April 28, 2017

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by Wan Ting Koh

IS IT any surprise that the only contraceptives most women know about are the condom and the pill? They might even know the varieties of condoms available since they are sold openly on the counter, and even the brands of birth control pills.

But a vaginal ring? It sounds more sexually erotic than procreation-prohibiting. Only 31.7 per cent of 259 women surveyed were aware of this contraceptive, according to a study conducted between 2013 and 2014 by National University Hospital doctors.

MSM has the results of the study, but doesn’t say much more about such non-traditional contraceptives apart from how some of them work. A vaginal ring is a small, flexible ring a woman inserts into her vagina to prevent pregnancy. It releases the hormones, progestin and estrogen into the body, which prevents the ovaries from producing mature eggs. Once in place, the vaginal ring is left alone for three weeks and taken out in the last week of the month.

Apart from gynaecologists, the ring, popularly known as the NuvaRing, can be found at Mount Elizabeth’s (Mount Elizabeth Road) pharmacy and costs $43.14 per box. Each box contains one ring. Now compare that to a minimum of $8 for a box of 12 condoms. Ladies, wouldn’t you rather get the guy to buy himself the cap than get you a ring?

The study also looked at women’s awareness of seven other contraceptives to ascertain the level of awareness and knowledge of contraception among women in Singapore, and to see if current measures to educate women on contraception are effective. All the women, who were between 21 and 49 years old, know of the condom, and 89.2 per cent were aware of oral contraceptives.

However, less than half were aware of five of the newer methods available. These five are: birth control patches, implants, hormonal intrauterine device (IUD), injectable contraceptives, and, yes, vaginal rings. Awareness of hormonal IUDs ranked at the bottom, with only 24.3 per cent being aware of them. Women ought to be aware of alternatives other than the pill and condoms, because they might be more suitable for their bodies, or even more effective.

MethodAwareness
Condoms100 per cent
Oral contraceptive pills89.2 per cent
Tubal ligation73 per cent
Copper IUD72.2 per cent
Implant48.3 per cent
Injectable contraceptive46.7 per cent
Patch40.9 per cent
Vaginal ring31.7 per cent
Hormonal IUD24.3 per cent

Here are the seven contraceptives (apart from condoms and the NuvaRing) available in Singapore, and where you might get them. Note though, that all require a prescription from, or a consultation with, a doctor.

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1. Oral contraceptives

These come in the form of pills which contain a combination of hormones, estrogen and progestin, in your body when ingested. These hormones prevent pregnancy by preventing ovulation.

Oral contraceptives are available at pharmacies and some GP clinics for a range of prices. You can buy these contraceptives after visiting a doctor for a prescription at certain Watsons, Guardian and Unity pharmacies. Pills cost between $6 and $50.

2. Implants

Birth control implants are devices that release a hormone which prevents pregnancy. They come in the form of plastic rods the size of matchsticks, and are placed under a woman’s skin – usually her upper arm. Implants are probably not available over-the-countertop at pharmacies, as they require doctors to inject them.

However, they should be available at gynaecologists or specialist clinics. GynaeMD Women’s Clinic provides Implanon, a type of implant, for $823, including the consultation fee and the device itself. Consultations range between $120 and $135. The implant should last for three years.

3. Copper IUDs

In case you’re wondering what they are, IUDs, are T- or U-shaped plastic devices that are inserted into a woman’s uterus by a doctor. The copper IUD is wrapped with a copper wire and makes the uterus and fallopian tubes produce fluid that kills sperm.

The IUD device has a plastic string tied to its end, which hangs down through the cervix into the vagina. The doctor uses this string to remove it. IUDs are a long-term birth control method that can last up to five years.

Copper IUDs are available at KK Women’s and Children’s Hospital’s outpatient pharmacy for around $40. You can visit a gynaecologist to have the copper IUDs inserted as well. A procedure at Judy Wong Clinic for Women would cost $420, not including consultation fee and GST.

4. Hormonal IUDs

Similar to the copper IUDs, hormonal IUDs are inserted into the uterus for long-term birth control. It comes in a T-shaped plastic frame that releases a substance and thickens the cervical mucus to prevent sperm from reaching or fertilising an egg.

KK Women’s and Children’s Hospital’s outpatient pharmacy has Mirena, a brand of hormonal IUD, for around $350. A procedure at Judy Wong Clinic for Women would cost $680, not including consultation fee and GST.

5. Birth control patch

The birth control patch is a small, square patch that looks like a plastic bandage. The woman sticks it to her skin, and it releases hormones into her body to prevent pregnancy. One patch can last a week. The more popular brand of patches in Singapore is Evra, which is stocked at certain Unity, Guardian, and Watsons pharmacies.

