Bringing changes to Cambodian dentistry

Introducing 4 handed dentistry to Cambodia

Fate leads people to many destinies. For me the moment I got into dental school there was no way I could exit my destiny as a dentist. Fate would make me even take a pay cut to leave for private practice and introduce me to the world of 4 handed dentistry. Tay and partners was then a young dental practice in Orchard Road, Singapore. It was ahead of the times.  It was also where I learnt how to deliver dental care in the most efficient and productive manner.

                                           Both dentist and DSA is seated down

                                        Patients cannot see the instruments

                       

                                           All four hands in action

                                   You can even use your left habd to take out teeth so no strength needed

Till today I am very surprised to find the majority of dentists all over the world who have no clue what 4 handed dentistry is all about. Dentistry is basically manual work. No matter which procedure is performed for the patient, it can be broken down into many simple and repeatable steps. The oral cavity is a very small worksite. All the materials and equipment need to be delivered to this worksite to finish what is needed to be done. The dentist being human must be able to conserve his movements throughout the day so that at the end of the day he is not stressed or tired. The patient obviously benefits from it as one need not open his mouth for too long.

The concept of 4 handed dentistry.

All dental procedures can be simplified. They also can be done with the least number of instruments and materials. More important a dental assistant can be taught how to deliver all the necessary instruments and material for the dentist to use. As such the dentist is fully focused on the work and using only finger and wrist action can deliver the highest quality of dental care.  With the additional hands of the assistant the term 4 handed dentistry was coined. It can also be extended to 6 handed dentistry if one more nurse is brought into the picture.

                                                              The ideal dental chair

One must start from the design of the clinic. The flow of patients and staff to and from the treatment area is very important. The patients should be able to reach and exit from treatment area is quickly as possible. The majority of dental chairs used by dentists all over the world is not ergonomically design for the patient. There is this equipment arm that is a barrier to the patient getting on to the chair. Personally I can never understand why dentist must be a slave to this arm, pushing it in or out every time a patient is seated or even when they want to rinse their mouth in between procedures. Imagine how much time can be save in their life just by using a different design.  

By introducing 4 handed dentistry to one’s practice , the productivity can be increased by at least 30%.  If the clinic setup is well planned, I am sure most dentist can double their productivity. If you extrapolate over the lifespan of a practicing dentist it is extremely significant.

The Cambodian challenge.

At a lunch gathering I was seated with Dr Khov Sov president of the Cambodian Dental Association who was visiting Singapore as a guest of the Singapore Dental Association. 3 other prominent Singaporean dentists were present. The conversation lead to the discussion on seated down dentistry. One of the most important rule in 4 handed dentistry is the dentist and assistant must be seated down at all times so that both of them have a clear view of the operating field. However as I found out I was the only dentist at that table that do so. My Singapore colleagues were arguing that is technically impossible to do all dental procedure seated down. Dr Khov Sov was surprised that since we were all graduates of  Singapore dental school we have different working style.

So here I am in Phnom Penh. As this was my first trip to Cambodia, I wanted to see for myself how Cambodian dentists are doing before introducing to them the art of 4 handed dentistry. I am quite sure nearly all Cambodian dentists practice 2 handed dentistry as few dental schools in the world teaches 4 handed dentistry. To change one’s style, one needs to completely change the mindset. Fortunately all the dentists I met were very young and eager to learn. As usual most questions they posed  focus on whether I do implants for my patients. There were surprised that I don’t. They were more surprise to hear that I am so productive such that I can earn a very good salary just doing very basic dentistry.

Visit to the dental school.

The dean

This brings back memories to me as the Cambodian dental school looks similar to  the facilities I was attending back in late 70’s. The dean was very kind to meet me and spoke at length of the changes to the school. The school is expanding and upgrading their facilities. It would be ideal if they can  introduce 4 handed dentistry to their students.

                                         The overhanging arm I mentioned

Taking one step at a time.

The first step was to conduct a clinic for some dentists at Dr Khov Sov’s practice. Four of his classmates turned up for the session. I put them through a slide show introducing them to the idea. It was difficult to impress them as I did not have it as a hands-on demonstration with my own dental chair setup and with a trained nurse assisting me. Well to add more fun I had asked Dr Khov to arrange for a patient with a mesio-angularly impacted wisdom tooth for me to perform a live demo. His clinic assistant came in as the right candidate. Obviously his setup was not for 4 handed dentistry. Still I managed to demonstrate to them how one can perform a surgical removal of  a wisdom tooth seated down. It also gave me an opportunity to show them the use of the subluxator for speedy extractions. They were amazed that  the whole procedure took only fifteen minutes.



my first group of students



performing the operation in a seated position



 

 A very bright future for them

It would be an uphill task to bring 4 handed dentistry to Cambodia. Their equipment does not pose any issue as their present dental chairs are modern. With the addition of the assistant’s mobile clinic they will be able to start on it. However just as any new skills, a lot of hand holding is necessary and as old habits are difficult to discard, most dentists will fall back when they are stuck with nurses who are not able to assist properly. In my own clinic all the nurses are trained to assist any dentists who join us. They are thus able to coach any newcomers.

