place in our society. God Bless!

Sincerely,

RAYMOND ANTHONY FERNANDO
Husband & Sole Caregiver To Doris Lau Siew Lang






















Friday, April 22, 2011

Raymond's letter to The New Paper: Compassion for dying child shows kampung spirit

Last week, a mother and child from China fell from their Bukit Batok flat. This is yet another tragedy that's so heart-wrenching. Read my response to that tragic incident in The New Paper.

Raymond's letter to The New Paper: Compassion for dying child shows kampung spirit


This letter was published today- Friday 22 April 2011, in The New Paper.

I refer to the report, “He watches as 9-year-old slowly fades away” (The New Paper, April 16).

While I am deeply saddened by the tragic loss of two lives through yet another tragedy, I am encouraged by the public spiritedness demonstrated by Mr Phil Devlin.

This Singaporean permanent resident from Australia went out of his way to try to save the life of the 9-year-old girl and comfort her.

It provides a classic example of how the kampung spirit can be revived here.

Mr Devlin proves that those from outside Singapore can not only contribute to the economic growth of this country, but can also play an equally important role in serving the needs of our people.

Though the child did not survive the fall, Mr Devlin's compassion and readiness to help another human being is notable. He should be commended by the authorities.

Such a commendation will go a long way in promoting a sense of caring and mutual concern for one another in our neighbourhoods.

If such virtues can infect everyone in our society, then we may see fewer such tragedies.

The Government, for its part, should provide a better support system for people who are unable to cope with the stresses of life.

Many people either just don't know where to go for help or are unwillingly to seek assistance.

Hence the need to reach out to these vulnerable groups.

RAYMOND ANTHONY FERNANDO

Friday, March 25, 2011

Talented psychiatric patients : Set up museum space for their work

My letter on the above subject was published in The New Paper today- Friday 25 March 2011, page 20.


I refer to the report, “He paints to save his mind” (The New Paper, March 20).

Some of our psychiatric patients are very artistic - as with the case of Mr Sim, a long-staying patient of the Institute of Mental Health (IMH).

I have also seen how a volunteer art therapist at the Singapore Association for Mental Health (SAMH) has trained his clients to excel in art - paintings, pottery and other types of artwork. The paintings are impressive.

Although IMH and SAMH has been supportive in giving their clients a chance to excel in art, we could also explore other opportunities and platforms for them to gain greater exposure.

Some of the artistic talents of these clients are displayed periodically at public forums and other related events.

After these events are over, people tend to forget that there are indeed such patients who can excel in life.

Government agencies can play an important role in helping to destigmatise mental illness.

To this end, I suggest that our national museum allocate a space within their premises that can permanently display the artistic talents of creative psychiatric patients?

This proposed sponsored art gallery will not only allow these patients to earn a decent living, but will send a powerful message - mental illness can be treated.

SAMH and IMH should also explore collaboration between their clients and patients or ex-patients who write poetry.

Then produce a book, Poetic Tapestry that combines colourful paintings matched with creative poems.

The sponsored book can then be sold and the proceeds divided among the clients who created the book and SAMH or IMH.

RAYMOND ANTHONY FERNANDO

Saturday, March 19, 2011

Would prizes encourage more gracious behaviour?

A pregnant lady ask for a seat on the MRT train and gets scolded by an old man.
Raymond comes out in support of the lady. - Here is my reply- published in MediaCorp's TODAY newspaer- Sat 19 March 2011.

I refer to reader Joanne Yeo Swee Tiangs' letter, "Pregnant commuter ask for a seat- and gets scolded" (March 16). I am shocked, saddened and ashamed. I agree with Ms Yeo that public transport operators should work closely with the Government to promote social graciousness.

It looks like all the efforts to promote civic mindedness and courtesy on public transport are not working. Punishing a person with fines or stiffer penalties could cause resentment and bitterness. I propose that the Land Transport Authority, in collaboration with SMRT and SBS Transit, introduce a "role model commuters" scheme in which gracious commuters who willingly offer their seats to the elderly, pregnant women, the disabled and the sick, and even help them get off the buses and trains, can be rewarded.