Unity pharmacies sell a box of Evra, which comes with three patches, for $43.15. Guardian sells it for $40 per box, while Watsons sells it for $35.70. Not all branches of the pharmacies stock the patches though – it is recommended that you call the branch before making a trip. KK Women’s and Children’s Hospital’s outpatient pharmacy also sells Evra for $36 per box. These require a prescription too.

 6. Injectable contraceptives

The contraceptive injection is a shot that contains hormones which stop a woman’s body from releasing eggs and thickens the mucus at the cervix. Shots are needed either once a month, or once every three months, and are administered by doctors.

Dr Tan & Partners clinics provide injectable contraceptives for $45, not including consultation fees. Its consultation fee for its branch at Robertson Quay is about $60 to $80. Judy Wong Clinic for Women provides the shot for $40, not including the consultation fee.

 

7. Tubal ligation

This is a permanent form of birth control that involves severing the fallopian tubes so that the eggs cannot reach the uterus. The equivalent procedure for a man would be a vasectomy, where the vas deferens from each testicle is clamped. This prevents sperm from mixing with the semen that is ejaculated from the penis.

Tubal ligations are surgical procedures that are subjected to hospital and doctor rates. You can approach gynaecologists and specialist clinics for them.

 

Featured image by Najeer Yusof.

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by Wan Ting Koh

 

Featured image by Sean Chong.

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A Tissot wristwatch with clock hands pointing at 8:30
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IT’S an ambitious target – to have nine out of 10 people who are infected to know that they are, and so on. But on World Aids Day today (Dec 1), this goal, known as the “90-90-90 Treatment Goals” and set by the Joint United Nations Programme on HIV/Aids, is a timely reminder of how much more work needs to be done to de-stigmatise the illness in society.

One way is to tell stories. In The Straits Times (ST) today, there’s a touching account of two patients from Dr Wong Chen Seong, a doctor at Tan Tock Seng Hospital, who cares for these patients.

The consultant at the hospital’s Institute of Infectious Diseases and Epidemiology describes a life of shame and regret, recently made a little better because of advances in medical treatment. HIV testing and treatments these days are now much more effective and affordable, lifting what was once thought of as a death sentence and offering patients a period of “hopeful living”, he said.

“People with HIV are living longer, healthier lives than could ever have been imagined during the dark early years of the epidemic,” said Dr Wong.

One such medical advancement is the availability of the HIV Pre-Exposure Prophylaxis, also known as PrEP. More on this coming up later today.

Speaking of hopeful living, look on the bright side if your pay isn’t going to go up this or next year – at least you’ve still got a job in this lousy economy.

Wage growth is slowing. The median income went up only 2.7 per cent in June, compared to 4.7 per cent a year ago, according to figures released yesterday by the Ministry of Manpower. Economist labour executives said they don’t expect the situation to be better next year.

Said National Trades Union Congress assistant secretary-general Zainal Sapari: “It’s more important to make sure workers continue to have jobs.”

Prime Minister Lee Hsien Loong gave an interview to Malaysian news agency Bernama on Monday, in which he reiterated the challenges of building the high-speed rail between Singapore and Kuala Lumpur, and pledged to get the job done.

“It is a very ambitious, very complicated and very expansive project,” he said in the interview, according to the transcript that was released yesterday. “We have to try our best to anticipate what the likely issues are… and have a clear understanding of how we will deal with it if a situation arises.”

He said both Singapore and Malaysia have made “very good progress” on the agreement, but did not give details about how the costs would be shared when asked. It was one of the items that made the project complicated, he acknowledged, but added: “We are almost there.”

Mr Lee was also asked about the presidential election, and if the G had a list of people in mind to run for the position. To that, he said: “There is no shortlist. It depends on who comes forward. It is not for the G to arrange.”

 

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by Li Shan Teo

THE number of Zika cases in Vietnam has more than doubled over the past three days to 23 cases, said the country’s health ministry. A dozen of the new cases were reported in Vietnam’s commercial hub of Ho Chi Minh City, and the country’s first case of microcephaly that is likely linked to Zika was reported last Sunday (Oct 30).

Singapore has been relatively lucky, with the number of Zika cases dwindling over the past month.

Since the first case came to light in August, the National Environment Agency (NEA) has reported a total of 442 cases, including 16 pregnant women. But if you think these numbers are alarming, there’s cause for relief: Only 12 cases were reported last week, and 11 cases the week before. So far this week, only two new cases have been reported.

How did we tackle the issue so quickly?

If you need a memory refresher, Zika is a virus transmitted by the Aedes mosquito. While the infection is generally mild, there can be some severe consequences such as microcephaly and neurological complications.

One of the measures taken by the NEA was vector control. Adult mosquitoes were killed using insecticide fogging and misting, and space spraying indoors. Mosquito breeding sources were also removed through intensive search-and-destroy operations to prevent disease transmission.

On top of that, other measures employed include encouraging residents to perform the “5-step Mozzie Wipeout“, and the release of mosquitoes infected with the Wolbachia bacteria, which results in eggs that do not hatch after they mate.