However I can come back again to Cambodia to show them again if the need arises. The ideal place would be to conduct the program in their dental school. This would enable a group of DSA’s to become well verse in the technique and be able to promote it. This should go for all other countries. Ironically I am not able to do so in my own country.

                                          A visit to a rice paddy farm

Its great to meet new people from all over  the world.
I wish to thank the Dean , Dr Khov Sov and his friends for giving me this opportunity to share my experience with them.

Singapore may have saved Phnom Penh from the great flood

Singapore may have saved Phnom Penh from the Great Flood.

The recent heavy monsoon rains have caused severe flooding in many south Asian countries notably Thailand. , Cambodia, Laos, and parts of Vietnam. This year's flooding is so severe that more than half of Thailand is coverd with water and severely threatens the capital city of Bangkok.  Television news broadcast shows huge swaths of land affected in these countries.  The flood water in some areas have reached the roofs of most of the houses.. One must bear in mind this houses are already on stilts.

The citizens of the city of Bangkok were in a state of frenzy with rumours swirling that the low lying city will be completely submerged by flood waters. To make matter worst there is nowhere to run as most of the country side is flooded.

As my plane flew  into  Phnom Penh airport , I can see through  the windows the large acreage of flooded areas. I was not sure if the plane is going to land and if the airport is flooded. Fortunately all went well and I was received by my host Dr Khov Sov. He assured me that the whole of Phnom Penh and its surrounding areas were not affected by the flood. The flooded areas were far from the city..

This is my first trip to Cambodia. I am on a personal mission to share my experience with Cambodian dentists. I am trying to introduce to them the art of four handed dentistry. I  have been practicing this style of work for 30 years delivering quality dental care quickly and efficiently. This is the most productive style of dentistry but alas few dental schools teach this method or even know about it.  

A friend had arranged for me to stay atthe River 108 Hotel. This hotel is located just across the road from the Mekong river. The Japanese government had developed the river bank into an esplanade and in so doing beautified the area. There are lots of small hotels in the area and is very popular with tourists. Since I had the afternoon off after visiting the dean of the dental school I wanted to take a river cruise just as the one I took on the river Seine.

To my pleasant surprise the hotel had sent one of their staff who was fluent in English to accompany me. The best part was the two of us had the whole boat to ourselves. The itinerary  involved travelling to the confluence of four rivers of which the Mekong and Tonle Sap  were the largest. I can see the water level is very high and probably about 1 meters short  of overflowing  the banks. My guide told me he had never seen such a high water level.

high wate level at the esplanade

Soon we cruising down the river. At the confluence of the river  was a sand mining ship. I was very surprise to see such a large vessel in this location. Then I remembered that Cambodia supplies sand to Singapore but I was still taken aback that this vessel is located in the capital. My guide said that this vessel has been working in this area for about two years now but he was very surprised that the sand was destined for Singapore, a land 1000 kilometres away.

Sand mining ship at the confluence of Mekong and Tonle Sap rivers

Now comes my observation. Could it be that Phnom Penh was not flooded because its river has been dredged?  Although most rivers are very wide but they are very shallow during the dry season. as overtime they  have been  silted up. By dredging them regularly they are deepened and results in swifter water flow. So when there is a large amount of water coming from upstream due to heavy rains they can drain the waters away pretty fast. This results in  the neighbouring areas not flooded.

                                             Flooding in the villages

Dredging rivers is an expensive task and worst of all the sand dredge up have to be deposited somewhere. Furthermore environmentalist has always condemned such practices citing erosion and resultant damage to the environment. Thus no governments have any budget to dredge unless iy is to deepen the river for ships to sail through. I have always suspected great floods are caused by human beings not managing their rivers. Little do we think of agriculture can caused lots of erosion that washes all the soil into the river system. This is in turn aggravated  by human activity of deforestation, construction etc. which dump a fair amount of rubbish into rivers.  When the great floods of Queensland occurred last year I concluded the Australian government had not maintained their rivers and even when the rains had died down water was still around for some time, This was true also of the great Pakistan floods.

Phnom Penh has possibly shown us that managed and regular dredging of rivers can reduce the amount of land that is flooded and thus save us a lot of damage and human misery.

Well I will let the scientists prove me wrong. Like I said maybe Singapore saved Phnom Penh from the great flood.

Prevention of flooding in Singapore

Transient Dams

Dr Seow Onn Choong

As we are all aware the recent floods have caused a great deal of discomfort  and loss of money in the areas affected. To make matters worse the recent  flooding of Tanglin Mall and St. Regis Residences coincided with the anniversary of the flooding of Orchard Road just last year.  PUB is at a loss on how these disasters can be prevented. Orchard road 's level was raised at a great cost with buildings installing flood barriers. This had now shifted the floods further up the drainage system thus affecting Tanglin Mall area.

