NSFs escape death by minutes

SINGAPORE - Just 15 minutes after the 19 full-time national servicemen (NSFs) got off the bus, it exploded.

But the driver of the CNG-fuelled bus died from complications arising from his burns four days later, a coroner's inquiry into his death in the August 2010 incident heard on Wednesday.

Mr Chan Beng San, then 56, had picked up the group of NSFs from Jurong Camp 1 at 6.45am on Aug 13, 2010.

He had ferried them to the Poyang Range at Old Lim ChuKang Road and the group alighted at 7.05am.

The group had smelled something similar to petrol or fuel when they boarded the bus earlier.

They alerted Mr Chan but he dismissed it and even suggested that some previous passengers could have brought durians onto the bus.

He then drove the bus away from the range. About 15 minutes later, the group, which had left some items behind in the bus, called Mr Chan's mobile phone for help.

It was answered by someone who told them that the bus had exploded.

Investigations also revealed that the explosion could have happened while Mr Chan was still in his driver's seat and the bus was on the move.

The explosion, which started at the front of the bus, was so great that all the seats in the bus were pushed backwards.

The windscreens were completely shattered and the roof above the door and the driver's seat were completely burned.

A witness who was driving along the same stretch of Old Lim Chu Kang Road spotted Mr Chan sitting on the road, a short distance away from the front of the burning bus.

The witness pulled him away from the bus to the side of the road and called the police.

When they arrived at the scene, officers found that Mr Chan could not speak and was disorientated.

He was rushed to the Singapore General Hospital by ambulance for treatment.

Complications

Mr Chan suffered burns on 39 per cent of his total body surface area. He underwent burns excision and skin grafting the next day.

But he faced complications such as acute renal failure and acute respiratory distress, in his recovery post-operation.

He died of broncho pneumonia on Aug 17.

Investigators later found a gas leak at a joint between the nut and the valve of some black tubing recovered from the rear left compartment of the bus.

There was also a part missing and this meant gas could have leaked out from the joint between the nut and the connector.

The gas had seeped into the passenger cabin of the bus and accumulated at the front of the bus, investigations showed.

An inspection of the bus also found a dashboard- mounted cigarette lighter near the driver's seat.

The court heard that the dashboard-mounted cigarette lighter wasn't part of the bus and that Mr Chan may have mounted it himself.

He was the only driver of the bus since its registration.

The eight CNG cylinders mounted on the roof of the bus were found intact.

The investigation report did not specify what sparked the ignition.

Design lapses

State Coroner Eddy Tham concluded that it was likely that CNG fuel had leaked at the joint of the tubing and had accumulated inside the bus.

An ignition of the leaked CNG fuel into the interior of the bus had resulted in the explosion at the front of the bus, followed by fire that went through the bus, he said.

He also said that the missing part on the tubing could have resulted in the gas leak.

The bus, owned by Sun-Gee Travel (SGT), was still under its one-year warranty.

Though its remaining 22 buses did not have missing parts, investigations by the Land Transport Authority (LTA) revealed that there were other several non-compliances to LTA's pre-registration approval standard in the design of the CNG buses.

The buses were impounded on Aug 24.

The bus manufacturer, Xiamen King Long, acknowledged that there were indeed lapses in their CNG bus design.

The 22 impounded buses were returned to SGT to be converted into diesel-powered ones in January last year. The licences for the buses were reinstated on July 25 last year.

Mr Chan's family members were not present in court during the inquiry.

They also declined to comment when The New Paper visited them at their home yesterday evening.

Struck with lymphoma cancer at 23

SINGAPORE - June 2009 started out like any other school holiday for Mr Raymond Tan.

Then 23 years old, he had just finished his third year in theatre studies at the National University of Singapore (NUS) and was lazing about at home and hanging out with friends.

He had one more year to go before graduating. He had no idea what he wanted to do after that but he was not overly worried. Life stretched out in front of him and things would just fall on his lap, he thought.

He was, however, feeling a little down because his 80-year-old grandmother, who had raised him, died at the end of May that year. She was diagnosed with stomach cancer about six months earlier. He comforted himself with the thought that she had led a long and relatively happy life.

But it turned out that his grandmother's death was not the only bad news to hit him that school holiday. Something else happened which changed his world forever.

On the third day of his grandmother's wake, he woke up with a throbbing pain in his chest.

When it would not go away after he took painkillers, he went to see the family doctor, who found nothing but advised him to go to the hospital's accident and emergency department.

He said: "I felt a bit worried. I thought I was on the verge of a heart attack. My father has a history of heart disease while my grandfather died many years ago from a heart attack."

But at the hospital, he was not prepared for what he saw on the X-ray of his chest. He said: "There was a black mass about the size of my fist near my heart."

The doctor told him it was likely to be cancer.

The next three days, as he waited for the result of the biopsy, were the closest he felt to death because he did not know how serious his condition was.

Depression 

When the results came back, he was somewhat relieved.

The doctor told him he had an aggressive form of lymphoma cancer called mediastinal large B-cell lymphoma, which was growing on the lymph nodes in his chest. The rare cancer tends to occur in the young.

It was at a relatively early stage as the cancer had not spread beyond the lymph nodes.

The good news was, mediastinal large B-cell lymphoma tends to respond well to treatment.

Over the next six months, he went through six cycles of aggressive chemotherapy, once every two weeks, followed by 20 rounds of daily radiotherapy.

