Friday, February 27, 2009

The GIC saga and the elderly......

It was revealed recently that the GIC losses last year totaled approximately S$50 billion. We don't how much since then. I don't know if this number just include realized losses,or do they include 'paper losses'? Many people believe the actual number may be substantially higher than revealed. I am not enough of a finance person to know who's right. In any case, my calculator cannot even input 50, 000, 000, 000 .... so I am guessing it's really a lot of money. A lot, a lot of money.

Now we hear, GIC is converting its prefered notes into common stock. Hmmm....

Wise decision? The less worse of two really bad options? Who knows? I certainly don't. I can't even get my own 'investments' to work. But I think it sounds logical to some extent to think about it as a long term investment. If we look at it with longer (much much longer) perspective, the investments so far has a good chance of yielding good returns for GIC. Hopefully. Citibank if it survives does appear to represent a good investment option. If it survives.

But not so our elderly. They are not really good investment options. They tend to die.

I think that's why the gahment isn't all to excited about putting any of those many zeroes into maintaining the elderly. Do enough to appear concerned, I think is the motto.

I really wish it were otherwise. It really breaks my heart each time I come across the elderly men and women cleaning out the toilets, our cleaning up after us at the food courts. Why do they have to be working at their age? And such demeaning work as well...They should be in the parks ...enjoying their retirement, playing with their grandchildren. They deserve it. Why do we make the elderly feel they have to continue to pay their way through the end years of their life? I think they are entitled to their rest....regardless of how much savings they have or how much they have in Medisave...

If we are a poor country, I can understand the need to be frugal where social support for the elderly is concerned. But the recent Temasek-GIC fiasco has revealed through, albeit through a glass darkly, the size of our accumulated wealth. Enough wealth to publicly declare a loss totalling some S$100 billion... and shrug it off, because other people have lost more.

Why can'twe spend a bit of this to make our elderly feel loved and honoured. And not just a burden to that we can't wait to be rid off.

Thursday, February 26, 2009

Why can't we care for our elderly in Singapore??

Today's Straits Times carried a report by Cheryl Ong on the lack of space and facilities for old people at the centres that care for them.

Clearly the aging of our population is going to put all kinds of strains on our society both in terms of the costs involved, as well as the modification of our living space to accomodate more aging problems. The government has not been sleeping where this is concerned and I believe has been trying to find meaningful solutions to this burgeoning problem.
But I would like to suggest that the government is not doing enough. Principally, I believe, because it is locked in a mindset that frowns on anything that resembles their going down the 'social welfare' road. I think this is a restrictive and self defeating mindset. Some would say, anal retentive.

It's time we look at our elderly as people we should treasure and cherish and honour. I don't think anyone but the government would object to spending more tax-dollars on the elderly. I wish the government would stop harping on the increased costs to look after the elderly, and see it as a necessary part of the filial concerns of our society. I wish they would stop making the elderly feel that it is their fault that they live a long life... what a sin...and what a burden they place on society if they should live beyond 80...or beyond the reach of the Medisave.
Why can't the government just tell the elderly...that we, as a society, celebrate their longevity. That when they grow old, they deserve a rest, not just from work but from the worries of having to fend for themselves. Free from the need to be financially responsbible for their rent, their food or the medical bills. Is it that terrible if they should 'wrongfully' use more tax dollars for their medical bills?

I think this is what we, as a society, owe the elderly.

Can we afford the tax dollars? Of course we can. We just lost an unquantifiable lot of billion dollars because of Temasek and GIC. Could we not spend sone of those billions on making the elderly feel loved?

C'mon governement, stop being so anal retentive about this. Can you afford to be a bit more loving and a bit less calculative? O course you can.

Tuesday, February 24, 2009

The Chikungunya chase...

I have been following the Chikungunya story even though it's not really a dangerous disease, because it's an intriguing lesson on how an imported disease establishes itself as an endemic one.

As we come out of the rainy season, the mosquito borne diseases should take a bit of a dip. This is not the season when dengue, for example will flare up. Chikungunya has been grumbling along at about 50-60 cases per week but has seen a rather significant drop in number of cases. Last week (week 7 on MOH data) saw 10 new cases, at least one of which was an imported one and 3 pending investigation. For Chikungunya to be endemic, it requires a reservoir to fuel continued infections in the population. It is uncertain if during this relatively dry season we might see a disappearance of the disease or not.