 

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by Li Shan Teo 

HEARD of pitaya (yellow dragon fruit) from Ecuador? What about the ghost pepper from India?

Well, these exotic produce might be a common sight soon at supermarkets, specialty shops and even market stalls here.

Stores like Fairprice Finest and Cold Storage are bringing in more exotic produce – from countries like Colombia and Ecuador – to introduce some variety to our grocery lists.

Have Singaporeans developed an appetite for the unusual?

Mr Victor Chai, the director of fresh and frozen products for Fairprice told TMG that the supermarket constantly looks for ways to engage its customers and “cater to their evolving lifestyles” by “periodically [introducing] new and unique products”. 

Singaporeans are becoming increasingly well-travelled – according to Visa’s Global Travel Intentions Study conducted last year, 95 per cent of Singaporeans have travelled abroad for leisure from 2014 to 2015. Introducing new products from “around the world” was therefore one way to engage with the customers of today. 

According to Mr Chai, the exotic produce available generally generate good sales. The moon drop grapes, which were introduced in Fairprice in August, have been “well-received by [its] shoppers” with good sales. Cold Storage is also selling this variety of grapes.

Blueberries, which used to only be available in limited quantities, were also well-received and are now available at majority of Fairprice outlets almost all-year round, Mr Chai added.

As for the yellow dragon fruit, Mr William Lim, the owner of Holland Village Fresh Fruits market stall, said that he had brought in the fruit from Ecuador about five to six years ago. While current sales are not as good as when he had first brought the yellow dragon fruit in, he would still continue to sell them, as he attributed the drop in sales as something inevitable due to the economic downturn – it may also be harder for smaller fruit shops to generate good sales due to their location and comparatively smaller customer base.

Mr Lim also imports the Ecuadorian passion fruit. He chose to import these fruits because Singaporeans are known to like sweet fruits, he said. The yellow dragon fruit and the Ecuadorian passion fruit are both well known for their sweetness.

Here are some interesting finds in the stores:

 

1. Ghost pepper

Touted as one of the hottest peppers in the world, the ghost pepper, also known as Bhut jolokia, measures more than 1 million Scoville heat units. For comparison, it’s 400 times hotter than Tabasco sauce. The pepper is cultivated in India and indigenous to the Assam region in the northeastern part of the country.

While Singaporeans love spicy food, it’s best to be careful with the ghost pepper. According to reports, a healthy 47-year-old man who attempted a super-spicy feat – eating a hamburger served with a ghost pepper puree – tore a hole in his oesophagus and had to be rushed to the hospital.

A seed from the pepper can cause the mouth to feel like it’s on fire for up to half an hour.

Still, ghost peppers can make a great ingredient for many sauces. Just remember not to go overboard.

You can find them at Fairprice Finest at $4.95 per box.

peppers-2

Image from TMG file. 

 

2. Yellow dragon fruit

We’ve all seen the “traditional” dragon fruit with the bright red skin. But yellow dragon fruit are rare and a novelty to Singaporeans. The main difference? The yellow ones are produced in only two countries in the world – Ecuador and Colombia. The flesh is also said to be much sweeter.

The dragon fruit is also rich with health benefits, such as aiding with digestion and improving immunity. Its high fibre content improves the body’s bowel movements, and high levels of vitamin C present in the fruit gives the immune system a boost.

These fruits are being sold at Momobud at $13 per piece.

They’re also sold at Holland Village Fresh Fruits for $8 to $10 per piece. You can also buy them for $28 per kilogram. The market stall is located at No. 1 Lorong Mambong, Singapore 277700.

Image from TMG file. 

 

3. Ecuadorian passion fruit

Unlike the normal dark-coloured variety, the passion fruit from Ecuador – also called the Granadilla – has transparent flesh and is sweet. The fruit is sold with straws at Fairprice Finest, so that consumers can “drink” the pulp.

The Granadilla has many health properties: rich in anti-oxidants, improves and maintains eye vision, alleviates asthma attacks and treats insomnia.

You can buy these passion fruits at Fairprice Finest for $6.50 – they come in a pair.

They are also sold at Holland Village Fresh Fruits at $3 a piece.

passionfruit

Image from TMG file.

 

4. Moon drop grapes 

Local supermarkets have started to import moon drop grapes, and unlike normal grapes, these are somewhat oblong in shape. The skins of the grapes are also darker than that of normal grapes.

The grapes are rich in vitamin A, vitamin C, calcium and iron. They also control your blood sugar, relieve constipation and improve your vision.

Cold Storage sells them at $15 per pack.

You can also find them at Epicure Fine Foods Pte Ltd for $25 (1 kg bag).

moon-grape

Image from NTUC Fairprice. 