When his hair came out in clumps after the first chemotherapy cycle, he shaved it off. His worst experience came after the third cycle.

Mr Tan, who describes himself as a fairly optimistic person, said the nausea and vomiting was so bad he sank into depression.

He said: "I was vomiting every few hours. I couldn't hold down any food except for a piece of bread or biscuit." Negative thoughts abounded.

He said: "I thought about my peers going on with school and wondered why this had to happen to me."

As his illness had occurred during an outbreak of influenza, his mother, a 62-year-old administrative clerk, forbade him from having visitors to prevent him from catching the flu from them.

Mr Tan resented the isolation and having to depend on everyone else. He had to be accompanied each time he went for a chemotherapy session. One of the chemotherapy drugs made his head feel prickly, almost as if he had eaten too much wasabi.

His mother took unpaid leave for his first two weeks of treatment and then for each of his chemotherapy sessions.

She lost almost as much weight as he did as a result of exhaustion and worry. After she went back to work, his aunt came by every day to cook lunch and dinner for him.

Touched by the concern of those around him, he slowly emerged from his depression.

His twin brother, who was then studying economics at NUS, would tell him jokes and show him funny videos to make him laugh. His father, a 69-year-old operations manager, and his sister, a 32-year-old senior executive, would often ask about his health.

Whenever possible, they also took turns to drive him to the hospital for his check-ups.

Slowly, he started to feel stronger and was able to go for radiotherapy on his own.

When it all ended, his doctor said he had responded well. Six months after his diagnosis, he was able to go back to school for his final year of studies and graduated in December 2010.

He now works as a relief teacher in a secondary school and writes movie reviews for magazines as a sideline.

But he wants to do more. He is now pursuing a master's degree in counselling, something which he had considered but did not pursue until now.

His goal is to be a counsellor who works with young people or other cancer survivors.

He said: "Having cancer makes you very focused on what you want in life. You realise that your time here is limited. There is a sense of urgency and you don't muck around anymore, waiting for things to fall on your lap."

His diet and lifestyle have also undergone a change. He pays attention to what he eats.

He said: "I eat more greens and I think twice about eating fast food, ice cream or fried hawker food such as char kway teow."

Regular exercise is now part of his life, when it did not use to be. He goes to the gym twice a week for about an hour each time during which he jogs on the treadmill and does weight-lifting.

He said: "To prevent a relapse, I have to live healthily and responsibly. I cannot afford to take chances."

Disease which mainly affects the young

Mediastinal large B-cell lymphoma is a rare form of lymphoma cancer, accounting for about 2 to 3 per cent of all lymphomas, according to the National Cancer Centre Singapore (NCCS).

For unknown reasons, it tends to occur in young people aged 25 to 40.

It leads to swelling of the thymus gland and lymph nodes in the mediastinum.

This is the part of the body inside the chest, between the lungs and behind the breast bone.

Symptoms are breathlessness and discomfort in the chest.

It is a high-grade lymphoma, which means it grows rapidly and needs to be treated immediately.

The good news is it responds well to treatment, which is usually a few chemotherapy drugs combined with a monoclonal antibody, a class of agents that target specific proteins on the surface of cancer cells and stimulates the body’s immune system to destroy these cells.

The NCCS found that after treatment, more than 80 per cent of its patients remained in remission after five years.

Mediastinal large B-cell lymphoma belongs to group of lymphoma called diffuse large B-cell lypmphoma, which is the most common type of lymphoma cancer in Asia.

Lymphoma cancer is a cancer of the lymphatic system, which is part of the body’s immune system that helps fight infection. The lyphmatic system includes the thymus gland and the lymph nodes.

Lymphoma cancer, of which non-Hodgkin’s lymphoma is the most common, happens when lymphocytes (a type of white blood cell found in the lymphatic system) grow in an uncontrolled way.
There are two main types of lymphocytes – B-cells and T-cells.

Cancer involving B-cell lymphocytes are more common.

Diffuse large B-cell lymphoma is the most common type of aggressive non-Hodgkin’s lymphoma.

Source: Associate Professor Lim Soon Thye, the deputy head and senior consultant at the department of medical oncology at the National Cancer Centre Singapore
 
On Nov 18, the 26-year-old will be taking part in Run For Hope, a fund-raising event for cancer patients.

While cancer is not a good thing in itself, he said it has taught him invaluable lessons. He said: "I appreciate my family more and I am more empathetic towards people in general."

RUN FOR HOPE 

Join a 3.5km or 10km run to raise funds for NCC Research Fund, which is managed by National Cancer Centre Singapore.

Details
Date: Sunday, Nov 18
Location: The Padang, 7am 
Price: $45 for an adult; $25 for a child/youth aged five to 18; Buddies special ($80 for two adults); Group special (20 adults or more - $35 each). 
Children below the age of four have free entry.

Sign up or donate on Runforhopesingapore.org 

Cancer drug helps multiple sclerosis patients, trials show

PARIS: A drug initially developed to treat some types of cancer now appears to help people suffering from multiple sclerosis (MS), a study said Thursday.

The drug, alemtuzumab, proved effective in patient trials at reducing relapses -- a key feature of MS which sees symptoms appear sporadically.