Many suggestions have been put forth. These include building additional canals running parallel to the existing canal or building underground storage tanks near these flood prone areas. AS PUB has put the blame on climate change would these measures be successful. Furthermore the construction of such devices at such built up areas will not only be very expensive but extremely  destabilising to the surrounding businesses. At best we are only trying to treat the symptoms.

What is the real cause behind the floods?

Climate change may be the cause but we cannot blame nature. We have no control over it and at best  must adapt to it.

The most important factor is also a man made problem. I would  like to call it the increase concretetisation of Singapore. As you can see there is rapid development in Singapore with construction of ever bigger shopping malls and homes. All these structures and the associated land are contributors to the floods we see. The rain does not just fall on the flooded areas but also on every inch of land.

Many government policies have also contributed to the sudden deluge of water. The most obvious is the efficient drainage of  water. When we see things locally we want to build drains that can drain away all the water as swiftly as possible so that the area does not flood. Recently one can see that most drains have been covered up.  This has brought us more walking space and also more greenery. However I was told it was meant to prevent leaves from falling into drains and thus do not end up in the reservoirs.  In addition gutters have been banned and the traditional water storage tanks for watering gardens have now been abandoned.

My proposal is very simple. Every building or land owner is a stakeholder and contributor to this flooding  problem we are now facing. We must now make every stakeholder hold on to the rain water that falls on their compound and release it at a rate that does not affect other stakeholders further down the drainage system. This would prove to be a cheaper and faster method to be implemented. It can be also used in all areas that was flooded  not just those prime areas.

Methodology.

The function of transient dams can be likened to fire rated doors. These doors are meant to delay the spread of fire in buildings so that not only can it give the occupants time to escape, It also enable the fire brigade to do its job without the building being gutted. The design of these dams is very unique.  When there is no rain  or during light rainfall water flows through this dams without any resistance.  This is possible by allowing an opening at the  base of the barrier. Thus there will be no stagnant pools of water or silting at the barriers. When heavy rain occurs, the amount of water reaching the barrier is now restricted by the flow rate through the opening. Thus water will build up behind the barrier . The top of the barrier is lower than the height of the drain . When the volume of water is too much for this section  water will overflow the dam into the next section . As such excess water is released . This prevents flooding at the vicinity of that dam. Technically speaking if many such dams are built in a drain , the whole  drain can  be converted into  a temporary reservoir. Now if you can imagine if all the drains in any drainage area is dam up , a giant reservoir can be created. Once the rainfall slows or when the rain stops, water will slowly drain away from this temporary reservoir.   Please see diagram to understand the construction of the dam.

The most important task is  to make a survey of all our drainage system with priority given to those areas affected by the floods recently.  With the information obtained  we can  outline all the contributors of the water to the flood prone areas .Next we must build transient dams in all  the drains involved.

Every building must install such dams at  their outlet which connect to the public drains. In addition they can construct water features to enhance the retention of water. These  water features can contribute to watering of plants in their compounds thus avoiding the present wasteful system of using tap water. In public areas which are relatively lightly developed existing  drains can be enlarged and deepened to create a bigger volume to hold the rain water. A good example is Dempsey area which in all  probabilities contributed to the recent Orchard Road floods.

In comparison  to those suggestions on prevention measures as outlined earlier, my proposal of creating transient dams could be the most effective  both in cost and the  quick delivery of the system  The dams are simple and cheap to construct. The existing infrastructure can be converted without any interference to the existing stakeholders

  Initially one  would need only  angled  metal bars and wooden planks. Since the dams are made of wood their effectiveness can be easily adjusted and the dams can be removed once better or more permanent flood prevention methods are introduced.

In future the design of drains must be changed not to drain water swiftly away but also to hold on the water for a period of time. We must also encourage homes and buildings to store rainwater not only for watering their gardens but also to use in their toilets. It does  not make sense for us to send our rainwater down the drain to be process and then bought  back to water our gardens. The fear of mosquitoes infestation can very easily be overcome as there are many  preventive measures.

The priority now is  to stop flooding in Singapore. We will never know when the next big storm will arrive.

Dr Seow Onn Choong   19 june 2011

Singapore's success story. Can it be repeated elsewhere?

Singapore success story, Can it be repeated elsewhere?

Dr Seow Onn Choong

The tiny island of Singapore is home to 5,5 million people with the second highest per capita income in Asia just behind Japan. It has no natural resources and nearly everything it consumes is imported. When it first gain its independence in 1965 nobody would give it a chance of survival and many believe it will soon be grovelling under the country that gave it independence. 46 years on , the story is so different.