I'm not optimistic. Firstly its not as dry as expected (in fact was raining today). Secondly, there is always a possibility that the virus has adapted an animal reservoir here.

Meanwhile the top 4 hotspots (>10 cases) for Chikungunya are:
Tanjong Kling Road, Leedon Heights, Swiss Club Road and Dalvey Estate. A lot of big houses in those areas...

Sunday, February 22, 2009

Tabebuia rosea - our cherry blossoms!

The Spring or Vernal equinox occurs at about March 20-21 every year. This is the occasion when the sun is vertically overhead the equator. By traditional reckoning, the Spring equinox (春分) is regarded as mid Spring.

In Japan, the Spring equinox ushers in the cherry blossom festival, while in China it seems to appear a month earlier.

For us the closest we get to having a cherry blossom festival is the annual blooming of the pink and white tecomas (Tabebuia rosea and roseo-alba). These South American flowering trees are magnificent when they burst into bloom in a wonderfully synchronized fashion. They have been wisely and strategically planted along various road stretches so tha during this time of year it just a splendid show of these pink and white flower covered trees. I know there is a short but now beautiful stretch on the AYE near Marina, and a lovely stretch along Buono Vista.

Medical Education in Singapore - a road downhill

I was worried that some of my comments about medical education is Singapore might have been too negative... or as modern management would have it...not appropriately progressive enough.

But I coincidentally bumped into quite a few colleagues who have attended the recent Asia Pacific Medical Education Conference, and was assured that my views were quite representative of what the local attendees felt. Of course the visiting pedagogues all had nice things to pontificate about, but once you got beyond the niceties, there was no denying the prevailing sense of negativity and despondency among the local medical educators. The Medical School they all felt, had sacrificed the education agenda for the more eye catching research targets. Resources meant for education had been hijacked to pay for expensive research activities - research labs and non-teaching researchers. Student intake has gone up significantly and is set to go even higher, yet the Medical School has capped the hiring of educators in favour of researchers. Instructions had apparently gone out that new hires cannot be for medical teaching. On paper, staff-student ratios appear appropriate by international standards, but many research oriented staff, cannot teach or refuse to teach. Curricular changes reflect this degenerating state of commitment to teach. 'Teach less learn more' while idealogically attractive, seemed to most a sad reflection of this diminishing and commitment desire to teach.


If all this is true, I think we are going to have problems in the future.

Friday, February 20, 2009

Universities, Medical Schools and disgruntled professors

The recent report on a bunch of disgruntled professors from the NTU raised a bit of a smile. Their grouse was the undemocratic and non-transparent way the university (NTU) awarded tenure. Presumably they were the ones not awarded tenure. But I am not so sure their complaints will go very far. There is no employee's union through which university professors can seek redress if there is any employment dispute. Once I remember there was an Academic Staff Union at the university but this, I am told, was unceremoniously dismantled a few decades ago by MM Lee KY. Now academic staff are entirely at the mercy of their employers.

Also they don't seem to have to much leg to stand on. The universities are brutally going ahead with the single minded drive towards 'excellence' (whatever that means). Ranking is important, apparently. The Medical Schools in Singapore have been similarly affected.

After my recent postings, I have had some passing discussions with colleagues from the NUS School of Medicine (correctly Yong Loo Lin School of Medicine ... duhhh....), and was reliably informed that the problems affecting the NTU staff were not unique, and that NUS went through the same painful process of renewal and redefinition. Actually many of them, having themselves suffered the same indignities, are secretly (and not so secretly) cheering on the NTU staff in the efforts to take on their university.

It sounds like they were not really questioning the university's need to reform and upgrade. Nor the need to set academic standards. Their main grouses appear to be related to their sense that they have all been treated very unfairly and sometimes very callously by their institutions that they had given so much for, and whom they have supported often so sacrificially in the past. Many of the staff had felt rather cheated because the universities had at the last minute moved the goal posts (something which happens rather commonly in Singapore). Many of the senior staff at the universities had committed the best years of their lives with the university, and had pursued zealously the university's educational mission. This was at a time when there was little money for research. Now in their 50's and early 60's, they have been told by their employers that they are pretty useless and unneeded because of their relatively weak research track record. No fault of theirs, they felt. Just that the goal posts shifted. Which was the other bone of contention.