 

5. Golden raspberries

Raspberries don’t just come in red. In fact, they come in a variety of colours such as purple or black. The golden raspberries that have recently been introduced in local supermarkets are the sweetest of the group – they tend to have a sweeter and milder flavour compared to their red counterparts.

Like all raspberries, golden raspberries possess a variety of health benefits. They contain powerful antioxidants that inhibit tumour growth and inflammation in the body. The fibre and water content of the fruit also help to prevent constipation and maintain a healthy digestive tract.

You can read more about the health benefits of raspberries here.

You can buy the golden raspberries at $7.95 per box at Fairprice Finest.

golden-raspberries-copy

Image from TMG file. 

 

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by Ryan Ong

INSURANCE riders have been blamed for pushing up treatment costs by 20 to 25 per cent. This could drive up health insurance costs, because the more insurers have to payout, the higher premiums get. A panel on controlling the rising cost of health insurance has now suggested riders be done away with completely. It’s the old age problem of consumption: when you don’t have to pay for something, you tend to use more of it.

by Wan Ting Koh

IF YOU’VE been frustrated by the lack of transparency in private hospital fees, you can now visit the Ministry of Health’s (MOH) website to look for prices of procedures ranging from a Caesarean to circumcision.

We did a cursory analysis of the 141 procedures listed and found that the difference in prices for the same procedure varied widely. We picked out the ones with the biggest price differences for each body part and found that a heart surgery topped the list with a $16,638 difference between its lowest and highest price.

The cost of an eye procedure was three times more than its lowest price point.

MOH started listing private hospital operation fees two weeks ago on its website. Even though individual private hospital fees aren’t revealed, fees are displayed as a range, with the lower amount reflecting the 25th percentile charged and the higher amount, the 75th percentile. Operation fees are split into three components: the surgeon’s fee, the anaesthetist’s fee and the cost of the facility.

The release of fees suggests a greater move towards transparency for the G. In 2013, when Parkway Pantai, the medical group which owns four hospitals, including Mount Elizabeth and Gleneagles, published its prices for 30 procedures for each of its hospitals, some were worried that the act might contravene anti-competition laws.

However the Competition Commission of Singapore said that compiling information from patients already billed, which was what Parkway Pantai did, was not illegal, unlike medical fee guidelines which determine the cost of a procedure. That was something that the Singapore Medical Association had to scrap in 2007 for fear of infringing the competition act.

With escalating healthcare costs in the recent years however, there have been more calls for transparency and the G began publishing total operation fees for public hospitals in 2014.

 

The biggest differences

But is this move really beneficial, given that the range of some procedures can be as much as three times the lowest price?

This was the case for an eye procedure – a lens implantation surgery after a cataract surgery. The operation fee can cost from as low as $3,605, to a high of $11,014 which is three times the lowest price point.

Delving deeper into operation fee components showed that both facility fees and surgeon fees contribute to the wide range as the highest price for each is nearly three times the lowest price. No anaesthetist fees were given for this procure as there were fewer than 30 cases.

Similarly, a procedure to remove unhealthy skin tissues in a wound measuring more than 3cm, ranges between $3,243 and $6,295, with the highest operation fee pegged at nearly twice the price of the lowest. Surgeon fees are the culprit for this wide range as the highest cost more than twice the lowest price.

In terms of numerical value, the heart and coronary artery bypass graft surgery had the widest range, from $35,566 to $52,204, which makes a difference of $16,638.

 

Body PartMost expensive procedureSurgeon feesDifferenceAnaesthetist feesDifferenceFacility feesdifferenceTotal operation feesDifference
AbdomenRepair of hernia (ventral/incisional/recurrent hernia)$4,815-$9,095$4,280$1050-$1,875$825$2,679-$6,294$3,615$9,297-$16,398$7,101
Blood vesselsVein, imaging guided laser treatment for varicose vein (1 leg)$4,120-$10,165$6,045--$1,336-$2,730$1,394$8,312-$11,659$3,347
Bone/jointsHip, total hip replacement$8,560-$16,050$7,490$1,750-$2,500$750$4,193-$6,479$2,286$14,040-$25,036$10,996
ChestHeart, coronary artery bypass graft$18,413-$26,857$8,444$3,000-$4,500$1,500$13,578-$22,175$8,597$35,566-$52,204$16,638
EyesLens implantation after previous lens/cataract surgery$3,000-$8,239$5,239--$830-$2,416$1,586$3,605-$11,014$7,409
Female reproductive systemOvary, removal of both ovaries, uterus, fallopian tubes with further cancer$9,257 - $15,034$5,777$2,000 - $3,500$1,500$3,554 - $9,099$5,545$17,110 - $27,139
$10,029
Hand/fingerCarpal tunnel release (single)$2,400 - $4,280$1,880$500 - $900$400$861 - $1,859$998$3,499 - $6,106$2,607
*HeadRepair of jawbone (simple)--------
*Lymphatic systemCervical lymph node, removal/biopsy of cervical lymph node$2,140 - $3,745$1,605$600 - $875$275$1,426 - $2,962$1,536$4,289 - $6,390$2,101
Male reproductive systemProstate, removal of tissue$4,280 - $5,783$1,503$1,000 - $1,500$500$3,370 - $4,822$1,452$9,191 - $11,819$2,628
*MouthRepair of gum tissue--------
Neck/throatThyroid gland, complete removal$6,634 - $11,400$4,766$1,500 - $2,675$1,175$4,534 - $6,502$1,968$13,226 - $20,606$7,380
NoseRemoval of sinus bones$6,420 - $10,980$4,560$1,500 - $2,200$700$3,357 - $6,661$3,304$11,148 - $20,384$9,236
Skin/soft tissueSkin, removal of unhealthy tissues in a wound >3cm$1,819 - $3,745$1,926$500 - $1,000$500$1,094 - $2,135$1,094$3,243 - $6,295$3,025
Urinary tractUreter, non-invasive shock wave therapy for stones$3,000 - $4,173$1,173$750 - $1,000$250$1,876 - $3,332$1,456$4,000 - $7,309$3,309