Its largest neighbour Indonesia gave Singapore its nickname , the tiny red dot. Obviously it is with reference to its majority Chinese population and its size being so small that militarily it could be run over easily. Little do they know they were one of the main contributing factors to Singapore's success story.

Singapore has a very large expatriate population. As a dentist inevitably I get to treat many of them. it is also my habit and source of enjoyment when I talk to my patients and through it develop a good relationship with them. There was one such lady from Ireland who was one of the directors in GSK. GSK is one of the largest drug manufacturer in the world. they had built a very large high tech  factory in Singapore. She was very curious about  Singapore's success story. As she was in a high level position, she had met up with high level staff from the Economic Development Board who were the architects of Singapore's industrialisation. To attract high tech investment such as from companies like GSK, foreign companies are given extremely good tax breaks for a period of 10 years. She was curious how Singapore can benefit from it and if The Singapore success story could be repeated elsewhere. She was not satisfied with the explanations provided by the EDB officers. She was told Singapore was in an ideal location with an educated workforce and a good government. This were all the factors for its success. To her these were not special as many countries have such similar conditions. Well she thinks her dentist can provide her with the answer, well of all persons.

Yes I d because I am from the era and is part of the Singapore success story. I was born in Malaysia in 1954 in the town of Kuala Lumpur. Due to circumstances at that time I ended up in Singapore University in 1974  as a dental student .Even though I left Singapore in 1984 to seek greener pastures in Brunei , I finally return to Singapore and eventually became a citizen. Thus I can see the Singapore story better than a Singaporean who has not left its shores.

There are 4 reasons for Singapore success. Most countries would have one or 2 of them but I don't think I have read about any with 4 together.

1) Lee Kuan Yew

He is the founding father of modern Singapore. He is the right man at the right place at the right time. A brilliant man who brought up in Chinese environment , he had the opportunity to study law in Cambridge , England.

Thus he was exposed to western ideas yet steep in Asian culture.

It was the era of change in the late 50's and early 60's. Britain was under financial strain and were giving up her colonies one by one. Second world war had  shown the colonies that their masters were not invincible. Thus through peaceful or violent ways, all the colonies were striving for independence.

 Communism was gaining ground in Asia after the Mao Tse Tung unified China. Singapore had a majority Chinese population who then look towards China as their motherland. Malaya had just gone through a period of communist insurgency. The tactics used by the communist were very harsh with many threats and assassinations. Lee Kuan Yew and his colleagues were very forceful in their handling of the threats posed by the pro-communist factions. Many of them were jailed ,some without trial. The government also took over the trade unions which were then fertile grounds for the communists.

The hall mark of Lee Kuan Yew's administration was a corruption free government. Corruption was endemic at that time and without eradicating it, no young country can survive its ills.

2) "You are all coolies' The local Singaporeans

the first time I heard about the phrase, I was quite angry. My Hong Kong patient was trying to explain to me why the population of Singapore can be subjected to strict rules in the country and still does not oppose the government.

His rationale was very simple. There are 3 places outside China which had a majority Chinese population. They are Taiwan, Hong Kong and Singapore.

A closer look shows that the chnese who migrated to these 3 places are very different types of people.

Taiwan is an island just off the eastern shores of Fujian province. Prior to the exodus of Chiang Kai Shek's armies after the their loss to the communist , it was an unimportant island. Obviously there were original Taiwanese people but they were overwhelmed by this refugee group of armed forces, warlords, and wealthy people.

Taiwan had a authoratian government during the reign of Chiang Kai Shek. It was more a less a police state until democracy took hold after the collapse of the Chiang dynasty. Even with its so call democracy, politicians can be seen fighting in parliament and when the masses do not agree with the ruling government they will demonstrate on the streets. As can be seen the Chinese in Taiwan are not the subservient type.

Hong Kong was under British rule. It became a British colony as a result of the opium wars. Effectively it was founded by British merchants and thus trade was the main concern. The Hong Kong Chinese were attracted to it because of the opportunity to make money. It was enhanced by the mass migration of business families from Shanghai who brought along with them even more money making skills. For all the Hong Kong Chinese making money was utmost of importance. the British can govern as much as they like so long as the conditions suited both parties. Politically the Chinese never develop a sense of belonging and eventually the confidence in governing itself. Hong Kong thus attracted many Chinese of the merchant class while the worker class who came along was subdued by the British money making trading houses or Hong's.

Singapore was situated at the most southern tip of the Malaya Peninsula which is part of South East Asia. Tin mines, rubber plantations were all sprouting up to feed the demand of raw materials needed by the industrialising western countries. Boat loads of workers were streaming in not only from southern China but also from the Indian state of Tamil Nadu Singapore was fast developing as a port . Not only were most cargo being handled through the port , it was also the first port of call for migrants.