Many of them also seem to felt that the universities had been less than honest with them. In all their meetings with university leadership management, there had always been emphasis on the three main pillars of excellence, namely research, teaching and education. These were to be their Key Performance Indicators (KPIs). In reality their performance reviews took into consideration primarily their research output. Many of the senior staff who had committed their lives to student management and the educational agenda, found themselves suddenly marginalized and very little valued in an organization that was intent on achieving research 'excellence' even at the expense of their teaching mission.

The medical educators I have had a chance to talk to all echoed the same sentiments, and almost uniformly lamented the recent obvious degeneration of the medical educational mission because of the (to their perspective) over emphasis on the research mission. In the clinics we see the same deterioration in quality of the students coming through.

What to do?

Sunday, February 15, 2009

Rohingyas - ethnicity issues

Still thinking about empathy and suffering, albeit closer to home than Darfur...

I have been troubled by all those reports about the Rohingya boat people, escaping from Myanmar. I can't say I knew very much about who they were and their political plight so I started Googling them out over the weekend.
Here's what I found out.
Myanmar is a large diamond shaped country locked in by the Ayeyerwadi delta and a significant coastline. It shares borders with Bangladesh, India, China, Laos and Thailand. Geographically the country is divided by large mountain ranges (Rakhine Yoma, Bako Yoma and the Shan plateau) oriented in a North-South direction which essentially separates the country into the three rivers valleys of the Ayeyerwadi, Thanlwin and Sitang.This orientation effectively meant that people movement tended to be in a southerly direction. As a result, most of the population tended to be of Sino-Tibetan origins. Over the millenia, various Asiatic/Sino-Tibetan groups moved into the region giving rise to various ethnic groups. Most became assimilated into each other giving rise to a major ethnic group loosely called Bamars (~70% of the population). Isolated hill tribes that managed to retain a stronger sense of their original culture are recognizable as distinct ethnic minorities.

The major ethnicity problem arise primarily in the western coastal state of Rakhine. This coastal state is separated from main Myanmar by the formidable Rakhine Yoma range. The indigenous people there were originally of negrito origins, perhaps similar to the Andamanese. Over time they became replaced by population groups from Bangladesh who are of Indo-European orgins and speaking Bengali dialects. These became the Rohingyas. Another group in this state were drawn from invading Mongoloid races which are now identifiable as the Rakhine. These are more similar to mainstream Bamar people and speak a similar language. The Rohingyas are Muslim, whereas the rest of Myanmar (incuding the Rakhines) are mostly Theravada Buddhists.

The difficulty in this region is that the Rohingyas who are so distinctly different ethnically, linguistically and culturally different from the rest of Myanmar, are also physically isolated from mainstream Myanmarese life because of the almost impassable Rakhine Yoma range. This makes it easy for mainstream Myanmar to consider them not "Myanmarese". The recent reference by Consul General Ye Mying Aung to the Rohingyas as being 'ugly as ogres' is as racist as anyone can get and clearly to be condemned. But the reference to ogres really comes from the supposed etymology of the term Rohingya/Rakhine from the sanskrit Rakshasa, refering to the negrito origins of the people west of the mountain range.

Here you have a classical situation of a marginalized people who are so isolated from mainstream Myanmar not just in ethnicity terms (language, culture, religion and race), but effectively prevented by geography in meaningfully integrating and participating in Myanmar life.

Sadly they remain marginalized, stateless and unwanted. Is there any wonder they try to escape this persecution? Not at all...But will they find life more bearable escaping to Thailand, Malaysia or even Indonesia. I doubt it, as these other countries having their own ethnicity issues to contend with, have no real desire to absorb them into their societies.

Meanwhile the world watches helplessly.

Is there any hope that this may be resolved anytime soon. Unlikely. Not as long as people divide people according to skin colour, language and the gods they worship. Not until those uncivilized and ignorant generals leave the scene. And this is not going to go away anytime soon.