In one trial, patients who received the drug "were nearly half as likely to relapse within two years than those who received interferon", the most commonly-used MS drug, said a statement by The Lancet medical journal which published the research.

A second trial had similar results.

The outcome "offers the prospect of substantial improvement in quality of life and a better future for thousands of people with MS," said Alastair Compston from the University of Cambridge, principal investigator on both studies.

Many MS patients already use alemtuzumab, even though it has not been licenced for this purpose.

Both trials were Phase III, which is the final testing stage in a process to vet a new drug. Together, the two involved some 1,400 patients.

About 100,000 people in Britain and about 400,000 in the United States are believed to suffer from MS, which sees the immune system attacking the body's own nerve fibres.

This affects vision, movement, balance, sensation, bladder control and eventually also memory and thinking.

About 85 percent of patients start with a form of the disease known as "relapsing remitting" MS, with symptoms appearing sporadically (a relapse) before fading away again.

There is no cure, and existing drugs seek to reduce symptoms, said the statement. Success of a drug is measured by a reduction in the frequency of relapses.

The researchers found that alemtuzumab, licenced to treat leukaemia, appeared to increase the risk of certain auto-immune disorders, particularly those affecting the thyroid, but said these could be treated effectively.

The Lancet, in an editorial, said the results were encouraging but added that there were concerns that licencing the drug for MS may lead to a rise in cost.

"More effective, affordable, evidence-based treatments with long-term benefits are desperately needed," it said.

"Finding promising treatments such as alemtuzumab is important. But so is keeping alemtuzumab accessible and affordable if its early success in these trials proves to be of enduring value."

Regulatory authorities in the US and Europe are likely to approve the drug for MS use during the course of 2013, according to University of Cambridge spokeswoman Genevieve Maul.

'Acid attack' baby an active boy now

When Samuel was just three months old, a maid poured acid down his throat. His injuries were so bad, nobody expected him to live. But today, the 13-year-old goes to school, swims and hangs out with his friends just like other kids. 

The only difference? Samuel has never tasted food - something his doctors hope he will be able to do someday. 

SINGAPORE - Like most boys his age, Samuel Lim Hong Xiang, 13, loves music, enjoys sports like badminton and spends hours on the computer, surfing the Internet and playing games.

But unlike other teenagers, Samuel has never tasted food. For almost his entire life, he has been breathing and feeding through tubes inserted into his body.

He was three months old when a maid poured sulphuric acid down his throat.

On June 29, 1999, the family had left baby Samuel at the flat of his grandmother before going to work. The grandmother had gone out, but the couple’s Indonesian maid Latifah was in the flat with him.

While she was in the kitchen and Samuel lay asleep in the living room, Sumiyem, 17, another Indonesian maid working with the family and jealous of Ms Latifah, poured sulphuric acid into Samuel's mouth. She wanted to get Ms Latifah, then 27, into trouble.

Sumiyem was jailed for eight years in 2000.

Tears well up in Ms Tan's eyes as she recalls that day 13 years ago, and what happened afterwards. Samuel was taken to the Paediatric Intensive Care Unit at the National University Hospital. He spent six months there.

The horrific attack left the infant with terrible scars, and also severely damaged his tongue, throat and vocal chords. His upper airway was completely blocked.

Associate Professor Daniel Goh, head of the paediatric department, saw Samuel right after the incident. He recalled: "Because the airway and the gut were badly burnt by the acid, his life was definitely in danger. His prognosis then was very poor."

'Nobody expected him to live' 

Samuel needed two major operations to enable him to breathe and be fed, his father said. Ms Tan learnt cardiopulmonary resuscitation (CPR) skills and kept vigil by her baby's side round the clock after he returned home.

She remembers waking up countless times during the night to feed and check on him.

"There were so many times when he choked on his phlegm or his airway got blocked, and we had to rush him to hospital in the middle of the night," she said.

"Once his whole face turned blue and I could not resuscitate him even after I performed CPR on him.

Somehow, out of instinct, I used a pair of scissors and snipped off his tracheostomy tube. Then I put in a new one for him before rushing him to hospital."

A doctor told her that Samuel probably could not breathe as his tracheostomy tube could have been blocked, and she had done the right thing by cutting the tube.

"Nobody expected him to live," recalled his father, Mr Lim Boon Keong, 41. "The surgeons said they would try their best. The rest would depend on him."

Amazingly, baby Samuel pulled through.

"It's a miracle that he survived. Doctors later told me that he is a very special child. The pain that my wife and I went through was indescribable," said Mr Lim.

But ask Samuel today and he describes his life as if everything is pretty normal.

What is different about him is that he depends on the tracheostomy tube to breathe. It is inserted in the front of his neck and into his windpipe.

He also relies on a gastrostomy tube inserted into his stomach for feeding.

Good listener 

He told The Sunday Times he got through the Primary School Leaving Examination last year with a score of 219 and is in Secondary 1 at Yuan Ching Secondary School, in Taman Jurong.

"When I am in school, I go to the pantry for my meals," said Samuel, covering the opening of his tracheostomy tube with his chin to make his speech clearer. "I am afraid people can't understand me.

So I don't like to speak."

His mother, Madam Tan Poh Ling, 41, piped in: "That makes him a good listener and earns him many friendships too."

When he was seven, Samuel started piano lessons. In Primary 4, he learned to play the guzheng, the Chinese zither.

Mr Lim said: "We wanted him to be able to use music to express his feelings when he got older."

