The Singapore Commentator

In less than two months, Singapore has seen 3 accidents resulting in a total of 13 deaths among workers.

Last month, we saw the collapse at the MRT construction site along Nicoll Highway — which saw four deaths — and at the Fusionpolis construction site along Ayer Rajah Avenue — which saw two deaths.

The latest tragedy occurred on Saturday at the Keppel Shipyard along Benoi Road. Seven foreign workers involved in welding work on an oil tanker were killed when a fire broke out. The workers were Indian and Malaysian nationals aged between 22 and 46.

Acting Manpower Minister Ng Eng Hen, who was at the scene of the accident, said: “This is the third incident in a row where workers' lives have been lost and this is again a wake-up call.”

According to Ng, Keppel Shipyard has a good safety record. However, he added: “It shows that even if you have a good safety record, just a minor slip-up — whatever the reasons we don't know, we have to find out — and you can have fatalities!”

Keppel Shipyard will give each of the victims' families $30,000 in compensation.

Yesterday, speaking at the sidelines of a PAP Community Foundation event, Deputy Prime Minister Lee Hsien Loong said safety measures at industrial workplaces would have to be tightened. “These things happen ... We have to find out the reasons and tighten up. We have to set an objective to bring down the rate by a third.”

At another event in Sembawang yesterday, Deputy Prime Minister Tony Tan said the Government was “concerned” about the spate of industrial accidents. “We cannot allow the spate of industrial accidents to continue,” he said. Regulations and requirements might be introduced, he added.

Statistics from the Ministry of Manpower show that the number of industrial accidents — including those from the shipbuilding and repair and construction industries — have been on a declining trend since the late 1990s.

Recognising the importance of smoking as a contributor to disease, the World Health Organisation (WHO) has declared tomorrow to be World No Tobacco Day. According to WHO, about 1.1 billion people around the world smoke. Around 3.5 million smokers die every year as a result of tobacco-related illnesses.

Illnesses long known to be caused by smoking include lung cancer, heart disease, stroke, emphysema and bronchial disorders. On 27 May, US Surgeon-General Richard Carmona said smoking also causes cataracts, acute myeloid leukemia and cervical, kidney, pancreatic and stomach cancers.

Smoking is addictive. The addiction is essentially due to the nicotine found in tobacco products. Nicotine stimulates the central nervous system to create feelings of pleasure. The effect of nicotine on the brain is rapid, but dissipates in a few minutes. This encourages the smoker to continue smoking throughout the day to maintain the drug’s pleasurable effects.

Treatments are available to help smokers quit while minimising withdrawal symptoms. The latest treatment being tested is laser (see the following stories: Laser Acupuncture for Adolescent Smokers—A Randomized Double-Blind Controlled Trial, New Treatment Offers Relief For Addicted Smokers and Laser Treatment to Quit Smoking).

The more conventional treatment, however, is nicotine replacement therapy (NRT). This comes in various forms, including nicotine gum, nicotine patches, nicotine lozenges and nicotine inhalers. The consistent use of one of these products is said to double a person's chance of quitting smoking.

The nicotine gum has only recently become available in Singapore, thanks to the Free Trade Agreement signed with the US last year (gum producers lobbied the US government to include it in the agreement). The first therapeutic gum to be sold here is Nicorette, produced by Pfizer.

The Sunday Times had an article today on Nicorette gum. It interviewed two people who had taken the gum. Interestingly, both said they failed to quit smoking despite taking the gum.

However, apart from its apparent lack of efficacy, another concern with NRT that is not pointed out in the Sundary Times article is the possibility that it may actually cause harm. In 2001, researchers at Stanford University found that nicotine promotes the growth of new blood vessels and can also stimulate tumor growth and the build up of plaque inside arteries (read article Researchers discover nicotine stimulates growth of new blood vessels).

Dr John Cooke, the lead author of the Stanford study, said, "As long as people are using nicotine replacements properly, it's a win for all of us, if we can get people to stop smoking. But, I would urge people not to use it long term."

Joel Spitzer, a smoking-cessation counselor and director of education at WhyQuit.com, recommends that smokers quit by going cold turkey. He says nicotine replacements keep ex-smokers in a protracted state of withdrawal.

According to the American Cancer Society, fewer than 5 percent of smokers who attempt to quit each year succeed. Of those who do, the society reported last year, 91 percent quit cold turkey.

For a one-stop guide to quitting smoking, readers should visit the American Cancer Society's Guide for Quitting Smoking at its site. And emulate Mark Twain, who is quoted as saying, "Quitting smoking is easy. I've done it a thousand times."

Then again, maybe that's not such a good idea.

Remember the guy in a post of mine about two months ago who needed to shed 10 kg? Well, according to The Sunday Times today, he has finally achieved his goal. His weight is now 61.7 kg compared to 71.5 kg 10 weeks ago. His waistline has also shrunk from 88 cm to 75 cm.