Saturday, February 14, 2009

Lee Wei Ling's lack of empathy

Notwithstanding Lee Wei Ling's privileged position to comment on just about anything, her forthrightness has earned her a weekly column in the Sunday Times. But unfortunately, except for the occasional pearls that fall out, most of her comments fall short of being wise in any way.

Her comments today on empathy was somewhat scary and unreal in its coldness and lack of logic.

Looking out for oneself and one's own is a reality of life which probably applies to most animal species. This is how packs, herds and tribes survive. Without this empathy, it becomes everyone for his/her own and everything unravels. She seemed somewhat surprised by her own empathy for people around her that she could identify with. But what really surprised and scared me was her confession of an obvious lack of empathy beyond what she could identify as family, friends or fellow tribesman. Did she not consider that a fellow human being in Darfur or further, was worthy of consideration or assistance? Was that distant being not a fellow citizen of our race, and a fellow passenger here on planet earth?

She excused herself in the end by the almost flippant remark that this lack of empathy beyond our shores kinda indicates that we have a "Singapore identify that transcends race and religion". And that somehow seems noble to her.

I would have been ashamed to discover that my compatriots cared little for people and suffering beyond our tiny prosperous little island where poverty was represented by not owning an HDB flat.

Friday, February 13, 2009

Our Medical School in Singapore - an anniversary of sorts!

Today as I walked passed the College of Medicine Building (COMB) on College Road, I was filled with an unexpected sense of nostalgia and sadness. I have walked this road many times before, regularly, and have frequently not taken even a second look at this wonderful stately building. Kinda took it all for granted. But this morning for some reason, the strong sense of nostalgia was unexpectedly overwhelming.

Still called the College of Medicine Building, it now houses the Ministry of Health. But it began its life in 1926 as the King Edward VII College of Medicine Building. I had another look at the foundation stone, and was surprised that although the stone was laid in September 1923, the building was opened by the Governor, Sir Lawrence Guillemard on February 15, 1926. Tomorrow is actually the 83rd anniversary of that glorious building!!

Does anybody care?...sadly, no...

I was particularly sad because the College and the campus that surrounds it was once home to several generations of medical students. We lived here, worked here, loved and got married here. Students have died here. The Medical School itself began earlier in 1905 and is now coming to 104 years old.

But that Medical School is now gone, and all but forgotten. The National University of Singapore, who inherited the school, in its rush to modernize, has all but lost the glorious heritage of the school. Now sited on a glass and steel campus on Kent Ridge, it cares little for the heritage of the school. The old Sepoy Lines campus was handed over unceremoniously to the Ministry of Health in the 80's when the school moved over to Kent Ridge. The site, where it all began, the old female asylum, was callously torn down and replaced with a carpark!! How souless can you be?

In more recent times, the NUS unilaterally, without any consultation of any sort with her alumni, changed the name of the school to the Yong Loo Lin School of Medicine. This was a real duhhhh moment....! I mean who was YLL, other than a man with money?? None of the alumni could identify with this change, and consequently, many have just lost interest in the Medical School. Sadly, the NUS has failed to see that the alumni spirit, based largely on a culture linked with geography and landmarks, can easily be lost. And once lost will be almost impossible to regain. Our old teachers and role models have been crassly tossed aside, in favour of distinguished scientists and Nobel Prize laureates with whom no medical student can identify. Recently when the great Medical School icon, Prof Wong Hock Boon passed away, there was barely a ripple at the new YLL Medical School.

So sad.

Sometimes, we wish that Singapore, as it becomes more affluent, will be able to spend a bit more effort to develop her soul. But this may be too much to ask. As we rush towards globalization, greed begets more greed, and we crassly abandon all the things that enrich our souls, and remind us of our humanity. Instead of providing us the appropriate leadership, the NUS appears to be leading us deeper into the state of self absorbed disinterest.

Monday, February 9, 2009

Freedomto think - Ngiam Tong Dow's views

Today's Straits Times carried an opinion piece from Ngiam Tong Dow entitled "Fostering the freedom to think". Not altogether new with respect to ideas, but provided much food for thought. I mean, we all know we ought to foster a culture where people are free to think...and innovate. The question is how ...and when?