*Body parts with only one procedure available

 

What’s in your operation fee?

But why do prices vary across private hospitals?

For many, many reasons. Each of the three components has a number of variables factored in. Surgeon’s fees take into consideration the surgeon’s skill level and experience and the techniques they use. A reputable private surgeon may charge higher prices than a lesser-known counterpart.

The prices charged also reflect the complexity of the operation involved, said Dr Gerard Chee, a specialist Ear, Nose, and Throat surgeon in private practice. “If I open only one sinus, I will charge $X for a procedure that will last about 20 minutes to half an hour. If I open all eight sinuses, I will charge about three times more for a three-hour procedure,” he said.

A difficult surgery might have a wider price range as compared to a straightforward one, like a tonsillectomy, he added. The difference in the range of prices listed for a tonsillectomy – which is the removal of tonsils – is $2,929.

According to Dr Chee, an anaesthetist’s fees is usually about 25 per cent of the surgeon’s fees in private hospitals. The surgeon would bill the fee for them, he said. However, there are other ways that anaesthesia fees may be calculated.

The price may vary according to the type of anaesthesia used, whether regional – which only numbs a specific part of the body – or general anaesthesia, which renders the patient fully unconscious.

There is also a lower level of anaesthesia known as sedation which keeps the patient awake, though unable to remember the operation. Anaesthetists may also charge more for a longer operation as they will have to monitor the condition of the patient throughout.

How the anaesthesia is applied may also be a factor, whether it is topical, injected through an IV drip, or given through a gas mask. Special equipment may also be needed for certain anaesthetic procedures, such as those that deal with complicated nerve blocks.

Then there are the facility fees which include the cost of the operating theatre, which varies according to each hospital’s rental rates, the quantity of disposables used, and the type and quality of equipment.

 

Will the list work?

The lack of guidelines means that surgeons determine how to charge their patients.

Most, according to a 2012 ST report, refer to fees drawn up by public hospitals and MOH’s rating of complexity of procedures as a benchmark before adding premiums such as the surgeon’s level of experience. Others refer to how much their peers charge by sending spies to rival surgeons’ prices.

But listing the range of fees may have a limited effect on the fees themselves. Plus, it is still possible for private surgeons to overcharge, since there is no hard-and-fast rule for charging patients. Furthermore, the operation fees listed on MOH’s website are only what 50 per cent of patients here pay.

Having the fees listed doesn’t mean that surgeons cannot charge above the norm, said Ms Tin Pei Ling, who is on the Government Parliamentary Committee for Health.

“But then they will have to give patients a full and proper explanation,” she added.

Though there is a possibility that surgeons who charge higher than the 75th percentile might lower their prices, surgeons who have fees which fall below the 25th percentile may also increase their prices. Said Dr Chee: “For example, if I charge $1,000 for a tonsillectomy and I find out that the lowest price in the range is $3,800, I might raise my fee.”

“Surgeons don’t want to look like they are ‘cheap’. If a doctor charges less than his or her peers, some patients might think that the doctor is not good, or that he doesn’t have enough business, or that he is desperate. This is human nature.”

Listing private hospital fees may be a step in the right direction, but more data may be needed to make the list more robust. Can we look forward to more procedures, including non-surgical ones, being added to the list too?

 

Additional reporting by Li Shan Teo.

Featured image by Natassya Siregar.

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An elderly man makes his way back to his room along one of the numerous aisles in the single-storey elderly home.

by Wan Ting Koh

AT LEAST they agreed on this one point: It’s high time we made our nursing homes better.

But how? That part of the problem has now sharply divided two groups of industry experts and professionals, who each believe they hold the answer to the future of nursing home care in Singapore.