If the World Health Organisation (WHO) has its way, more people should follow his example. Yesterday, the policy committee of the WHO launched a global campaign against obesity. It plans to set out recommendations such as the reduction of sugar, fat and salt in processed food, the control of food marketing to children and of health claims on packaging, and more comprehensive nutrition labeling and health education.

With this plan, it hopes to combat the surge in cardiovascular disease, type 2 diabetes and some cancers which, according to the WHO, account for nearly 60 percent of the 56.5 million deaths a year around the world that are deemed preventable.

According to the World Heart Federation, there are over 300 million obese adults globally. 115 million persons in developing countries suffer from obesity-related health problems, including heart disease, hypertension, non-insulin dependent diabetes and high levels of cholesterol. About 22 million children under five years are obese across the world and many more are overweight.

And what about the statistics for Singapore? Well, we will know soon. From September to November, the Ministry of Health will be conducting a National Health Survey on obesity and other risk factors like blood cholesterol, smoking, physical inactivity, obesity, alcohol intake and dietary practices in Singapore. It will also determine the prevalence of diseases like diabetes mellitus, high blood pressure and coronary heart disease.

While the survey will be helpful to the Ministry of Health in gathering detailed statistics for its planning, we don't really need it to know whether Singapore is part of the world-wide trend toward obesity. Just take a walk down the streets of Singapore; the evidence should be apparent enough.

An article in The Straits Times today may shed light on why Singapore's fertility is falling.

According to the article written by M. Nirmala, many Singaporeans think that age is no barrier to a couple's ability to have children. A recent survey by the Ministry of Community Development and Sports found that "six in 10 believe that fertility can be turned on like a tap at any age thanks to medical technology," she wrote.

Couples with this belief and are delaying their first baby in favour of spending more time and effort on their careers as a result may be in for disillusionment. As Nirmala pointed out, a woman's natural fertility "declines gradually from her late 20s, more rapidly after the age of 35 and very sharply after 40". Women aged 25 to 29 have an 80 percent chance of getting pregnant, but women aged 40 to 44 have less than 40 percent chance. Men's sperm count and quality also fall with age, compounding the problem for older couples.

Nirmala believes that the misconception on fertility may have arisen from publicity of successes in treating fertility problems through science. "But paradoxically, the advances may have had an unintended consequences of lulling Singaporeans into a false sense of security," she wrote.

The misconception is apparently not limited to Singaporeans. The article highlighted a 2001 survey of the top 10 percent of high-earning American women, which found that of the women aged 28 to 40, almost 9 in 10 believed that they would be able to get pregnant into their 40s.

If the Singapore government is serious about reversing the country's declining birth rate, this misconception is a problem that it must tackle.

"The problem with diets is that before you get to your goal weight, you might just drop dead from boredom." So wrote Tan Hsueh Yun, news editor of The Sunday Times, in a column today.

That really is the problem with healthy diets: they tend to be boring. Or maybe I should rephrase that.

We tend to eat tasty foods to excess, until they become unhealthy. For it is excess that is really unhealthy. Most foods that we like are actually relatively healthy when eaten in moderation.

In another column for The Sunday Times today, Wong Ah Yoke wrote about Eng Wah Organisation's first restaurant, Legends Garden. The restaurant serves mainly Cantonese fare.

One of its dishes is deep-fried beancurd, "golden on the outside and snowy white inside". Wong described it as a "tasty and healthy dish".

Deep-fried? Healthy? Whatever happened to the acrylamide scare?

For those who have forgotten, in 2002, researchers from the Stockholm University and Sweden's National Food Administration, a government food safety agency, found that bread, chips, crisps and other carbohydrate-rich foods, when fried or baked at high temperatures, contain high levels of acrylamide. The researchers found that an ordinary bag of crisps may contain up to 500 times more of the substance than the top level allowed in drinking water by the World Health Organisation (WHO).

Acrylamide is classified as a probable human carcinogen. It induces gene mutations and has been found in animal tests to cause benign and malignant stomach tumours. It is also known to cause damage to the central and peripheral nervous system.

Subsequent studies from other countries have found similarly high levels of acrylamide in many baked and fried foods. Scientists suspect that acrylamide is produced when asparagine, an amino acid abundant in cereals and grains, is heated above 100 degrees Centigrade with either of two sugars, glucose or 2-deoxyglucose.

However, the link between acrylamide and cancer, especially in humans, is far from proven. In fact, early last year, a report in the British Journal of Cancer from a study by researchers from the Harvard School of Public Health and the Karolinska Institute in Stockholm, Sweden, found no association between the consumption of foods high in acrylamide and increased risk of cancer.

Having said that, fried foods have long been considered "heaty" in traditional Chinese medicine. Whatever the exact effects may be, it is probably desirable to eat fried foods in moderation, and eat more fresh fruits and vegetables instead.