It made me think about how we train doctors, and what it means for doctors to be 'free' in their thinking...Quite frankly, I am not sure I feel very comfortable with doctors who think too much ... It seems to me like most of the practice of medicine is really based on dependability and quality of diagnosis and care. This comes only with experience, and drill. The more a surgeon does, the better he gets. The more cases a dermatologist sees, the better he is in making a diagnosis. Likewise, the more trauma cases a physician gets to manage, the faster and safer he is when confronted with a crisis situation. I mean, do I really want a physician who is thinking about creative ways of sticking an endotracheal tube down my lungs if I am suffocating?

Having said that, it is true that the medical profession will benefit from a group of smart people thinking of ways to innovate therapy. These are the so called clinician researchers. But these represent a minority of doctors in the profession. The people who go on and win awards. The vast majority of doctors really need to go out there and try and do a decent job of looking after their patients. I think that's what a patient really expects. After all medical malpractice is really based on peer acceptability of what you do. Woe betide the practitioner who innovates too much in managing his patients. That's why I shudder when I read about our Medical School experimenting with all kinds of newfangled ways to teach our medical students. Problem based learning...vertical integration...horizontal integration...and what not.......What on earth are they thinking? We don't really need to make all our doctors become experimental physicians and surgeons! What we need are safe, caring and consistent practitioners of their craft.

To some extent it does mirror Mr Ngiam's have a bunch of safe (perhaps restricted, oversafe) architects in HDB who do a fairly good job in delivering cost effective (albeit unimaginative) solutions. If and when they go to Surbana, they can let fly and win innovation awards.

Let it be that way with our training of doctors. Put the bulk of them through a stiff rigorous training so that they become competent, safe and caring practitioners. Restricted and unimaginative, perhaps. But find some way to identify and allow the really good ones to break free from the constraints of their mundane practice, and innovate for the benefits of patients at large.

Ho Ching's departure - timing is everything

There is a dearth of political humour, so a site like My Sketchbook, showcasing political cartoons can be quite appealing.

The above one about Ho Ching's departure from Temasek Holdings play on a commonly held view. But I think it is probably wrong, and quite unfair. I can nonetheless see how that perception can be perpetuated given the 'disasterous' investments Temasek has made in recent times.

The truth is probably much more mundane, in that Ho Ching's position in Temasek has been quite an embarassment for Temasek as it goes about on its business as a sovereign wealth fund. I think it has become increasingly difficult for her in Temasek, so something had to give. It was probably only a matter of time before she had to distance herself from Temasek. Unfortunately she had to depart in the depths of an extreme economic depression.

Timing is everything.

Friday, February 6, 2009

Woes of the commercialization of medicine - octuplets??

There was a convergence of a number of medical issues in today's Straits Times: The controvery of the recent octuplet birth, Andy Ho's review of multiple IVF births and Dr Huang Shoou Chyuan's letter on doctor's fees guidelines.

The common but often missed thread that connects these is really the fact that the practice of medicine has become so commercialized. Medical ethics has become the servant for the need to generate revenue through medical procedures. To those who would disagree, let me ask if doctors would hesitate to say 'no way' if we were still operating in a 'government hospital' system? Let's be honest, that we are now smack in the middle of the fees-for-services rendered (or more a services-for-fees paid) system makes it extremely difficult for doctors (or even their hospital ethics committees) to be objective about the ethics (or lack of ethics) involved.

Ms Ho Ching to leave Temasek!

Image 'curi-ed' from Asia1

I was truly surprised by the announcement that Ms Ho Ching was leaving Temasek Holdings.

I haven't been particularly enamored by the fact that the wife of our Prime Minister, and daughter-in-law of the MM was running our nation's biggest business holdings. Eighth most powerful woman in the world! Not that there was anything dishonest about it but it just didn't make good sense to perpetuate the suspicions that this was just part of a business as per normal for the Lee dynasty.

But the announcement yesterday put all that to rest. And I celebrate it.

I further celebrate the fact that the transition of power was done in such an open, objective, professional and dignified manner. In a world where ruling elites secretly and not so secretly amass great wealth for their families through corrupt dealings, this public transition deserves to be applauded.

Thank you Ms Ho for all that you have done and accomplished on our behalf.

