A New Kind of Hospital and a Different Way of Viewing Diabetes

Mr. Liak gives diabetes patients a year of treatment and education at Alexandra Hospital. If they improve and own their management, then he encourages them to become peer-mentors and help the hospital provide its services to even more patients. If they don’t take responsibility for their care after a year, they are free to seek help elsewhere, leaving space for new patients at the hospital.

| Feb 17, 2009

Can you imagine a hospital where the floors are carpeted, so you feel soothed and protected? Where the doors open silently so as not to jar your nerves? Where vending machines are filled with fresh fruits, and the healthier the meal in the cafeteria, the less it costs? How about elevator doors covered in exotic floral motifs, or a diabetes center where you never wait more than ten minutes to be seen?

I saw them with my own eyes in Singapore at the Alexandra Hospital during a five-week trip that I took through Asia and Australia in December 2008. Partly a gift to myself after completing a book last year, the trip was also an opportunity to learn about diabetes care on the other side of the world.

I was introduced to the CEO of the Alexandra hospital, Mr. Liak, by my husband, who had previously worked with him. But once Mr. Liak heard that I worked in diabetes, his interest was captured. As my husband said, "He paid me no attention; his eyes were focused on you."

This amazing hospital is a product of the vision of Mr. Liak and his passionate staff. It is their mission to create a place of healing where people are helped to make healthy choices, even if it's just taking the stairs instead of the elevator.  Stairways are easily accessible throughout the hospital, not hidden behind locked doors, and they are marked by big red wooden hearts that say, "Please give your heart a lift: Use the stairs."

Mr. Liak and I discussed the state of healthcare and the treatment of diabetes in Singapore and the U.S. for almost three hours. He shared what some would call a contrarian view: Give diabetes patients a year of treatment and education at Alexandra Hospital. If they improve and own their management, he encourages them to become peer-mentors who help the hospital provide services to even more patients. If they don't take responsibility for their care after a year, they are free to seek help elsewhere, leaving space for new patients at the hospital.

To say the least, it makes one think. In the U.S., the healthcare system does not particularly motivate patients to become self-reliant and responsible for their own care, although we know that is paramount in managing diabetes. In fact, I once heard a critical tone from my own endocrinologist when I hadn't been there for a year. But why would I need to come every three months? I am a well-informed patient who manages my diabetes daily. I have an A1c in the 5s, and I get the necessary tests regularly. I can easily discuss my test results with my doctor over the phone and make any necessary adjustments. In fact, I am doing exactly what medical professionals say they want patients to do, managing my own diabetes.

After explaining to Mr. Liak the work I am doing to help patients bring a more positive attitude to managing diabetes, I gave Mr. Liak five copies of my book, The ABCs Of Loving Yourself With Diabetes. As he thumbed through it, his face lit up page by page. He loved it. "This is what we need, a more cheerful and optimistic attitude about managing diabetes!" he said. And with that, he asked us to meet his staff at the hospital's diabetes center.

I was introduced to the Diabetes Centre staff, and two copies of my book were handed to the Centre's Director and diabetes nurse. I was shown the book that the diabetes nurse uses with patients and was asked my opinion about it. The first thing I noted, besides its outdated layout and pictures, was that although the book included tabs for medicine, food, exercise, and such, there was no tab for dealing with the psychosocial aspects of living with diabetes. Talk began of translating my book into the Malaysian language, Malay, for the hundreds of thousands of people who live in Singapore and the surrounding region.

Thank goodness my head had not grown so large that I could not fit it through the door to the cafeteria where our tour ended. Over a bowl of vegetables and tofu, Mr. Liak asked me about the presentations I deliver to patients across the country and told me that he'd like to employ someone such as myself to help inspire and encourage other patients. Can you imagine going to a diabetes center to give a talk and having a well-educated patient there to help you? In Singapore, it's already on the drawing board.

While on my trip from Australia to Japan, I met with two mothers in Sydney whose children recently developed type 1 diabetes. They described their difficulties in getting a school nurse into their children's' school. In Japan, I learned that diabetes is a growing problem, but not talked about openly, so you won't see TV commercials for meters or celebrities talking about having diabetes.

But it was while leaving the Alexandra Hospital that I thought, "If I ever need to be in the hospital, maybe I'll consider hopping a flight to Singapore." Meanwhile, upon leaving Mr. Liak that morning, I did what most people in Singapore who are not in the hospital do-shop! 