The majority who arrived in south east Asia (SEA) were the poorest of.the lot in their homeland. Nearly all of them were trying to escape extreme poverty due to the many wars in China. Food was scarce and there was no law and order back home. Thus as the story spread in southern China about the wonderful opportunities in SEA ,boat loads were arriving by the day. In fact those who had arrived will send  money home so that all their relatives can join them here.

The mantra then was simple. Don't cause any trouble with the authorities and you will not be send home. Always be on the good side of the law. That was what my mum repeatedly drum into me when I was a kid.

So now you can understand the source of Singapore's very obedient people. This set the opportunity for Lee Kuan Yew's government to rule with an iron fist.

3) Suharto and the Indonesian purge in 1965.

One of Singapore's largest neighbour is Indonesia. This country is huge in comparison not only in land mass but also in population. The majority of Indonesians are like the Malaysian Malays. They make up more than 90% of the population. Once again there are Chinese migrants who make up about 3% of the population. Unlike Singapore and Malaysia , Indonesian was ruled by the Dutch. Since they already have such a large local population there was no necessity to bring in migrant workers to exploit the land. Thus the small Chinese population. Maybe it is due to the climate and subsequently the abundance of food resources  the locals ( that includes the Malays in Malaysia) were very contented with whatever they had. You will be surprised , the simple coconut tree can provide virtually all the needs of the locals. Its fruit can provide not just a drink, it also provides milk that is used for cooking the favourite curry. When you squeeze the dried kernel you will get coconut oil which not only can it be use for cooking but also hair oil. What is left can be chicken feed. The shell can be turned into bowls and ladle. The list is very long.

The Chinese on the other hand were trained over the centuries to accumulate wealth, soon dominated the economy This domination is not well taken by the locals especially the ruling elites who at times needed the rich  Chinese to finance their activities. All these came to a boil in 1965. A army general by the name of Suharto came into power. A good excuse then was that the Indonesian communist wanted to seize power, and the army rose to the occasion to save the nation from communist rule. The chinese were an easy target as they were label as communist due to China being a communist country. A pogrom was launched.
SIngapore was the nearest safe haven. Most of the Indonesian Chinese had already developed a trading relationship with Singapore, thus many of them carried suitcase of cash to avoid disaster back home. Back then in 1965 Singapore had just been kicked out of Malaysia. The Malay politicians thought that soon SIngapore will be on its knees, as this small island nation had no resources at all.

The money from the Indonesian tycoons was a blessing for Singapore just as the welcome rain in spring. This was in reality a cheap source of borrowings.

4) The Malaysian Chinese Diaspora.

Malaya gained its independence from the British in 1957. In 1963 it was enlarged by the inclusion of  SIngapore , Sarawak and Sabah. By the time it gain its independence, the foreign population made up of Chinese and Indians had made up nearly 35 to 40% of the population. The British made a deal with the Malays insisting that all those resident at the point of independence be granted citizenship. The Malays had fought for independence but with the communist insurgency going on , they had little choice but to accept the British demands. The communist were defeated , and peace reined. When Malaysia was formed, the Malays were quite happy as now they have a country twice the size.

Lee Kuan Yew had a different idea in mind. With Singapore's inclusion into Malaysia the non Malay population cam to nearly half of the total. Mr Lee started to campaign for a Malaysian Malaysia. To the Malays this was a big threat. How can the newcomers usurp their dominance. Thus Singapore was expelled.

The seeds for political battle have already be sown. Being a young democracy, everyone had their own aspirations. With lots of similarity to Indonesia, the Chinese majority lived in the cities and other than some leftover British companies dominated the economy. Everything look peaceful on the surface. The government was formed by a coalition of 3 major political parties each based on their racial background. This was known as the Alliance party with the Malay Umno group in dominance. Every party knew their position.

However in 1969 things began to unravel.

The May 13 riots.

May 1969 was time for elections. As Malaysian political parties were formed on racial lines, so too was the opposition parties.  Malaysia was made up of 13 states with Selangor being the most prosperous state. The reason was the countries capital Kuala Lumpur was situated in Selangor. Thus with the majority of the businesses and industries situated int he state , it also had a very large Chinese population. The results of the elections in Selangor came as  a shock to the Malays. The opposition made up of mainly Chinese and Indian parties won with a one seat majority and thus was to form the government. This was definitely an unacceptable position. Rumours that a large group of Malays gathered at the home of the ousted chief ministers home and a huge pogrom was started.

The result was the government declared emergency rule, and with that the situation changed in Malaysia.

From once a democracy, the new constitution now preach Malay dominance. Overnight the system had been changed and now the races were no local equal. Discrimination  in all aspect of life was now implemented with the aim of bringing the Malays economic status on par with the Chinese. These sow the seeds of the Malaysian Chinese migration, probably one of the largest undocumented migration.

Just as the purge in Indonesia, some Malaysian Chinese left immediately for Singapore. The greater numbers were yet to come as  the impact of the discrimination set in. It is still going on.