On one side is the Lien Foundation and Khoo Chwee Neo Foundation, who say the “medicalised” model with its dormitory beds needs to be thrown out. They want to build more “home-like” environments, with single- or twin-bedded rooms that give the elderly more privacy.

On the other side: Representatives from six of the nation’s best-known nursing homes, who say that is a waste of money and by the way, some old people actually prefer to share a big room because it makes them feel less lonely.

Said S. Devendran, Chief Executive of the Sree Narayana Mission (Singapore) in a Straits Times Forum letter today (Oct 13): “While there may be a need for more eldercare options, our experience has been that not everyone prefers single rooms … As charity organisations dependent on public donations, we need to be prudent.”

The letter was signed by representatives from five other nursing homes: Kwong Wai Shiu Hospital, Lions Home for the Elders, Man Fut Tong Nursing Home, Moral Home for the Aged Sick, and Singapore Christian Home.

“While there may be a need for more eldercare options, our experience has been that not everyone prefers single rooms.”

The argument comes after a new 131-page industry report was released last week by the two foundations, put together with input from academics, policy-makers, the residents themselves, their family members, and more than 50 nursing home operators.

Titled Safe But Soulless, it argued for an urgent overhaul of how nursing homes are designed and operated, given the expected boom in Singapore’s elderly population by 2030.

Currently, two-thirds of the nation’s nursing homes are run by charity groups, which suffer from a lack of resources as they rely primarily on donations and G subsidies. The remaining third are privately-run: They are more comfortable, but can cost up to $6,000 a month for a single-bedded room.

Some people interviewed for the report likened nursing homes facilities to jails because of its barred gates and locked doors. Also, as many as one in three residents that suffer from mental illnesses are tied to their beds. They require constant supervision, which the nursing homes cannot afford.

Yes, these are all part of the difficulties of running a nursing home, but many improvements have been made over the years, Mr Devendran said.

“Being branded in one sweep as “soulless” in the Safe But Soulless study on nursing homes… despite our collective efforts to improve the quality and standard of nursing homes – is difficult to accept,” he wrote.

Instead of building new homes that prioritise personal space, the group believes resources can be put to better use by recruiting more volunteers, or organising more activities such as music and art therapy sessions.

These programmes help the elderly feel less lonely, which they say is the real problem.

“Many of us can share stories which affirm that loneliness is one of the biggest fears for the elderly,” said Mr Devendran. “This can strike regardless of generation or accommodation type.”

“Many of us can share stories which affirm that loneliness is one of the biggest fears for the elderly.”

One way or the other, both groups agree more resources are needed – and much of it will come from the G. But which side of the argument will it agree with more?

The G is keeping an open mind for now, it seems.

Last year, it declined to provide subsidies to a project that favoured the foundations’ vision of single- and twin-bedded layouts, saying it would be tantamount to subsidising a private or A-class hospital ward.

But since the release of the new report, the Health Ministry has said it would review the report’s findings, adding that it held some “interesting ideas”.

In the meantime, it will continue to do what it can to help the situation. The first G-run nursing home, Pearl Hill’s Care Home, was opened in Chinatown last month. Pearl Hill’s Care Home is a three-storey buildings with 130 beds.

 

Featured image from TMG file.

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by Li Shan Teo

IF YOU’RE a die-hard foodie, you would have probably caught wind of the country’s latest food trend: poke bowls.

No, they have nothing to do with Pokemon. Instead, poke is a colourful bowl of fish salad that is both Instagram-worthy and fast becoming a favourite for the health conscious.

Since the opening of the first restaurant here that focuses solely on poke bowls (pronounced “poh-kay”) in early October last year, many other places that sell poke bowls have since sprung up. The bowls come in various colours and textures that are bound to whet your appetite – from those that stay loyal to their Hawaiian roots to bowls that are more adventurous on the taste buds.

 

What is it? 

Poke is the Hawaiian verb for “section” or “to slice or cut”. The dish is essentially a Japanese-inspired raw fish salad, originating from the streets of Hawaii. It consists of cubes of raw fish, usually Ahi tuna (yellowfin tuna), served with a bed of salad greens and topped with sauces.

Although it’s commonly served as an appetiser in Hawaii, the poke available here tend to be served as a main course with rice and other options such as quinoa. It’s a style that is similar to the bara chirashi, which is a Japanese dish that features diced sashimi on top of rice. If you’re wondering why there are similarities between the Hawaiian and Japanese dishes, it’s because a sizeable portion of the Hawaiian population has Japanese roots – 16.7 per cent of Hawaii’s population is Japanese, forming the largest group of Asian-Americans.

The dish has also been adapted to cater to the Singaporean palate. Instead of sticking to the traditionally used Ahi tuna, poke bowls here offer a wide selection that range from salmon to chicken.