Riva Greenberg is the author of the book, The ABCs Of Loving Yourself With Diabetes. Her new book, 50 Diabetes Myths That Can Ruin Your Life: And the 50 Diabetes Truths That Can Save It, will be published in July 2009.

Click Here To View Or Post Comments

Categories: A1c Test, Diabetes, Diabetes, Food, Hospital Care, International, Professional Issues, Type 1 Issues


Diabetes Health Professional
Take the Diabetes Health Pump Survey
See What's Inside
Read this FREE issue now
For healthcare professionals only
  • What's on the Horizon with Diabetes Research and Therapy
See the entire table of contents here!

You can view the current or previous issues of Diabetes Health online, in their entirety, anytime you want.
Click Here To View

See if you qualify for our free healthcare professional magazines. Click here to start your application for Pre-Diabetes Health, Diabetes Health Pharmacist and Diabetes Health Professional.

Learn More About the Professional Subscription

Free Diabetes Health e-Newsletter

Latest
Popular
Top Rated
Print | Email | Share | Comments (8)

You May Also Be Interested In...


Comments

Posted by Better Cell on 16 February 2009

Here in the U.S. T1DM should be treated by Clinical Immunologists rather than Endocrinologists since it is auto-immune in etiology.
in addition, while self-reliance, education and responsibility for managing T1DM is conveyed to the patient..........in reality many Health care professionals become "uneasy" when the patient is in charge of his/her chronic Disease.
the system(Health care) is full of Hypocrisy, Irony and Insecurities.

Posted by Anonymous on 23 February 2009

Who pays?

Posted by lalalatoya on 24 February 2009

Well it is up to a patient how they would manage the illness. A lot of resources for Diabetes Healthcare Providers are now aimed at assisting each patient by providing latest information and updates on diabetes management, diet, nutrition, self test kits, supplies and medicine.

Posted by Anonymous on 24 February 2009

For Type 1's as I have been for 38 yrs...
Insulin pump, diet, daily excercise -- it hasn't failed me yet....

Posted by diabeticdiva on 24 February 2009

The healthcare system in this country needs a serious overhaul. Good for Singapore that they are being proactive in their approach. Maybe if we weren't so greedy in this country, more people would have better healthcare.

Posted by Anonymous on 24 February 2009

Good for you in empowering those with diabetes to take control. I had to move on through three doctors before I found one who could be comfortable with self management. My A1c is around 6.0, I manage my Novolog dosages and my Lantos dosages 4 times per day based on counting carbs and incorporating exercise. One doctor actually "ordered" me to change my dosage to the same dose every meal. When I told her that the data didn't support it she asked me to leave her practice.

Good ridance to her I say. Doctors can be quite insecure about letting patients manage their own health/illness. If you find a good doctor you are luck. 2 out of 3 know less about diabetes than you and know much less about you than you.

Posted by seashore on 25 February 2009

I have had strong allergy since I was a child. I shudder to think of a hoispital with carpeted floors. How does one keep the mold and dust mites out of the carpets, particularly in a hot-humid climate like Singapore. You can't.

Asthma has increased enormously in recent years. The probable cause is too many homes with wall-to-wall carpeting, which cannot be properly cleaned.

Posted by Carol100 on 28 February 2009

Thank you so much Riva! Keep up your work for us. I would love to see more fresh, healthy food and snacks in America everywhere. We are so behind in teaching "we are what we eat" and we can benefit from learning what is good for each one of us as we are all different in our needs.


Add your comments about this article below. You can add comments as a registered user or anonymously. If you choose to post anonymously your comments will be sent to our moderator for approval before they appear on this page. If you choose to post as a registered user your comments will appear instantly.

When voicing your views via the comment feature, please respect the Diabetes Health community by refraining from comments that could be considered offensive to other people. Diabetes Health reserves the right to remove comments when necessary to maintain the cordial voice of the diabetes community.

For your privacy and protection, we ask that you do not include personal details such as address or telephone number in any comments posted.

Don't have your Diabetes Health Username? Register now and add your comments to all our content.

Have Your Say...


Username: Password:
Comment:
©1991-2014 Diabetes Health | Home | Privacy | Press | Advertising | Help | Contact Us | Donate | Sitemap

Diabetes Health Medical Disclaimer

The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained on or available through this website is for general information purposes only. Opinions expressed here are the opinions of writers, contributors, and commentators, and are not necessarily those of Diabetes Health. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this website.