Samuel's love for music grew and his talent has been recognised by Club Rainbow, which gave him a talent development fund grant for the fourth time this year.

"I have passed my Grade Three practical piano exams and Grade Five for theory," said Samuel softly.

"I don't like to speak, I like to play the piano. Now I play the piano daily and the guzheng twice a week."

His passion for music and opportunities to perform on stage helped to develop his self-esteem and he has grown to be a cheerful boy, said his parents.

The couple, former engineers, work in Mr Lim's family hardware business, which gives them the flexibility they need to care for Samuel and their younger children, son You Jun, 10, and daughter Yong Zhen, seven.

"Samuel is always surprising me with what he does," said Mr Lim. "Just the other day, he told me that he signed up for the hip hop dance class as part of his physical education programme. That's him, never afraid to try new things."

Samuel walks and runs like a typical teenager. On weekends, the family plays badminton together.

An attempt at a normal childhood
When Samuel was younger, he would go with the family on outings to McDonald's, even though he could not eat. He has never complained or asked to eat, said his mother.

Samuel said: "I just find food disgusting."

His birthdays used to be at a Swensen's restaurant, complete with an ice cream cake. But as he grew older, he told his parents he preferred not to have such celebrations.

Madam Tan recalled how Samuel would attract a lot of attention in public, and she would find herself fighting back tears when strangers asked about his condition.

But she and her husband wanted their special son to have as normal a childhood as possible and did not believe that he should be kept at home, away from stares.

"We wanted it to be easy for him to grow up, so we did not see the point in hiding him at home," she said.

"We took him to swim at public pools and we taught him to take care of himself and not let water get into his tracheostomy tube. We would find a quiet corner in public to feed him." Mr Lim said: "Now that he is older, he has no problems feeding himself in public when he goes out with his friends."

Samuel’s recovery, repeated hospital trips and his growing-up years have been a long journey for the couple.

And they are always prepared for the unexpected.

Last year, Samuel had to sit his Chinese and science papers for the Primary School Leaving Examination in hospital, as he was suffering from an intestinal obstruction as a result of his tube feeding.

Strong will to live 
 
Ms Tan said: “We rushed him to hospital on a Sunday night after he complained of a severe pain in his stomach.

“The next morning, I informed the Ministry of Education of his condition and the ministry managed to arrange for him to take his exams at the hospital.”

Mr Lim said: “After the accident, doctors told me that he is a very special boy. Every time I’ve needed to rush him to the hospital, I would be praying that he survives the ordeal and for his pain to be reduced. Samuel has shown that he has a very strong will to live.”

Samuel's school principal, Mrs Saraspathy Menon, told The Sunday Times that her staff help to make sure Samuel takes his meals punctually, at three-hour intervals, in the privacy of the staff pantry.

"In class, he is just like everyone else and he has been participating in most activities," she said.

"Samuel is a pleasant and friendly boy who interacts with classmates and teachers actively through non-verbal communication such as gesturing, writing and Facebook posts."

She added: "Samuel is a remarkable child. He has a smile for everyone and he has never complained about the challenges that he is grappling with.

"He exemplifies resilience and courage and all of us in Yuan Ching Secondary School have much to learn from him."

What lies ahead for Samuel? 

Associate Professor Daniel Goh, head of the paediatric department at the National University Hospital, has been seeing Samuel since the day of the acid attack and monitoring his progress.

He said that later this year a team of paediatric surgeons will attempt to reconstruct Samuel's gullet, and another team will re-evaluate his upper airway for possible reconstructive surgery later.

"It is hoped that he may ultimately be able to breathe and eat without the tubes. The reconstruction will likely be complicated and may require many staged operations," he said.

Describing Samuel's condition as unique, he said: "The circumstances under which the injury occurred as well as the extent and severity of the damage are certainly not something we have seen before.

"What's also special is Samuel himself, and his parents. Samuel has been a very brave young man who has overcome the odds and not only survived the initial ordeal but also lived to lead a good and fruitful life.

"His parents are also fantastic in supporting him through the years and have loved and cared for him very well. Despite his injuries, Samuel has grown up to be a well-adjusted, polite and delightful young man."

Samuel knows what happened to him when he was a baby. Asked what he feels about the maid who assaulted him, he said: “I don’t hate her.”

The rainbow connection 
 
Club Rainbow, a charity that helps children and young people with chronic illnesses, was one of the first to offer help to Samuel Lim and his parents after the acid attack. It has remained a source of support for them.

Its president, Mr Gregory Vijayendran, said: "One of the greatest joys I have experienced in service in Club Rainbow is watching Samuel grow up.

"At first, five to six years back, he was a shy, slightly withdrawn child with a budding musical talent and a quietly expressive demeanour and manner.

"He has blossomed and matured into a confident, socially engaged young man with wonderful piano playing skills that are a gateway to his soul filled with joy, hope and great sensitivity." Three months ago, Samuel played the piano for more than 300 guests at Club Rainbow's 20th anniversary celebration.

He was among 19 young people who received the charity's talent development fund grant, of between $400 and $800, that night.

3-year-old meningitis patient allowed to pay hospital bill over 42 years

SINGAPORE - A 42-YEAR arrangement.

That is what the Ting family has with KK Women's and Children's Hospital (KKH). It is to settle three-year-old Ting De Keat's medical bill.