We’ve compiled a short list of the different types of poke bowls you can find. So dive right in!

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Aloha Poke

The first poke restaurant to open in Singapore in October last year, Aloha Poke is the one to go to for a more traditional take on the salad. The restaurant claims to stay true to its Hawaiian heritage, with its fish seasoned “to perfection”.  This is true, with its fish options more on the side of traditional poke bowls – you can choose between tuna and salmon.

The poke bowls come in three standard sizes: the Lil’ Swell that comes with one scoop of poke (75g), Standard Nalu with two scoops of poke (150g) and Big Kahuna with three scoops of poke (225g). They’re priced at $11.90, $15.90 and $19.90 respectively.

Every bowl is typically served with rice (white or brown) and salad, your choice of poke, and topped off with scallions, pineapple and lime. You may also choose two complimentary add-ons and one superfood from their selection.

To spice things up, Aloha Poke offers three flagship sauces – original, wasabi mayo and spicy.

Image from Aloha Poke’s website. 

 

Marina Bay Link Mall, 8A Marina Boulevard, #B2-46, Singapore 018984
Opening hours: 11:30am – 8pm (Monday to Friday), 11:30am – 2:30pm (Saturday)

92 Amoy Street, Singapore 069911 (Telok Ayer MRT)
Tel: +65 6221 6165
Opening hours: 11.30am – 2.30pm, 5.30pm – 11pm (Monday to Saturday), Closed on Sunday

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Rollie Ollie

For a more Asian-inspired bowl, head down to Rollie Ollie, which is touted as an “Asian fusion restaurant with a touch of California style”.

The poke bowls are available in unique Asian flavours such as Seoul Surfer ($13.95) and Thai Twist ($13.95). If you’re craving for some Korean food, the Seoul Surfer will be able to satisfy your appetite with its inclusion of seaweed, sesame seeds and a Korean spicy sauce. If you prefer Thai food, the Thai Twist has Asian ingredients such as mango, coriander, and Thai fish and lemon sauce. The restaurant’s Japanese-inspired bowls are Yuzu Bliss ($14.95) and Wild About Wasabi ($14.95).

To complete your meal, you select your rice preference –  sushi, brown or tea infused rice.

Do note that the poke bowls are only served at the Suntec outlet, and not at Star Vista.

rollie-ollie-2

Image from Rollie Ollie’s website. 

 

Suntec City Mall Pasarbella #01-K42, North Wing 3 Temasek Blvd Singapore 038983
Tel: +65 8188 1531
Opening hours: 10am – 10pm

 

A Poké Theory

If you’re more of a free spirit, then A Poke Theory would be perfect for you. The bowls are fully customisable, giving you the freedom to have the salad you really want.

You get three options for the base: sushi rice, romaine lettuce or lemon herb quinoa. Then you choose from four different flavoured cuts – original shoyu tuna, spicy garlic sesame tuna, spicy mayo salmon or avocado miso salmon.

A regular bowl (100g) of tuna will cost you $11.50, while a large bowl (150g) costs $15. For the salmon, a regular bowl costs $12.50 while a large bowl is $16.50.

The restaurant is also big on “premium” toppings such as kimchi and kale chips, so if you’re craving for something more atas (“high class”), A Poke Theory is the place to be.

a-poke-theory

Image from A Poke Theory’s Facebook page.

 

27 Boon Tat Street, Singapore 069623

Opening hours: 11am – 6pm (Monday to Friday), 11am – 4pm (Saturday), Closed on Sunday

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Katto

Poke bowls can be pricey, especially when many poke restaurants are located in town. So for something a little easier on the wallet, head down to Katto.

Unlike the other poke restaurants, Katto offers an option for a mini size bowl ($7.90). It contains one portion of 70g fish, one base of 250g of white rice, brown rice or salad, and a vegetable side. If you have a bigger appetite, opt for the main size bowl ($12.90), which includes an additional serving of fish and side.

It doesn’t hurt that Katto also offers some fun flavours – entice your tastebuds with chicken rice chilli salmon, creamy goma tuna, tangy thai tuna, classic shoyu salmon and California unrolled salmon.

katto

Image from Katto’s Facebook page

 

1 Fusionopolis Place, Galaxis Building, #01-21/22, Singapore 138522
Opening Hours: 11am – 8pm (Monday to Friday), 11am – 2pm (Saturday), Closed on Sunday

 

Featured image Poke Bowl by Flickr user Michael Saechang. (CC BY 2.0)

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By: Gabriel Crispinohttps://www.flickr.com/photos/ciriloman/8222747688/in/photolist-dwBJpS-fB95SP-fB7fsM-fBmB8W-fBmA2S-egM3in-fB7cBM-fBozGY-fB9aU8-fBo93N-oC3Uht-bwFUqT-dkCMf1-r64Dxf-fB8NaK-fBn6eA-bBpoaA-fBmxSb-fBoiJA-fBmAHb-fBmBzj-fBosTd-fBoALL-fBmCim-fBoxX5-75maqD-fBoweA-fBow6G-aAXFHD-fBonE7-fB9hBt-oNPwv8-fBo8VJ-fB7hM4-fB9dUe-bBEHMj-dkCJvR-cXditU-aAW388-9qVTdL-axN9ek-7Whtnb-4Ukpmr-fBoxuf-aAYHL3-9rNWMT-fB7n8t-fB9dEz-fB7ggP-Jf2MaQ

by Wan Ting Koh

ARE your fruits and veggies clean enough to eat if you run them under running water? Probably. Are there better ways to clean them? Absolutely.

