Doctor's Review: Medicine on the Move

January 22, 2022
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Singapore sling

This multicultural island nation packs an exotic punch

"No, no, no! You won't be dragged away and caned for chewing gum on the street." The telephone connection was so clear that I could hear my friend sighing on the other side of the world, in Singapore. "But if you drop a piece of paper on the sidewalk, the sensors will trigger an alarm." She waited a few seconds, and started laughing, "Just kidding."

At that point, illegal gum and public canings were all I knew about this tiny island nation at the southern tip of Malaysia. But my trip was a chance to learn much more, not least of which was the fact that Singapore is only one degree north of the Equator.

That was clear each time I stepped out of an air-conditioned taxi or bus and slammed into a wall of humidity and heat. After a few weeks, I was used to having rivulets of sweat perpetually running down my back. But getting accustomed to a population density of 5900 inhabitants per square kilometre (Toronto's is at 3939) and a constant cavalcade of cars driving through an ultra-clean city where every bit of space has a designated use — well, that took more time.

So did the language. Shortly after arriving, I settled into my first cab. "Where you go, lah?" The driver turned to me and brusquely demanded. "Where? Where?" he prodded, when I wasn't quick enough on the uptake.

Fortunately my friend took over and gave the cabbie equally rapid directions to her apartment. As I listened to their conversation, it dawned on me that they were frequently using English words, but I really couldn't understand what they were saying. Then the English disappeared entirely, and they switched to another language.

"What was that?" I asked a few minutes later. "Singlish," she said. "It's a Singaporean mixture of English and Chinese, mostly Hokkien. Everybody speaks it. Most speak standard English too. But the driver is Chinese, so I switched to Mandarin. Anyway, don't worry. I got you a Singlish-English dictionary. You'll see." We settled back as the cabbie zipped along at a pretty good clip. "Ah, you're so blur," she added.

Over the next few weeks, I learned many handy tidbits from my Coxford Singlish Dictionary. For example, that "lah" is often added to mark the end of a sentence and that to be blur means to be in a world of my own, or dazed.

Raffle it off
The best place to get a feel for Singapore's beginnings is where the winding Singapore River opens to the naturally deep harbour of Marina Bay. Life-sized statues scattered along the banks capture some of the history and culture — Chinese merchants with long braids show their wares, Malay traders are deep in conversation and muscled workers load carts. Behind them, old wooden bumboats cruise the gentle river, carrying tourists past Boat Quay and Clarke Quay, where riverside shophouses have been converted to popular bars and restaurants.

Modern Singapore was born here, when Sir Stamford Raffles came ashore January 29, 1819. With deft political manoeuvring, he claimed the trading island outpost for Britain and broke the Dutch monopoly through the all-important Straits of Malacca.

"In short," wrote Raffles, "Singapore is everything we could desire, and I may consider myself fortunate in the selection; it will soon rise into importance." So did Sir Stamford. He's immortalized at the official riverside Raffles Landing Site with an elegant statue.

A few steps from Raffles' watchful gaze is the Asian Civilisations Museum (1 Empress Place; tel: 011-65-6332-7798; It's the best place on the island to get a handle on the different cultures that make up modern Singapore. Exhibits explain how immigrants — from the early Malays in the 14th century to later migrations from China and India — came looking for a better future in the rapidly growing trade centre. As migrating Chinese intermarried with Malays centuries ago, their cultures blended to create peranakans, literally "half-castes" in Malay. Names and religion remained Chinese, but dress and customs became Malay. The language — Baba Malay — is a fusion of Chinese Hokkien, Malay, with even some English and French words; it's spoken by less than 5000 Singaporeans today.

The search for a better life wasn't without difficulty. Under British rule, opium was the biggest money-maker, and it ruined the lives of many poor Chinese workers as they attempted to ease the pain of their arduous workdays — a fact which is honestly described in the ACM's exhibits.

Today, of the 4.3 million people who live on the 42-kilometre-long by 23-kilometre-wide island, 77 percent are Chinese, 14 percent Malay and 7 percent Indian. As a result, the island is home to Buddhist and Hindu temples and Islamic mosques. There's even an old synagogue, the Maghain Aboth, built in 1878 by Jews from Iraq.

And Then Came Yew
Between 1945 and the final departure of British forces in 1971, Singapore changed tremendously. Lee Kuan Yew, the country's first prime minister from 1959 to 1990, writes about this in his autobiography From Third World to First. Under his paternal leadership and one-party rule, the country gradually developed from a place of quiet, and often neglected, wooden villages (called kampongs) with poor sanitation and a fragile economy, to an industrialized urban nation prospering from banking, hi-tech and biotechnology.

The keys to this success were Lee's government-initiated projects for urban renewal, infrastructure, health, education and transit. Kampongs were bulldozed, folks moved to now-ubiquitous highrise apartments, and home ownership was encouraged with attractive prices.


The government has had a reputation for paternalism and social engineering. ("If this is a 'nanny state' I am proud to have fostered one", Lee is said to have punned.) One of his most controversial proposals was to offer tax breaks and schooling incentives to encourage educated men and women to marry each other and have kids. In addition to bans on public urination, littering and chewing gum (recently relaxed, it is true) the government also forayed into the more personal area of dating.