This is the first time a hospital here has allowed a large medical bill to be broken up into interest-free monthly instalment payments over such a long period.

The amount? A whopping $130,000 - to treat and manage the boy's meningitis.

De Keat came down with fever on June 21 this year.

His mother, housewife Koh Tat Hong, 34, said: "He was seen by the family physician near our home, but when he vomited and complained of a neck ache the next day, we took him to the emergency room at KKH."

The boy was given stronger medication and sent home, but his temperature continued to rise.

"It was hovering at 39.9 and 40 degrees (Celsius) and he was given a suppository. But that helped only for a while," Madam Koh said.

Five days later, he was taken back to KKH and rushed into the Intensive Care Unit (ICU).

"Doctors said he had developed meningitis and it was causing his fits," his mother recalled, eyes brimming with tears.

De Keat underwent three operations to relieve the pressure in his skull and had a shunt installed to drain excess water from his brain.

He was in ICU for 24 days and was warded in the hospital for a total of 50 days.

"When we were handed the bill and told to settle $30,000 first, we were shocked. How could we afford to pay? We couldn't even afford to settle the first $30,000 let alone the full bill," Madam Koh said.

She and her husband Ting Kok Ing, 36, a container truck driver, are Malaysians living here.

"He gets paid on consignments and makes about $1,000 a month to support the family," she said.

The Tings have a younger son, who is being looked after by Madam Koh's mother in Malaysia.

To help the Tings with the bill and follow-up treatment for De Keat, a medical social worker at KKH approached several charitable organisations.

But when none of them replied, the couple approached MP K. Shanmugam.

Mr Shanmugam, who represents Nee Soon GRC, wrote a letter to the hospital on behalf of the Tings, appealing for its understanding.

If boy were Singaporean... 

Mr Shanmugam, who is also the Law and Foreign Minister, told The New Paper that if the boy were a Singapore citizen, it would have been easier to help.

"We have several ways of helping citizens and our 3M framework (Medisave, MediShield and Medifund) would also have kicked in. But here the situation was different.

"Both parents are permanent residents from Malaysia and the boy is not a Singapore citizen. But we have to be compassionate - the father is a delivery driver and the mother has quit her job.

"We can't walk away from them. So I tried to help them," he said.

Madam Koh said: "We were happy when we received a letter last month from the hospital informing us we could make payment in monthly instalments of $250."

De Keat is recovering at home. He is conscious and reacts to what he is told, but cannot talk or stand up. He is still being fed through a tube.

Unique agreement 

This case is the first of its kind.

A National University Hospital spokesman said a 42-year repayment period is uncommon.

"Assistance schemes are available for patients who have genuine financial difficulties. These patients will be referred to the medical social workers to explore means of assistance.

"No patient will be denied medical care due to the inability to pay," she said.

Medical social workers TNP spoke to said hospital bills can be paid by instalments, but they "didn't know it could be done to such an extent".

Ms Jacqueline Ang, a medical social worker for HCA Hospice Care, said: "Instalment payment is negotiable and handled on a case-by-case basis. This shows the compassion of an institution such as KKH."

KKH could not reply to our questions by press time.

As for the Tings, they are hopeful De Keat will recover and return to being the bright-eyed intelligent boy he was before he fell ill.

MENINGITIS Q&A 

What is meningitis? 

It is an inflammation of the membranes surrounding the brain and spinal cord (meninges).
Causes:

• Viruses: This is the most common cause. A number of different viruses can cause the disease, including mosquito-borne viruses.
• Bacteria
• Fungi
• Parasites

What are the signs and symptoms?
In its early stages, symptoms might be similar to that of flu, but some people have become seriously ill within hours. Early symptoms include:

• Vomiting
• Nausea
• Muscle ache
• Fever
• Headache
• Cold hands and feet
• A rash that does not fade under pressure

What is the treatment? 

Viral meningitis will resolve itself fairly quickly and does not usually need any medical treatment. See a doctor if symptoms continue after two weeks.

Severe meningitis, which is nearly always bacterial, is treated with antibiotics, usually given intravenously, and other drugs.

Source: National Health Service (UK), The Mayo Clinic and National Institutes of Health (US)

MediShield to be tweaked from March next year

SINGAPORE: The national medical insurance scheme, MediShield, will be tweaked from March next year to provide better coverage for the elderly.

The Ministry of Health (MOH) said on Friday that it is raising the limit on the amount that can be withdrawn from Medisave, a national medical savings scheme, to fully cover the premiums for basic MediShield schemes.

Those who are between 76 and 80 years old can withdraw a higher amount of S$1,000, compared with the current S$800; while those who are above 80 years old can withdraw up to S$1,200, compared with S$1,150 currently.

The age limit for MediShield will also be changed.

The government will scrap the maximum entry age of 75 so that more elderly people who are healthy but not insured can get insurance coverage.

At the same time, it will raise the maximum coverage age to 90 years, from the current 85.

Coverage will be extended to inpatient psychiatric treatment at S$100 per day, up to 35 days per year.

The coverage limit per policy year will be raised from S$50,000 to S$70,000, and the lifetime limit will be higher at S$300,000, compared with the current S$200,000.

In addition, coverage will be extended to short-stay wards in Emergency Departments.

Other adjustments include increasing the deductibles for Class C bills from S$1,000 to S$1500, and S$1,500 to S$2,000 for Class B2 bills.

