With its theme of “Towards Humanistic Medicine,” the long awaited conference organized by the Tzu Chi International Medical Association (TIMA) Singapore members officially commenced amidst warm applause and the blessings from many. This was the first TIMA conference held outside Taiwan and it had attracted 488 participants. The event was held from 6 to 8 March 2015 at the Matrix@Biopolis, Singapore’s international research hub for biomedical sciences. The opening ceremony was graced by Minister for Health Mr Gan Kim Yong, Member of Parliament Mr Yeo Guat Kwang, CEO of Tzu Chi’s Medical Mission Dr. Lin Chin-Lon, CEO of Tzu Chi Foundation (Singapore) Mr Low Swee Seh, TIMA members and 378 healthcare professionals from 11 countries and regions.
In his opening speech, Minister for Health Mr Gan Kim Yong noted that the clinical knowledge and experience of Singapore’s healthcare professionals are much-needed skills that can be tapped to help others beyond our own shores.
The year 2015 marks the 50th anniversary of Singapore’s independence, and is also significant for Singapore TIMA members as this is the first time their numbers have exceeded 100 since its establishment 16 years ago. Tzu Chi now has two free clinics in operation and has also begun providing quality medical home care services to the needy. In view of this, it specially compiled 50 heartwarming stories of humanistic medical care in TIMA’s bilingual commemorative book, “Humanistic Care Through Humane Hearts” and Minister Gan, Dr. Lin, and Tzu Chi’s CEO of Global Affairs Stephen Huang, together with the other VIPS took the opportunity to recommend the book. Minister Gan thanked Singapore TIMA members for their contribution and hoped that the book would inspire more healthcare professionals to participate in overseas humanitarian missions and together, share and learn from each other’s experiences.
In its World Health Report 2000, the World Health Organization (WHO) ranked Singapore’s health system 6th in the world and foremost in Southeast Asia. Since 2003, the Singapore government has also been actively promoting Singapore as an Asian medical tourism hub. However, Minister Gan pointed out that the poor and needy still exist in our society and that it is imperative for the Ministry of Health to work with local healthcare organizations, medical specialists, community volunteers etc. in policy-making in order to help them more effectively.
Using English as an International Language
In response to the rousing drumbeats that filled the air in welcome to conference participants hailing from Singapore, Malaysia, Indonesia, Philippines, Cambodia, Hong Kong, Taiwan, PRC, Sri Lanka, USA, and Germany, the entire auditorium resounded with warm applause. Clad in their white doctor’s garb, Singapore TIMA members presented their item with great sincerity, the result of applying themselves earnestly to drum practice sessions for close to a month outside of their busy preparations.
Rohaizan Rahmad, a nurse from the Tan Tock Seng Hospital marvelled at how the moment she stepped into the conference venue, she could feel the humble sincerity of Tzu Chi volunteers. In addition, the venue decoration made one feel calm and at ease.
Since 4 March 2015, there had been a continuous arrival of over 80 overseas participants to the Lion City. More than 300 volunteers were deployed in the preparations, and they tirelessly travelled back and forth between Jing Si Hall, the airport, hotel and the conference venue, emulating the same spirit of attention to details which was typical of the Taiwan TIMA conferences. The planning team rented a function room at the hotel which enabled the overseas speakers and conference attendees to connect with the Jing Si Abode in Hualien via video conference, making possible their participation in the early morning Dharma talks.
“TIMA conferences were always hosted in Taiwan in the past. This is the first time that it has been held outside Taiwan and it is truly a golden opportunity,” said Dr. Lin Chin-Lon, CEO of Tzu Chi’s Medical Mission. He further expressed the hope that Tzu Chi could share the spirit of humanistic medical care with the world, a holistic concept which encompasses “the whole journey, the whole family and the whole team.”
TIMA currently has a network exceeding 30 countries, comprised a majority of Chinese-speaking members. “This time, the entire programme was conducted in English. The US, Europe, Indonesia and the Philippines all speak their own languages, and English is the common language they can understand,” said Dr Lin as he explained why the team had decided to conduct the conference in English. Seeing how Singapore is the gateway between Asia, the US and other regions, he expressed the wish to see the participants bring their learning back to their respective countries, letting it take root and flourish.
The three-day conference boasted a programme lineup that was of very practical value to participants. Apart from the sharing by the superintendents of the various Tzu Chi hospitals in Taiwan, the topics of bone marrow donation and “silent mentors (body donors)” were also covered in depth and participants were given a rundown of the international humanitarian aid efforts and medical missions that had been carried out in Indonesia, US, Sri Lanka and the Philippines etc. The dual themes on the third day’s agenda focused on humanistic education as well as how to actualize humanistic medical care, and it was divided according to the specialised branches of western medicine, Traditional Chinese Medicine (TCM), dentistry and nursing care. The conference also adopted a small group format so as to facilitate discussions and workshop participation.
Gratitude and Respect as Part of Humanistic Medical Care
Dr. Lin and Associate Professor Chang Shu-Chuan, Director of Nursing at the Hualien Tzu Chi Medical Centre, each gave a talk on Tzu Chi’s humanistic healthcare, with Dr. Lin urging participants to ponder over the question: disregarding the level of medical skill, what is of utmost importance in healthcare?
Associate Professor Chang had also been asked this same question once in an international seminar. Her reply was that it was to see the most beautiful smile in the world—the smile of a patient. As long as a patient’s mental and bodily suffering has been alleviated, a smile will naturally light up his face.