Thursday, February 5, 2009

Government in cyberspace - Rear-Admiral Lui Tuck Yew

I'm afraid Senior Minister of State Rear-Admiral Lui Tuck Yew's rant was neither rational nor admirable. Sadly it may kinda reflect the gahment's view of the world - sanitized, monolithic and 'proper'. Surely Senior Minister of State Rear Admiral Lui Tuck Yew must know that cyberspace is not only populated by a diverse group of people, but that the loudest voices are usually those with extreme views or those with an axe to grind. Most rational voices tend to remain relative silent. But that's the nature of cyberspace. And and that's also the beauty of it.

Ironically Admiral Lui's tirade against the failure of cyberspace to 'self-regulate' points an accusatory finger at Admiral Lui himself and the gahment, because it reflects upon the failure of themselves and their proxies to effectively engage cyberspace. It is no point pontificating from some isolated mountain top as if you are an oracle. Gahment and officialdom has a responsibility to also engage its citizenry at their lowest levels even if they deem it beneath them. How do you shape people's ideas if you don't engage them where they are? You don't organize meet the people sessions in the posh offices in city hall do you? You need to go on more walkabouts, sit in coffeeshops. Likewise, gahment's invisibility in the apparent chaos and squalor of cyberspace perpetuates an unbalanced circulation of extreme and negative views. I am not refering to the occasional interjections of officious statements, but the participation of gahment and their representatives in presenting rational and balanced arguments that has real strength, and that will shape the opinions in cyberspace. If your arguments are sound what are you afraid of?

The Straits Times carried an editorial 2 days ago which also brought into focus some of these issues.

The question I want to ask Admiral Lui is this...does the gahment want to engage its citizenry...or does it expect its citizens to engage it? The answer will make clear where the appropriate places of engagement might the apparent chaos of cyberspace...or in some officious sterile chatrooms.

Tuesday, February 3, 2009

Chikungunya in Singapore - latest from MOH

The latest MOH figures for chikungunya in January 2009 has been released.

In January alone we've had 160 new cases detected with only 10 positively identified as being imported cases, i.e. ~93% of cases are locally transmitted. Good news is that over the last week of January, the incidence dropped to 17 cases (only one imported).

It seems pretty clear that the disease has become quite endemic and the infectious clusters are being maintained by a local reservoir of the virus.

Following data from MOH weekly update. I found it quite curious that NEA, after a flurry of updates in first half of 2008, has become deathly silent about this...and there has been only one update since September 2008.

Active Clusters with 10 or more cases

Cluster Name (Number of cases)
Sungei Kadut (59)
Jalan Papan (49)
Tanjong Kling Road (44)
Leedon Heights (13)
Swiss Club Road (12)

Active Clusters with less than 10 cases

• Penjuru Road
• Jalan Samulun
• Woodlands Industrial Park
• Kian Teck Crescent
• Bukit Batok Crescent
• Cluny Road
• Balmoral Road
• Cedarwood Grove
• Jalan Rumah Tinggi
• Queen Astrid Park
• Ubi Crescent
• Pandan Loop

Monday, February 2, 2009

The great cholera epidemic

The humongous cholera epidemic in Zimbabwe at the moment introduces another funny bug, Vibrio cholerae.

Such a tragic epidemic that has left more than 60,000 people reeling and at least 3100 dead. Tragic because it is such a manageable disease by today's standards. The water can be disinfected and the profuse debilitating diarrhea managed.

This vicious bug has no concern for its human host because it is a freewheeling, freeliving organism that can exist in various aquatic reservoirs. It callously makes use of the human body as little more than an incubation chamber, even exploiting the gastric acidity to enhance its virulence. Once it secures itself on the intestinal mucosae, it releases a potent toxin that causes a profuse watery diarrhea. The poor victim continues to pass out buckets of watery stool full of bugs that are ready to inflict damage on the rest of the world. It doesn't really care if the host dies.

Apparently first detected in India, it is thought to have originated there, in the fetid waters of the Ganges. The first pandemic was recorded in the early nineteenth century so it does not seem to be a very ancient bug.

