“I remember our first chronic disease patient, let’s call him Amin, in 2014. Back then, we said that we didn’t want to see chronic disease patients because it’s too complicated to follow-up with HbA1c, renal panel and eye screening etc. Then he showed me his polyclinic bill and I was shocked – $149.50! He was totally devastated and said ‘Please, sir, help.’ The look in his eyes was haunting, as though saying if HealthServe helps migrant workers but only acute cases, then what about me? All my defenses were broken. My heart overtook my head.”
“He really caught me off-guard. I knew his context – that he was a Clementi bin centre worker. If it’s you or me, while $150 is relatively expensive, it is still manageable. Months later, I had offered him a lift home as I was on the way to Clementi. He was so thankful as he could save a few dollars of MRT fare. If those few dollars were so precious to him, could you imagine $150?
When I dropped him off at the bin centre where he lived, I asked if I could take a look inside. He was delighted that I’d asked! I had the privilege of entering into his space and his world. I was honoured that he allowed me to be a guest in his ‘house’ in the HDB bin centre – next to the smelly compacting machines. That changed my life. It really hit me.
Amin was the reason we now see chronic disease patients and we are determined to help them.
We cannot pretend that, “No such thing la, there’s no chronic disease amongst the migrant workers because they’re all young and fit.”
We’ve really come such a long way and MOM just announced the new Regional Medical Centres will manage chronic diseases for migrant workers too!
Of course, I wasn’t always so concerned about social issues.
Back in medical school (when it was at SGH in Outram), we had a subject called SMPH – Social Medicine & Public Health. The lectures were held across Outram Road, one street away. Little did I realise, this was next to Jalan Kukoh where 70% are low cost 1-2 room rental flats. One of the cases assigned to my CG was a lady with a thyroid problem. We had to learn and find out about her social issues, but it did not strike me then that social issues were a big deal.
My curiosity and attentive presence to social issues around me only developed later. To be honest, I feel mine came quite late in life, unlike people like Tan Lai Yong – he was my classmate! My first interaction with fringe communities was with him as he chose to work as an MO in prison. I often visited his wife and him in the prison quarters.”
“I interacted closely with the people I was doing the annual medical examinations for as I entered their lives having heard their stories firsthand. I gradually developed an awareness of deeper social issues.
At an international conference, I met a dentist (Simon Mahendran) who had set up a clinic for migrant workers, called Karunya Community Clinic. He got me interested and he’s really a silent hero. Simon had difficulty getting doctor volunteers. So I rounded up my friends like Dr Shawn Vasoo, and as we volunteered, we got more familiar with the migrant worker space.
Idealistic and impatient, my head was in the clouds with big issues like poverty and inequality in healthcare access. Thus, I needed my co-founder Shin Yeong, who wasn’t a doctor. With his MBA, he could help me precipitate the rain. Many doctors still don’t understand when we say health is interdisciplinary. They’re thinking cardiovascular, CNS, but no – we’re talking about social workers, politicians, lawyers – HealthServe is now being chaired by an economist!
The medical part is at most 1/3 of the work but sometimes doctors think the world revolves around us. But I’m privileged to have been part of this collaborative space.
Did I give up a lot going into this? No la, I think I had fun, maybe because I happen to find unknowns exciting. If you find something interesting, go in and invite other people. If it’s a big mess, then other people will share the problem with you. Friends give you perspective, advice, support – doing it together and walking into the unknown together really makes a world of difference. I think it was the friends that made all the difference for me.”
Contributed by Jarret Ng and Joanna Yang. This article first appeared on Humans of Medicine YLL (@humansofmedyll), an Instagram page by NUS Medical Society from Yong Loo Lin School of Medicine.