My Singaporean host explained, rather matter-of-factly, that in the 1980s, birthrates started to decline, especially in the educated classes, because women were paying more attention to their careers. The People's Action Party created a Social Development Unit, and part of its services included government-run dating. They organized events and trips to create opportunities for upwardly mobile singles to meet.

She rolled her eyes before continuing. It seems that some trips — particularly those to nearby Indonesia or Thailand — were so enticing that folks who were already in relationships decided to take part. When the SDU realized this, they were really embarrassed, so they stopped the trips.

Today there are non-governmental Internet dating sites, including a unique Singaporean website called Wholives, which aims to connect singles who live near one another and "rekindle the kampong spirit of yesteryear."

Prime Minister Lee's success in turning Singapore into a prosperous First World country wouldn't have been possible without his people's powerful work ethic.

If "keeping up with the Joneses" is our predicament in the West, the Singaporean dilemma would be getting there ahead of the Joneses.

Over 86 percent of Singaporeans own their flats — the highest rate of home ownership in the world. Now there is a drive to work harder to buy a privately built condo, pay for overseas educations for the kids and buy a flashy car. The per capita GDP speaks volumes. From the time Lee took office to the writing of his book 40 years later, it rose from $400 to $22,000 per person.

In a recent burst of governmental energy, the People's Action Party announced that "to ensure continued economic prosperity," not one but two casinos would be built on the island.

Even the national airline isn't content to run with the pack. A year ago, Singapore Airlines announced the introduction of the world's longest flights (non-stop from both Newark and Los Angeles to Singapore ) at just over 18 hours. In 2006, they plan to add the Airbus A380 — the new double-decker will be the world's largest passenger plane.

Melting Pot Mix
One way to get a taste of Singapore's true flavour is, of course, by eating. Singaporeans love dining out and for good reason: food is fresh, plentiful and, you guessed it, multicultural.

Open-air food markets, called hawker centres, are the country's authentic eating experience where a variety of Asian dishes are served alfresco from dozens of tiny mom-and-pop stalls. Every housing estate has a hawker centre, open to residents and tourists alike.

There's a terrific variety of Chinese, Malay or Indian dishes. Pull up a plastic chair and an inexpensive feast will soon arrive at your table. Chicken, beef or tofu in a noodle soup, washed down with fruit juice or a beer might cost a few dollars.

You can expect a few polite stares from the local residents. After all, you're eating in what's essentially their front yard. After several weeks at my friend's housing estate, I hadn't encountered another Westerner at one of the food stands.

Like the blend of languages and customs that make up the culture, the cuisine too is fusion. Instead of stir-fries, dishes are individually cooked with spices or herbs ground into paste or powder, so each dish is full of distinct flavours.

At the edge of the neat-as-a-pin Chinatown is the popular Swee Kee Fish Head Noodle House (96 Amoy Street; tel: 011-65-02-224-9920). It's known to locals as Ka-Soh Seafood Restaurant. Ka-Soh, which means daughter-in-law, refers to the relationship binding the two grumpy women who started the original emporium. Complementary achar — pickled cucumber, carrots and pineapple mixed with Chinese spices and chilies — arrived as we sat down. Our friendly waitress (clearly not the daughter-in-law) soon returned with our moist braised tofu, salted greens, and a filling rice noodle soup with slices of fresh fish.

For the full-on Malay dining experience, the most historic spot is Tepak Sireh (73 Sultan Gate; tel: 011-65-6396 4373; in the former residence of the Prime Minister of the Sultanate of Johor (a Malay province which controlled Singapore in the 15th and 16th centuries). The house was originally built in the 1820s by architect and bridge designer G.D. Coleman, and reopened in 2003 after a loving restoration. In lofty cool rooms, Malay women wear traditional Tudung headscarves, and the foyer houses an everything-you-always-wanted-to-know-about-betel-nut exhibit. Makes sense, since the tepak are the five ornate containers which hold the ingredients for sireh, a betel-based concoction which is chewed like tobacco.

It was an overcast muggy day when we arrived for brunch, and a heavy downpour started just as we sat down. Their weekend lunch buffet has a wide selection of dishes and desserts fit for a head of state at only $10 per person. Beef rendang is the spicy, coconut-flavoured signature dish. The Talam Keladi yam and screw-pine pastry was a sweet way to end a meal.

The House of Peranakan (Hotel Negara, 10 Claymore Road, Level 1; tel: 011-65-6733-4411), near the shopping mecca of Orchard Road, serves traditional Straits-Chinese cuisine. We had a lively fish curry in tamarind, nicely balanced with a soy-based chicken stew with lemongrass and green long beans in sambal chili paste with dried shrimps.

While I had quickly taken to Singapore's fragrant fusion dishes, the drinks we ordered came with a surprising dose of culture shock. One was a translucent boiled barley concoction served ice cold; the other was green lime juice with agar-agar jelly made from seaweed. I presumed they were an acquired taste, and what I needed was time to acquire that taste. It seemed like a good reason to consider extending my trip — for at least a few more months.


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