The deductible is the amount of a hospital bill that patients have to pay before claiming insurance.

MOH decided on these changes after it consulted the public in July and August on ways to make MediShield more inclusive.

It is still looking into another suggestion on using MediShield to cover outpatient treatment, saying this involves a major shift in MediShield's focus and could have significant impact on the premiums.

Boy, 13, meets stranger who saved him twice

Photo left: (From left) Madam Roseline Chin and her sons Bryan Pang, 13, and Brandon, 10, presenting a drawing to bone marrow donor Lim Shi Hong, 23. 

 

At 19, Mr Lim Shi Hong donated his bone marrow - not once, but twice - to save the life of a nine-year-old stranger.

This was in 2007 and amid protests from his grandmother, who was afraid for his life.

The patient, Bryan Pang, now 13, had Hyper-IgM Syndrome, a rare genetic immunodeficiency disorder that causes frequent lung and respiratory tract infections.

Though the two never met, Mr Lim was kept updated on Bryan's progress by the people at the Bone Marrow Donor Programme (BMDP) until he left for his studies in Britain three years later.

On Wednesday, Mr Lim, now 23, finally got to meet the boy he saved at the BMDP office at Mohamed Sultan Road.

According to an anonymity clause, a bone marrow donor and recipient can meet only after two years.

Bryan's mother, Madam Roseline Chin, 38, wanted to thank Mr Lim in person and had asked BMDP to help arrange a meeting.

There to meet Mr Lim were Bryan, his brother Brandon, 10, his mother and grandparents.

Initially, Bryan was shy, but his grateful mother broke the ice.

"If it wasn't for this young man, my son would not have a chance in life. He not only came through once, but also the second time when he was approached. For that, I am forever grateful," she told The New Paper.

Bryan's immunodeficiency disorder was not diagnosed until he was three.

"His younger brother Brandon was diagnosed at birth. Since he had the same symptoms, Bryan was tested too," Madam Chin, an early childhood educator, said.

Bryan underwent Intravenous Immunoglobulin Therapy and was often in and out of the hospital.

In 2007, Brandon received a stem-cell transplant from cord blood, making him the second recipient of cord blood from the Singapore Cord Blood Bank, less than two years after it opened its doors.

But Bryan did not find a match at the bank and had to turn to the bone marrow option.

It took BMDP a year to find a perfect match in Mr Lim. And in the same year as his brother's transplant, Bryan had his at the National University Hospital.

But complications soon set in.

Infection 

Said Madam Chin: "His doctors thought after the transplant he would be out of the woods but on the 40th day post-surgery, his immune system crashed and he suffered fungal infection."

"None of the antibiotics given to him was effective. He suffered a stroke, became blind in his right eye and fell into a coma. The hospital told me I had to prepare for the worst, unless the donor was willing to donate his marrow again."

Madam Chin admitted she went into a depression and "was not at all hopeful".

"How many people would give once, let alone twice? But Shi Hong was godsend. He offered a sliver of light in my dark period when he said 'yes' for the second time," she said, her eyes brimming with tears.

19 when he first saved a life 

Mr Lim was serving his national service at the Officer Cadet School (OCS), when he was first told he was a match to save a boy with Hyper-IgM Syndrome.

"I was in Hwa Chong Junior College when BMDP came to give a talk. I was convinced it was a very good cause and gave my blood sample. Little did I know I would be called upon," he said.

He said his parents were very supportive when he told them he had been called to be a donor.

"But my grandmother, being very 'traditional', was very worried and was trying to dissuade me. She was concerned that this operation would affect my own health," he said.

When approached a second time and told of the urgency, Mr Lim did not hesitate, much to the chagrin of his grandmother.

"Since I was in OCS, I had to inform my supervisor, who gave me permission to go ahead," he said.

After donating, Mr Lim went on with his life, and Bryan was discharged after spending about half a year in the hospital.

"Someone from BMDP kept me in the loop of the recipient's medical progress. But I lost touch three years ago when I left for my studies," he said.

He is currently doing a post-graduate course in mechanical engineering in Britain and is back in Singapore for the holidays.

President of BMDP Jane Prior said: "We are looking at young people like Shi Hong to step up as volunteer donors. They are in their prime and would be the best candidates to offer help to those who need transplants."

Thank you

To encourage them, BMDP is organising Match for Life, a high-profile drive to recruit at least 3,000 new donors.

Today, Bryan is back at Dazhong Primary, and playing football, something both he and his mother never thought he would be able to enjoy.

"The first day he stepped into his school after his medical ordeal, he said 'I never thought I'd be able to come back here again'," Madam Chin said.

To say thank you to his saviour, Bryan made a photo collage of his being in hospital and his travels after being given a second lease on life.

"It is my way of saying 'Kor kor, thank you for giving my life back to me and allowing me to do stuff other boys do'," he told TNP before presenting it together with a drawing to Mr Lim.

What's Hyper-IgM Syndrome?

Hyper-IgM Syndrome is a immunodeficiency disorder present from birth. A child with this congenital disorder fails to produce certain specific types of antibodies.

It affects only boys, but girls are often carriers. The disorder shows up during the first year of life when the child develops recurrent infections of the respiratory tract and chronic diarrhoea that do not respond to standard antibiotic treatment.