From powders to machines, these solutions claim to help you remove the pesticides from your fresh produce.

 

Most farmers use pesticides on their produce to keep the pests away. Even organic fruits and vegetables may accumulate bacteria on their surfaces in the process of being transported to markets – never mind what organic actually means.

About 3 to 5 per cent of fruits and vegetables imported from overseas were rejected last year for containing too much pesticides. This was a rate that has remained constant over the years, said the Agri-Food and Veterinary Authority of Singapore (AVA).

The authority sampled 8,000 consignments of imported produce for pesticides and rejected about 300 batches of vegetables and fruits.

Of course, this doesn’t mean that pesticides will kill you – though, it’s probably not a good idea to consume it in large amounts.

To reduce your intake of potential pesticides, AVA recommends rinsing your produce with water for 30 seconds, followed by a 15-minute soak. Then, give them a last rinse. Peeling the skins of fruits will also help to remove any pesticides found on its surfaces.

If, however, you feel like you need something stronger than tap water, here are four other solutions you can consider adding to your counter-top.
1. ETL No. 9 All Purposes Green Formula
Bottle of vegetable and fruit wash
Image from ETL No.7 l 9’s  website.

Made of ingredients such as coconut extract, aloe extract and lemon extract, this multipurpose product claims to remove up to 98.6 per cent of pesticide residue from the surfaces of fruits, vegetables, tea leaves, legumes, beans and rice grains.

Amazingly, apart from being a fruit and veggie wash, this product is so strong that it can also be used for hand washing, dish washing, cleaning baby milk bottles and even laundry washing. If that doesn’t bother you, you can get the formula, which comes in a 1-litre bottle, for $35 on ETL No.l 9’s website.

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2. Bacoff Organic Fruit & Vegetable Wash

bottle of veg and fruit wash
Image is a screenshot from RedMart’s website.
This fruit and vegetable wash, which is from Australia and contains octanoic acid, claims to be able to remove wax and pesticides from fruits and vegetables safely. Also known as caprylic acid, octanoic acid is a fatty acid which is found in coconuts and breast milk.
According to the instructions, wash fruits and vegetables thoroughly with a diluted solution and “apply pressure” to ensure all “wax and pesticide” is removed. For “tough” wax and pesticides, allow fruit to soak for up to 10 minutes before applying pressure. Not sure why there would be wax on the produce – maybe it’s an Australian thing. This product comes in a 500ml bottle and is available at RedMart for $10.90.
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3. Safeguard Fruit & Veggie Wash
bottle of vegetable wash
Image by Esther Au Yong

Another product from Australia, this wash claims to “safely and effectively” remove “up to 100 times more contaminants” than if you rinse the fruits and vegetables with water alone.

According to its company website, the solution uses ingredients which are natural and organic, such as aloe vera, citrus essential oils and olive leaf extract. A few drops of the solution in half a sink full of fresh water is enough to clean your fruits and vegetables. Safeguard comes in a 750ml bottle and sells for $10 at Cold Storage.

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4. Zairyo natural sea fruit and vegetable wash 

bottle of powder for washing vegetables
Image from Zairyo website.

According to Zairyo, this fruit and vegetable wash is made of natural scallop shells that get rid of pesticides, chlorine, wax and bacteria. The wash, which comes in a powder form, was imported from Japan and is apparently highly popular with households there.

The multipurpose solution can also be used to disinfect cooking equipment and utensils, for laundry and to deodorise rooms when used as a spray. Each bottle contains 90g of powder and is currently retailing on Zairyo’s website for $19.90.

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5. Dew Vegetable Washer D818

hyflux
Image from Hyflux Shop’s website

At $319, The Dew Vegetable Washer D818 is the most pricey of the bunch here. It resembles a glass bowl with a lid and requires electricity to operate.

Place your fruits and vegetable in the machine, fill the bowl with no more than four litres of tap water, close the lid, then select either the 10-minute or 15-minute wash mode. Bubbles will be emitted from the base of the 1.65g machine. If money isn’t an issue for you, you can order it from Hyflux Shop’s website.

 

Featured image SPLASH by Flickr user Gabriel Crispino. (CC BY 2.0)

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