The Chinese on both side of the causeway were very similar in literally all aspects of life. After nearly all of them came from the same source i.e southern china. Thus the new migrants were able to blend in without any one knowing except the government. These new comers provided Singapore with a very cheap source of workers. They were very similar to the local Singaporeans who followed the rules without much of a complaint

The biggest contribution must be to the talent pool. Few people know that the University of Malaya in the 60's was a premier university with many top rated students. With increasing discrimination few Chinese could enrol to study there. Most of these so rejected talented students came to study in Singapore University. Many stayed back after their education.

When we plot a Bell curve of the population, it gives us an idea of the of the number of smart , average and the not so smart people. With the top students from all the 13 Malaysian states now migrating to Singapore, the bell curve is greatly shifted towards a higher percentage of talented people. Thus the government was able to undertake rapid industrialisation, propelling the nation to a developed status. There at least 1 million Malaysians mainly Chinese with some Indians out of Singapore's total of 5.5 million people.

So you have a great leader, an obedient population, seed money and a large talent pool.

Which country in the world was so lucky? I am sure history cannot be repeated.

Now you can understand the reasons behind Singapore's success story.

Can Singapore grow 10 percent of its electricity

Can Singapore grow 10 percent of its electricity

A country’s energy needs would include firstly all its electricity generated and any other petroleum products used to power all its other machines which do not make use of electricity. This would make up in bulk by the automobiles (including buses) and other forms of power equipment such as tractors. Also gas used in cooking involves a smaller part in our energy needs.

Electricity plays a major role in the power needs of Singapore.  From lighting, heating and cooling it also plays a major role in our physical movement such as running lifts and our trains.

The energy requirement is huge and is still increasing in tandem with the improvement in quality of our lives. At the last count the generating capacity of electricity  in Singapore was a whopping  11.56giga watts with a reserve capacity of 30%.  Most of this electricity is generated through the burning of gas which amounted to 70%, 30% from fuel oil and a bit through burning of rubbish in incinerators. Soon a coal fired power station will come on stream.

The process of generating of electricity itself uses quite a lot of energy. Gas, coal , fuel oil must be burned to create lots of steam which then turns turbines that spins coils of copper wires around magnets to produce the wonder juice that is electricity. The end result energy is only about 40% of the original input. Worst is yet to come.

Nobody knows who will throw on the switch at any one time. Through daily usage we know all people go to work on weekdays. Thus starting around 6am the amount of electricity needed climbs and hovers around a fairly constant rate until when all the people leave their offices. As evening comes most of the city lights turn on as the entertainment world begins its nightly life. Even though we see the lights come on at night and feels the energy all around us the rate of electricity used is lower than in the day. To cope with the unpredictably of electricity usage at any one time, a huge gap exist between the amount used and the amount of electricity being generated at any one time. If there was no such safety margin, any sudden surge in electricity demand will exceed the power available and caused the system to trip so as it is called. This as highlighted earlier is the 30% reserve capacity.

When the electrical system “trip’, some part of the generating must be shutdown unless new sources of supply can be brought in immediately literally in seconds. If not there will be blackouts. All of us know the consequences of lost of power supply. We are so dependent on a failure free electrical supply that when the power supply is down a great deal of inconvenience is created. To make matters worse it will take the generation companies some time to check their system and to fire up their generators again.

 The amount of energy generated as a safety margin is a terrible waste. However no government will dare to cut away this margin. In fact most government will negotiate with the generation companies a fairly lucrative deal to ensure that their electrical supply won’t falter. In the days of cheap oil this was a fairly easy arrangement. However when the price of oil hovers around US$100 per barrel, this wastage seems a bit odd. Till date there is still no solution o this problem.

Coming back to the use of fossil fuel, be it gas, fuel oil and even coal that is used in our electricity, a lot of carbon dioxide is created. This in turn speeds up global warming through the production of carbon dioxide.

 One source of fuel that has not been given serious consideration is the use of biomass in electricity generation. In fact Singapore treats biomass as waste and is burned in incinerators. This ‘waste” usually made up of horticultural trimmings and waste wood from construction can total up to a quarter of a million tons year. Producers of such waste must even pay for their incineration. Sadly more often than not plastics and all other contaminants are also burned in the incinerators. Many people may not agree with me but incinerators are relics of the past.  They were not built for efficiently extract the energy from burning thus their contribution to the power system is paltry. So the supply chain for the incinerators has created yet another inefficiency and also wastage of fuel.

As we can see most of the biomass found in Singapore is horticultural waste. In 2008 about 265000 tons of biomass was collected. Most of them ended in the incinerators while the rest were used for composting. All of us know from time immemorial we have been burning tree cuttings and grass etc. As they created a lot of smoke, such open fires are no longer permitted and thus all of the biomass is burnt in incinerators which have very tall chimneys.