The disorder causes frequent infections of the ears, eyes, sinuses, lungs, skin, respiratory tract and other areas of the body.

Children who are not diagnosed early, may show delays in growth and normal weight gain.

Bone marrow transplants are considered a cure for immunodeficiency disorders that are present from birth.

The best sources of bone marrow for transplants are the affected child’s siblings or one of the parents, as the closer the match, the lower the chances of rejection.

Cord blood stem cell transplants are another cure for Hyper-IgM Syndrome.

Stem cell transplants from cord blood have two advantages over bone marrow transplants – lower rate of rejection in recipients, and they can be stored ahead of time.

Bone marrow recipients, like Bryan Pang, owe their lives to the thousands of anonymous donors who register themselves with the Bone Marrow Donor Programme (BMDP), a group that matches bone marrow donors with patients.

Bone Marrow Donor Programme and what it does 

Established in 1993, BMDP is a non-profit organisation responsible for building and managing Singapore’s only register of volunteer donors, who are willing to donate their bone marrow to save the lives of patients with leukaemia and other blood diseases.

The BMDP also provides a 365-day service to hospitals here to search the local register – and if necessary, partner registers around the world – for a match.

Every day, six Singaporeans are diagnosed with various life-threatening blood diseases, such as leukaemia and lymphoma.

Many will not survive without transplant using donor bone marrow or stem cells from cord blood. To date, there are 50,000 donors on the database and BMDP has facilitated over 420 transplants. To improve the odds of finding a match, BMDP aims to increase the register by 5,000 new donors each year.

Next month, BMDP is organising Match for Life, a high-profile drive to recruit at least 3,000 new donors.

Save a life A collaboration between the BMDP and the corporate sector, Match for Life aims to take advantage of the communications infrastructure within each organisation to reach out and educate staff on the role they can play in saving a life.

President of BMDP Jane Prior said: “Signing up as a bone marrow donor takes just a few moments, but the commitment to actually donate in the future if identified as a match, means that people must be fully-aware of the long-term implications.

"By sharing details about our work through company intranets and speaking to staff at lunch talks and other forums, we are confident that more people will step forward to commit to our life-saving mission."

A swab of the cheek for DNA is needed to put a person in the database. The BMDP receives no Government funding, and it needs to raise $2 million for laboratory tests required to add each new donor to the database.

Girl, 4, suffers from rare disease that causes tummy to bloat

SINGAPORE - 4-year-old Zecia Chew suffers from a rare condition that has caused her tummy to bloat and look like a pregnant woman's.

She suffers from Gaucher's Disease - a genetic condition where a fatty substance called lipids accumulates in cells and certain organs.

The disease is characterised by the enlargement of the liver and spleen, fat hoarding and a distended abdomen.

Her limbs are also painfully thin, as they have difficulty absorbing nutrients. Being extremely weak, Zecia is constantly in danger of falling and hurting herself.

And if she falls and hurts herself, her bruises take weeks to heal, as her blood platelet levels are extremely low due to the disease.

It is believed that there are only two known cases of Gaucher's Disease in Singapore, Chinese daily Shin Min reported.

As both of Zecia's parents have no history of the illness, it came as a great shock to them when their daughter was diagnosed with the disease.

Unluckily, medical tests revealed that both of them are carriers of the gene. If so, a child has a 25 per cent chance of inheriting the illness.

The first sign that there was something wrong with little Zecia was innocuous enough, her parents Sharon and Avan said.

They noticed that her belly was growing faster than the rest of her tiny frame. Yet she didn't seem to be eating that much food. Worried, they brought her to see a number of medical practitioners, many of whom said she had "poor digestion", "too much wind" or "a weak stomach".

When Zecia finally mastered walking, she did so with huge difficulties, often tripping and falling.

Finally in October 2011, Zecia's bloated tummy, poor sense of balance, frequent complaints of tiredness and many other seemingly unrelated symptoms became too much for her parents to dismiss as "normal" for a child her age.

On October 18, Sharon and Avan received the devastating news - Zecia was suffering from a disease so rare, they had never even heard of it.

$12,000 medical bill a month 

Even with treatment, which costs a hefty $12,000 a month, the swelling of her tummy has just gone down slightly.

Zecia has to go to a hospital every two weeks to have an intravenous therapy drip inserted into a vein for medications to be introduced into her body. The treatment includes enzyme replacement therapy, which helps to reduce the enlargement of the liver and spleen, resolve blood abnormalities and improve bone density.

Without a suitable bone marrow transplant, Zecia will have to undergo the treatment for the rest of her life.

As she cannot find a suitable bone marrow match among her family members, the family is hoping that Zecia 's five-month-old sister might prove to be her saviour.

As Zecia grows older, she requires a larger therapy dosage each session. This means that her $12,000 monthly medical bill will only grow bigger over time.

Her father Avan, 33, is working as a hotel employee, while her mother Sharon, 28, is working as a shipping accountant.

However, the couple's combined take-home pay only comes up to $3,000 a month.

They are currently relying on a medical subsidy of $30,000 to help foot the bills, but the fear is that the money will soon run out.

The treatment bills are too heavy for the family to bear. But untreated, Zecia will almost certainly not survive.

A 'princess' birthday party 

To celebrate her fourth birthday, which falls on this coming Friday, Make-A-Wish Foundation organised a "princess" themed party at Siloso Beach Resort last Sunday.