When I was reading this, I immediately thought of the nouveau riche 'chau ah bengs', who obvious care little for the world they inhabit. They rape and pillage resources in order to propagate their genes, and are oblivious to the the damage they inflict on the rest of mankind, or the world they live in. Like the cholera bug, I don't think they care if the world dies in their wake.


Can we eat shit and get away with it? Coprophagy is normal.

Talking about gut fermentation and ruminants got me thinking the physiology of eating faeces. Animals like rabbits have to do it because their fermentation chamber is sited quite far down their alimentary tract. If they don't eat their own faeces, the fermentation products and nutrients have little chance of being absorbed. And rabbits don't die from eating their own shit.

We are actually more like rabbits than cows where our gut is concerned. While we do not have a large caecal fermentation chamber, scientists have documented considerable digestion occuring in the colon and have suggested that as much as 10% of our nutritional needs may be contributed by what happens in our colons. So why don't we eat our own shit... can we do it and get away with it?

Many animal species in fact do engage in coprophagy. Our closest primate relatives do it regularly. But we don't ... and in fact regard it as an abnormal activity reserved for mad people.

Actually from a biological perspective, there is really no problem in eating our own shit. Mad people do it and they do not fall sick, or die. Our gut is full of bacteria, and our shit is teeming with bugs. But in reality, most of them are friendly creatures. Reswallowing them should really not cause any problems.

The problems with coprophagy is when we are sick and carry some abnormal, pathogenic bacteria in our gut, as when we have salmonellosis, or a pathogenic coliform bacteria, or the dreaded norovirus... then eating shit becomes a problem...not so much for ourselves because if we are already infected, eating more of it is not really going to make much of a difference. The problem is when other people eat our infected shit. Then the infection spreads across the community.

For this reason the practice of eating shit or shit contaminated materials is not recommended. Public health people look for evidences of such contamination by counting the number of Escherichia coli present in food. These otherwise friendly bugs who live happily in our colon, generally do not cause problems unless they have a chance to attack other organs They generally do not live long outside our bodies so their presence in food generally indicates fresh faecal contamination.

So the long and short of it is that eating shit is fine. I wouldn't recommend it though, because I don't think it will be a pleasant experience. But whatever you do, try not to eat other people's shit...

Bon appétit

Dengue and Chikungunya in Singapore - endemicity and ecdemicity #2

Chikungunya virus particles
An interesting thing happened to me on the way to the toilet. Someone I knew, and who knew of my posts on this matter whispered to me (hushed tone with a wicked grin) an interesting exchange between the Ministry of Health (MOH) and the Ministry of the Environment and Water Resources (MEWR) / National Environmental Agency (NEA) about the chikungunya problem.

Apparently the MOH is somewhat sensitive about acknowledging that chikungunya has become endemic in Singapore ( a bit of misplaced pride here), while the NEA is somewhat keen to declare it endemic. Apparently if it is endemic, NEA's vector control people no need to work so hard to stem the spread of the disease (which is inevitably happening anyway...).

I don't know how much of this is true, but since I have no reason to doubt my source, there may be some truth lurking in there somewhere. Kinda amusing thinking of these serious policy makers approaching this issue with that kind of childish parochial mindset.

Kinda misplaced priorities if you ask me...

Nadal and Federer - two great champions

I saw something beautiful yesterday. In the most unlikely of places and moments.

The Australian Open Tennis Finals between Roger Federer and Rafael Nadal.

It was an exciting match, even for someone not too accustomed to tennis. Here were two great proponents of the game, perhaps two of the greatest, slugging away at each other for 4 hours and 23 minutes. And in the end someone had to lose.

There was no doubting the passions that each brought to the tournament, and their commitment to win. And in the end, tragically, one had to lose. And there was that incredible scene of the past champion bawling away like a baby on the podium in full view of a globalized television audience of perhaps millions. It wasn't easy for him to lose. And there was that incredible scene of these two grown, beefy men, sweaty from their herculean effort, with their arms around each other, almost snuggling up like lovers. No hint of homophobia there.

And most beautifully, in that vital moment, when one had to give way to the other, ....when a champion had to step aside for a successor, there was grace and sportsmanship like never seen before in any other sporting occasion.

We have been treated of late to so much childish, petulant and temperamental behaviour by sporting stars. Me first, and damn the rest! But here was sport at her best.

Two real champions.