 Few of us realise if you process them properly they can burned very efficiently and without smoke at all. For this to happen, the biomass is processed by grinding leaves and wood into small sizes. This pulp is then compressed into briquettes or sticks. When burnt in furnaces line by special bricks they can attain much higher temperatures thus resulting in more complete combustion. The result is more energy produced and less pollution. Other innovations include the “cooking” this biomass to form a combustible gas.   This resultant gas can be converted to products that can be used very similar to petroleum products. The left over products from this burning of biomass is clean and without pollutants. It can be used as fertilisers, making of bricks and also in landfills

Many countries in the world have started to use biomass as a renewable fuel in their energy needs. Generation plants can come in various sizes. Experience has shown that a 100MW generation would require an input of 400,000 tons of biomass.

What are the problems involve

1)  Collection of Biomass

The biggest problem involved is obviously the collection of biomass. As it is we are already collecting it by our contractors and waste disposal companies. We can enhance the collection process by using the “karang guni” system. We are well versed with the masses of karang guni people who go round collecting old newspaper and whatever we discard.  When we use biomass as a fuel there is economic value in this waste i.e a price for it, it would incentivise groups of people to collect and sell it to the generation plants.

2) Creating more biomass.

To help develop a electricity generation system using biomass as a fuel source, we must be able to a have a sustained supply of biomass. In the equatorial zone there is ample sunshine and we have evergreen trees and shrubs growing all year round. Anyone with a garden will tell you the amount effort needed to prune the garden and the amount of waste in can generate.

When we talk about biomass our ideology is clouded by countries in the temperate zone. Their biomass is usually sawmill’s by products i.e from trees or agricultural waste from farming. They do not have rapid growing evergreens like us. We must think differently. There are many shrubs which we can harvest monthly. These shrubs are usually seen as hedges in our gardens. In order to save human cost, we must develop methods to plant them in ways which we can mechanically harvest them. As can be seen there are still lots of empty land that such shrubs can be grown. Examples are empty land slated for development. When these lands are needed for use the shrubs can easily be uprooted. Shrubs are the best source of biomass as they are a mixture of wood and leaves. This combination provide for easy grinding and also the best source of energy. Leaves have a layer of wax on them. When heated to a high temperature they are turn into a gas that burns at very high temperatures.

The possible contribution from National Parks of Singapore

As we have read of newspaper article that he trees planted many years ago are fast aging, we should be planning to harvest such trees. At present most of our secondary are not pruned. Usually they are left on their own. A good farmer will tell you that is not the way to ensure you get the most healthy plants. Thus pruning the undergrowth and trimming away all the climbers will give rise to healthy growth. National Parks of Singapore is still in the old mindset when it comes to growing plants. Their mission has been the greening of Singapore and thus their motto of living in a park reflects their ideas. The by- products of their work is called horticultural waste. It cost them money to dispose of it thus the less they create the less cost involved. If we turn it round and buy it from them, then this so call  cost centre becomes a profit centre. They will then relook their workings and not hesitate with plant renewal.

Railway land

A great opportunity will come the biomass way as the trains stop running down the railways. This will present environmentalist a vast tract of greenery. It also presents a huge source of biomass farming whilst maintaining the environment. The existing track will provide easy collection and transportation of the biomass without being seen. 

The future supply of oil and gas

The supply of oil and gas is running down in the world. As oil companies go out to search for more oil and gas, they have to go to places further away and drill further down into the earth’s crust. Not only is it much more costly to do so, it has also led to huge disasters such as the recent Horizon oil rig blowout in USA.

The transport of oil and gas is not without risk. The tanker Valdez ran aground of Alaska and caused huge damage to the environment. There are many more such incidents. Storage of oil and gas is also equally expensive. Special tanks are build costing billions of dollars. You will need a large tract of perimeter land adjoining such storage sites for safety reason. For any reason any one of these storage facilities catches fire the losses can be very great.

The transport and storage of biomass on the other hand involves very little risk. There are no blowouts. When a ship laden with biomass sinks there is no pollution. Fire is the only risk but the consequence of a biomass fire is definitely less harmful and polluting then fossil fuels.

Carbon credits.

As biomass is a renewable source of energy, we can claim carbon credits when we use it for generation of electricity. Singapore has a very large deficit of carbon credits. Although our real use of energy per capita is not much higher than others, the carbon fuel use in our chemical, petroleum refineries, bunker supplies to ships and aeroplanes is huge. In future when carbon trading becomes a reality we can still claim some credit offset.  

Spreading the good news to all our equatorial neighbours.