Boring, you say? Well, maybe Tan Hsueh Yun has the right answer. Which is: Eat as many different things as possible so you don't hanker after anything and go on a massive binge.

"The answer has to be about seeking out flavours to keep the taste buds interested," she wrote, "and eating a variety of healthy food to keep the boredom at bay."

Yesterday, the Immigration and Checkpoints Authority (ICA) announced that children born abroad to Singaporean mothers now have the same right to citizenship by descent as those born to Singaporean fathers.

Until recently, for children born overseas, only those who had Singaporean fathers could claim Singapore citizenship by descent. Those born overseas to female Singaporeans had to get their citizenship by registration. The Singapore government changed this law last month after observing a persistent decline in the country's birth rate and realising that Singaporeans were not replacing themselves. Last year, Singapore's fertility rate was only 1.26, well below replacement rate (see earlier post Baby talk in Parliament).

Singaporeans living abroad can now pass on Singapore citizenship as long as mothers or fathers meet new residency rules, including spending at least five years in the country before having a baby. "The main focus is to make the rules more gender neutral," said ICA spokesman Chia Wei Kiang.

In fact, Singapore is not the only country facing a declining birth rate. Much of the rest of the world faces it too.

The developed countries have long faced declining birth rates. In 2002, on average, women had 1.32 children in Japan, 1.6 in the United Kingdom, 1.9 in France and 2.1 in the United States.

Developing countries are fast following the same trend. In 2002, South Korean women had 1.17 children. And last month, the China State Statistics Bureau stated that the country had a low birth rate, without providing figures. Just earlier today, Randy McDonald posted an article The Third World: Staying Poor and Growing Old? on BonoboLand covering this point.

So what we have is a rapidly ageing world. The median age in the United States is now 35, up from 30 about 50 years ago. It will reach 40 in another 50 years. The developing world is fast catching up. According to UN projections, the median age in Iran will reach 40.2 by mid-century. Mexico's median age will reach 42 at about the same time, even older than its northern neighbour.

Ageing populations have economic consequences. Initially, the consequence may be good. Fewer children means fewer dependents. Available resources do not have to be divided among so many children, so each child can be better fed, better clothed and better educated.

However, when the children grow up, there will be fewer of them to become productive workers, which means that there will be less available to provide for the elderly. As an editorial in The Korea Times earlier this month pointed out in relating its country's population woes: "Various pension funds will be depleted, threatening the welfare system in its infant stage. The nation will suddenly become an aged society. Retired people will be compelled to return to worksites."

So countries facing ageing populations are concerned. Like the Singapore government, other governments are also giving out incentives to households to have more babies. The Korean government recently decided to grant three-month leave to working husbands when their spouses give birth. The Australian government is handing out a total of A$3,000 for every baby born after June. And in Estonia, the government will give either the mother or father the equivalent of a year's pay while she or he stays at home looking after the baby.

However, while such measures address the time and financial costs of raising children, declining fertility also has a lot to do with the greater economic and reproductive freedom enjoyed by women and the declining importance of marriage. Women are spending more time getting educated and delaying having babies until they have established a career. Obviously, this means they have less time to produce babies.

As long as such trends persist -- and it is difficult to see how they can reverse -- whatever measures governments can think up are likely to, at most, slow down the decline or arrest further decline in birth rates. Governments will also have to think of ways to handle the consequences of ageing populations.

A Yale undergrad's view of Singapore: Singapore, A Globalizing City-State

A pretty good overview of the country, I must say.

SingTel is certainly riding high.

After criticism from various quarters for failing to snag HK Telecom in 2000 and then supposedly overpaying for Australian telecom Optus, many had written off SingTel as just another government-linked company that keeps messing up on its investments.

The latest annual result should put an end to such opinions. Yesterday, the telecom giant reported a full-year net profit of $4.49 billion, three times the previous year's result, and the biggest ever for a Singapore-listed company.

The result was boosted by exceptional items totalling $2.29 billion, including gains from the divestment of Belgacom, Singapore Post and SingTel Yellow Pages. But even without such exceptional items and goodwill, the company earned $2.85 billion, a 32 percent increase over the previous year.

Optus, the Australian subsidiary, earned A$440 million excluding an exceptional tax credit of A$24 million, far better than the A$28 million earned the year before.

Shareholders should be especially pleased (remember that SingTel is the most widely-owned company in Singapore after the Singapore government's partial divestment in 1993 that allotted citizens with shares). SingTel management reported that it would increase its final dividend to 6.4 cents a share from 5.5 cents the previous year. In addition, the company would buy back one share for every 14 from shareholders at a price of $2.36.

While future earnings growth will probably slow, SingTel CEO Lee Hsien Yang was confident of prospects. "Our medium-term target of double-digit earnings growth remains," he told reporters covering the announcement of the results.

China confirmed the first death from SARS this year but no one seems to care (Sars death doesn't scare travellers).

What a difference a year makes.