An annual lucky draw can be held, in which these role models can stand a chance to win sponsored prizes and free travel on board MRT trains and buses. Commuters can nominate those who have acted graciously on board public transport systems, and they too can stand to win prizes.

Photographs of winners can be put up at MRT stations and bus interchanges. The publicity material can read: "Act graciously and stand a chance to win attractive prizes." With this in place, I have every confidence that in time, more graciousness will be displayed on board MRT trains and buses, leaving reserved seats to be set aside for those who need it most, like Ms Yeo.

Raymond Anthony Fernando





Friday, March 18, 2011

Japan's monster tsunami a 'wake-up call' to people : Raymond Anthony Fernando gives his views in The Catholic News

My letter on the above matter is published in The Catholic News. Look out for it  this weekend - Saturday 19th/20th March 2011.



Could massive destruction of the Earth and seabed be the cause of quakes and tsunamis?

I refer to the several reports in the media on the monster tsunami that hit Japan on Friday, March 11.

I am deeply saddened by the loss of lives, property and infrastructures. My heart goes out to the Japanese people, and I hope that many lives can be saved through rescue efforts. Undoubtedly, it is going to take years before the Japanese economy can recover.

The tsunami disaster that hit Asia in 2004 saw 230,000 people, including women and children, killed and the livelihoods of millions destroyed in over 10 countries. They have all perished in a most cruel way.

Despite God giving us such a beautiful world, man continues to pollute the environment. When God gave us this Earth, He created man in his own image and to be the custodian of all living things.

Despite this God-given role, almost every day, the newspapers are full of reports of wars, terrorists' bombings, power struggles, corruption and greed either directly affecting or insidiously taking control of our lives.

While there are wealthy countries in the world, there are still many countries in abject poverty that have increasing numbers of children that are homeless, hungry and have no education.

It is apparent that man has not been taking his responsibility seriously enough to ensure peace on Earth.

I am no engineer, but my gut feeling tells me that the massive pounding and hammering of bombs during raging wars and conflicts, nuclear testing and terrorists' bombings in many parts of the world, could cause much stress to the seabed, making it unstable. It is similar to volcanoes that erupt - too much stress and it will snap.

Such disasters also take their toll on the mind.

According to experts, by the year 2020, depression is going to become the second highest disability worldwide. This prediction is worrying.

However, we have also seen that out of such human tragedies, it is the milk of human kindness that has united people together, against the odds. It is encouraging to read of reports that 45 countries have stepped forward to help Japan in search and rescue missions.

Now, if only countries worldwide can adopt this positive attitude of supporting one another, we will definitely see a much more peaceful and happy world.

World leaders and politicians must not just tackle climate change, but must also go out of their way to find peaceful solutions to conflicts that may arise from time to time in many parts of the world.

Church leaders worldwide could also play a part in influencing politicians to be more tolerant in adopting peaceful resolutions to conflicts.

If this second tsunami is not a wake-up call, then I just don't know what is.

Raymond Anthony Fernando


Singapore 560601

Monday, March 14, 2011

Tidal Waves, Tidal Graves: The Japanese tsunami

The ground has been shaken

The shorelines have changed

The massive destruction

From the furious tidal waves...

That brings tidal graves


The seas that has given sustenance to many

Has now become angry

Thousands have been left homeless

Thousands have died

Millions -worldwide have cried


The nuclear crisis deepens,

The death toll is set to rise

Even from here in Singapore,

I can hear their cries

Is there no end to this nightmare?

Save them, my Lord, I declare

For YOU will surely care


Strangely, through this calamity,

Nations become united

In a world that is often divided

Donations and help is pouring in every hour, every minute

People from across the globe doing a kind deed- bit by bit

We must have unity and love for everyone on earth

Weed out selfishness in our lives

Stretch out you hand

Do it whenever you can

For GOD moves in strange and mysterious ways

And from HIS love and teachings, we must never stray



Sincerely,


Raymond Anthony Fernando

@copyrightraymondfernando2011