 It has become an annual affair when the haze blows over the whole of South East Asia when the dry season comes. There are many culprits namely the developers of palm oil plantations, illegal loggers and last but not least the farmers. Why do they burn the forest or left over crops?. Obviously the cost factor is the main concern of the plantation developers. The cost of burning down thousands of hectares of forest is only a few match sticks and a few litres of kerosene. However if what they burn can bring them money, then the whole story will change. Not only selling the biomass can bring them money, a lot of jobs downstream is created to the locals by processing the forest waste to biomass fuel. Isn’t this a win win situation as they will benefit from extra income plus job creation whilst we will not have to endure the haze annually. Finally we also have another great source of renewable fuel, without ever worrying about the price of oil going up. It is definitely better to let our neighbours benefit from this revenue than to benefit the petrol dictators.

So with this possibility why are we not embarking on it?. We must come together and change our mindset and start on this path before our national growth comes to grinding halt due to sky high energy prices. If we think our country is too small to generate the amount of biomass needed, we can spread our development to our neighbouring countries. We must start developing the techniques and machinery to handle biomass fuel. Obviously along the way we will become more efficient and will be able to squeeze the most energy out of biomass.  Generating 20% of our needs is the first step. In time we probably can grow enough biomass to satisfy all our energy needs. Who knows?.

First dentist in singapore to lead lined xray room?

Dr Seow Onn Choong

Modern dental clinics are all equipped with xray facilities. Some dentists attached the xray on the wall of their treatment so that the patient is still seated on the dental chair when the xray is taken. Majority of dentists build a special room to house the machines and in such cases may be more than one type.
This posed a a dilemma for me back in the 1981.
When I started my first clinic in Plaza Singapura then , my lease was only for nine months. Plaza Singapura in the 70's and 80's was a very popular shopping center with Yaohan supermarket as its start attraction. It had a mediacl centre on level 5. This medical centre was very popularwith the Indonesians who at that time came in big numbers. For some reason the owners of the of that building felt that a medical floor did not suit the image of the shopping centre and thus  they were going to convert two floors to office building. Thus all the famous doctors and dentists were asked to leave.
I have found a unit on level 5 situated on level 5 located at he passage from the carpark to the shopping i.e a busy thoroughfare. I was hoping that after the short lease I would be allowed to have a clinic in the building  at another location. This actually came true.

As I planned for the renovation works I realised I had only two choice for an xray room. The most common choice was to build a room with concrete wall of sufficient thickness so as to block off the penetrating xrays. This was not a good option as I needed a stuctural engineer's approval to check and approve the plans  to see if the floor can take the the load of the concrete.
The next option was to import a special xray  box from Japan. This box has special lead line walls and also a lead lined glass window. The only problem was it will cost me $8000 and 3 months for it to be shipped to Singapore. $8000 was a lot of money at that time and also I did not have 3 months to spare.
Well it was good that I had studied Physics in school. I know lead can absorb xrays and thus can prevent the rays from passing through the wall. Now I had plan to fabricate all the partitions of the clinic with gypsum board. Gypsum board partitions were very cheap then, and all the partiitions in the clinic can be done in 2 days. Futhermore when it comes to removal one can do it equally fast. The only problem was where to get the lead sheet.
The first thing that came into my mind was the lead sinkers you use for fishing. So without hesitaion I trooped down to the fishing tackle shopped to buy lead sinkers hoping to hammer them flat. The owner was taken aback when I asked to buy 200 sinkers. He could not control his laughter when I explained to him why I needed so many sinkers. You see to make sinkers he bought lead sheets which he melted down and poured into moulds into the shape of sinkers. Well as s dentist how would I know that.
The kind owner pointed out ot me that that hardware stores In King Georges Avenue were the wholesale merchants for lead and I found out later they sold all types of metal. The shop assistant was amazed that  a finely dressed gentlement like me would come to his shop. He informed me they only sell lead sheet in rolls, they came in certain thickness and  volume. Well it did not really matter to me as lead was a very cheap metal. So I bought 1 large roll. Fortunately at that time aI owned a coupe stationwagon nad I promptly carted it back to Plaza Singapura.
The renovation contractor was amazed when he saw the roll of lead. I had to show him how to cut the sheets and then hang them betwee the hollow gap of the partitions and also between the plywood of the door.
Inspection day for the clinic came .The renovation was done in record time leass than 10 days. It probably was the fastest renovation of a dental clinic ever. All thanks to my good friend and mentor. An engineer by training he enlightenes me on The Critical Path Analysis method . This was something very new to a dentist.
The inspector from the Radiation Department was not impressed when he knocked on the partitions and already he was shaking his head in disapproval. Well since he was here he might as well go through the motions. To his utter amazement he could not detect any xrays leakages. Obviously he wanted to find out how I did it.
Now in Singapore this format of lead lining gypsum board partitions is a standard feature. As the dental suppliers came to visit me they found out about my innovation as they were equally surprised that I had a xray room without concrete wallls. Soon they were recommending this method to other dentists intheir renovations.
I am sure I am the first dentist in Sinagpore to use this method of a xray room. I wonder how many other places in the world that dentist also use this method.
It is good to study all the sciences in school.