Zecia, who loves swimming and everything princess-related, had wished for a fun and memorable holiday with her parents and her baby sister.

Upon arrival at the resort, Zecia and her family were greeted by the welcome party dressed in Disney Princess costumes.

The party saw more than 30 relatives and friends invited, and dressed in her very own princess costume - complete with a tiara, wand and glass slippers - Zecia celebrated the next few hours with games, balloon sculpting performance and even a magic show.

A spokesperson for the foundation said after visiting the family, they found out that Zecia especially misses the times the family travelled to China together. Thus, they decided to fulfill Zecia's wish of enjoying another holiday with her family.

The celebration was continued over the next two days, with visits to Underwater World Singapore and the Dolphin Lagoon.

Make-A-Wish Foundation has also agreed to help with fund-raising activities to ease the medical burden of the family.

Interested donors can call the foundation at 6334 9474 from 8.30am to 5.30pm on weekdays for more information, or email info@makeawish.org.sg.

A donation can also be made by visiting her Facebook page at www.facebook.com/SaveLittleZecia.
 

Quadruplets cost family more than $180k in hospital fees

The quadruplets born on July 19 are still in hospital, and their estimated hospital bill is around $180,000. Their grandparents are frustrated over the large sum, which is still increasing, as the babies have been warded for about 30 days and have not been discharged.

Madam Lily Lim, 52, told Shin Min Daily News that the babies were born premature and had to be warded in the neonatal intensive care unit, which costs $1,000 a day for each baby.

The current bill is around $135,000, as the babies have been warded for 28 days as of August 15. The eldest child Janessa Phua is 1.8kg, and Madam Lim says she is likely to be discharged next week.

However the other three - Joelle, Jovianne and Kingsley - might have to stay in hospital for a few more weeks. Madam Lim estimates the bill to hit $180,000 when her grandchildren are finally discharged.

She lamented that while the government encourages having more births, her family is unable to bear the high costs of having quadruplets.

Madam Lim said the family considered using the Child Development Account to pay the bills, but they found out that the money cannot be used for this hospital bill.

The paper understands that Madam Lim has filed applications with the Central Provident Fund (CPF) Board and Ministry of Health to request to use both her husband's and her CPF accounts to help ease the financial burdens of her son and daughter-in-law.

As of yesterday, Madam Lim has not received a reply.

She says that with their combined CPF of about $90,000, they would be able to pay for half the fees.

A spokesman from the Ministry of Health told the paper that they have contacted Madam Lim and Gleneagles Hospital to enquire about the details to evaluate the case.

The family has paid her daughter-in-law's medical bill of over $40,000. Madam Lim said that they had appealed to the hospital and received a discount of $1,500.

Others have questioned the Phuas' decision in choosing a private hospital over a government one, as the latter would be a much cheaper option.

Madam Lim told Shin Min Daily News on Thursday that the family chose Gleneagles, because they felt that delivering quadruplets would be risky. Also, a Chinese practitioner recommended the hospital when her son and daughter-in-law were trying to conceive.

When the paper contacted National University Hospital and Singapore General Hospital, both spokespersons said the hospitals have adequate resources to manage multiple births.

Army suspends field training after jeep accident

The Army has suspended all field training for five days as part of a safety time-out, said the Ministry of Defence (MINDEF) in a statement today.

The suspension, which will last from May 11-15, is the longest halt in military exercise to date.

MINDEF said it is to serve as a reminder of the current safety measures.

This comes after a national serviceman (NSF) died after sustaining injuries from a jeep accident on Friday afternoon.

It is the second training fatality in less than a month.

3rd Sergeant (3SG) Tan Mou Sheng, 20, was in a scout jeep with a few other servicemen when the driver of the jeep lost control of the vehicle at the Marsiling training area, said MINDEF.

The Straits Times (ST) reported that he was sitting at the back of the jeep when the accident happened at about 6.50am. It is not known if he was belted up or not.

He was found pinned under the vehicle and had lost consciousness. Efforts to revive him failed.
He was in a critical condition when he was sent to Khoo Teck Puat Hospital (KTPH).

According to ST, the former Hwa Chong Institute student underwent surgery, but was later pronounced dead at 1.56pm.

Another NSF, 3SG Hong Dickson, 20, had a laceration on his right leg and was discharged after receiving outpatient treatment at KTPH.

Buying insurance: Start early, don’t procrastinate

YOUNG adults should consider buying insurance early in the light of the recent discussion on pre-existing conditions. Serious illnesses can strike at any time, leading to hefty medical bills and the likelihood of not being able to work for a significant period.

 

What's more, buying insurance as a young adult is generally affordable, with monthly premiums costing as little as what one would spend on a night out with friends.

 

Some can even be paid using Medisave, thereby saving a person from forking out cash. Medical conditions and risk factors typically increase with age, resulting in decreased insurability.

 

Many Singaporeans do not know how secondary health care is provided and paid for, and perceive insurance agents as people who are out to fleece their clients by selling expensive policies they do not need.

 

Many young people often overlook the long-term implications of being uninsurable when they grow older.

 

Conversely, purchasing hospitalisation insurance when one is young gives peace of mind for the long term, as many policies guarantee renewal even if illness strikes subsequently.

 

While the old may already be uninsurable, young adults have no excuse not to insure themselves and their future.