It was because Master Cheng Yen had realized in the course of doing charity work that sickness brings about poverty, that she had later established a hospital in the rural area of eastern Taiwan, which later became the Hualien Tzu Chi Medical Centre. The provision of medical care is an undertaking to benefit lives and to relieve suffering. Dr. Lin further explained how Tzu Chi’s philosophy of humanistic medical care places emphasis on respect for life and the provision of patient-centric services. Over the past twenty years, the six Tzu Chi hospitals in Taiwan have become known for various unique aspects, including its patient-centric medical information system, focus on health promotion and environmental protection, as well as the global reach of TIMA’s network. All six hospitals work closely together guided by Tzu Chi’s four overarching missions of Charity, Medicine, Education and Humanistic Culture, expressing the spirit of “gratitude, respect and love.”
With the help of video footages, Dr. Lin brought his audience on a tour of the six Tzu Chi hospitals to experience their humanistic culture. Conference participants were impressed at how the healthcare workers started by cultivating gratitude for their colleagues, made aspirations to help others, and took part in various endeavours including medical home visits, house cleaning for beneficiaries, the Tzu Chi Year-end Blessing ceremonies, as well as other voluntary activities. The management staff also express appreciation for their staff and patients through the presentation of sign language and drum performances.
“Birth, sickness and ageing are the realities of life and nursing professionals are themselves participants in this natural cycle.” Associate Professor Chang explained that the provision of nursing care must develop according to the needs of patients and it is in the provision of medical care that one can clearly see the qualities of a bodhisattva manifest in the ever-present and timely response to the cries of the sick.
Apart from on-the-job training, training and briefing sessions, community service, role model exemplification etc., the Tzu Chi Medical Centre’s nursing team also work hard to nurture a working environment of mutual gratitude where “new nurses” progress to become “good nurses” and finally, “model nurses.” Associate Professor Chang gladly noted that their retention rate of new nurses is as high as 80%.
People First-- Rethinking the Approach
Group CEO of Alexandra Health System Mr Liak Teng Lit put it across bluntly in his talk, “Humanistic Medicine in Singapore’s Healthcare Landscape-Lofty or Lost?” that many doctors nowadays focus on the technical; they treat the illness and not the patient. For example, the different doctors will all prescribe separate medicines, such that the same patient will have to take more than 20 different types of medication at the same time. Through this approach of breaking down an illness into its various aspects and treating each ailment separately, it becomes hard for patients to benefit from a comprehensive treatment plan. Though it is possible to treat emergencies and save lives with such an approach, it is not conducive to the treatment of chronic illnesses.
According to the 2013 figures released by the Ministry of Health, Singapore has 25 large hospitals and specialist treatment centres. With 11,000 patient beds available, on average there are 2 doctors for every 1,000 people. Mr Liak feels that the public hospitals face a patient crunch and while healthcare professionals may try their best, they face the danger of succumbing to burnout in the long run. Thus, promoting a humanistic medical culture here is a challenge.
Mr Liak first got to know about Tzu Chi 11 years ago. After the South Asian Tsunami disaster, Mr Liak, together with a medical team, was in Aceh, Indonesia taking part in a humanitarian aid mission and it was then that he saw how efficiently the Tzu Chi humanitarian team worked.
During his talk, he also stressed on respect and quality of life over lifespan. Using the topic of an ageing population to illustrate his point, he described how a third of the nation suffers from chronic illnesses, with the majority having to live with their ailments for 10 years or more before passing on. “Integrating and being a part of society is important, not more medication. Life must be lived with meaning, without losing one’s independence and mobility.” He states that healthcare is not just about science; it is about love too. Patients should be given choices and they need wise doctors to help them make wise choices.
Passing on the Medical Baton
During the conference, images of the TransAsia air tragedy in Taiwan flashed across the screen-- Tzu Chi medical volunteers showing concern for the rescue team, the hospital superintendent and doctors trapped in a muddy bog while making their way into the disaster zone, doctors braving the wind and rain to bring food to families of the air crash victims……all those images spoke volumes of the commiseration and compassion of volunteers. As Dr. Lin put it, charity and healthcare together go hand in hand.
Outside the auditorium, the posters, partitions and decoration were carefully put together to project the humanistic culture of Tzu Chi. There was also a display of products that was used in Tzu Chi’s international humanitarian aid missions, such as multi-purpose portable beds, hardy cloth shoes, solar-powered knapsacks, solar-powered caps, instant rice etc. These attracted a lot of attention from conference participants who marvelled at the ingenuity of the products.
First time TIMA conference attendee and radiation therapist Xu Wen Shi from Terengganu, Malaysia, had accepted her senior’s invitation over an online chat platform to sign up. She commented how different the TIMA conference felt with its “artistic decorative feel” as compared to the other events she had attended in the past. She expressed how much she liked the sign language item presented by Singapore TIMA members at the opening, as the lyrics of the accompanying song made her remember why she had chosen a medical career in the first place.
After her first three years as a medical rookie, Xu needed to find a new point of reference after the daily grind of work pressure and feeling that she was mechanically going through the processes. “Today I learnt many things that are not taught in the textbooks, such as how to interact and get along with patients.” She felt as though her spirit was recharged and hoped to become part of TIMA one day.
In the song, “Ode to the White Coat” presented by Singapore TIMA members, the lyrics liken Tzu Chi’s Medical Mission to a world in which the sun never sets because of the presence of healthcare teams who bring forth Great Love from their hearts. In a similar vein, head of TIMA Singapore Dr. Fong Poh Him extended a warm invitation that would have resounded in the hearts of conference participants long after the curtains fall: “We welcome you to be part of TIMA!”