Letter in Today (29 Oct 2005) - Drains in S'pore just do not drain
http://www.todayonline.com/articles/81104.aspDrains in S'pore just do not drain
Thorough review, redesign needed for sustainable efforts in fight against dengue
Letter from Jeffrey Ho Loon Poh
I refer to Channel NewsAsia's report, "More than 1,000 mosquito-breeding sites found during 6-week carpet combing exercise" (Oct 27), which noted that "the main problem areas were drains … And PUB has checked 300km of drains and started work on 10km that require minor repairs".
.One of the reasons why so many of the public drains are favourite spots for collecting and retaining stagnant water is because they are almost level, without any gradient to allow for drainage (hence, the drains in Singapore are a misnomer because they don't drain!). I have taken some photographs at various locations to illustrate my point.
.The drains along Chancery Lane and Gentle Lane are debris-free, so the only reason there is stagnant water is because the water doesn't drain.
.The greatest irony is the entry ramp to the PIE from Adam Road (coming from Farrer Road), where the engineers who designed and built this stretch of drain intentionally "levelled" the drains along the otherwise naturally sloping ramps.
.Is it any wonder why so many of the drains are potential breeding grounds for mosquitoes? I believe it is imperative that any dengue measures must be sustainable and not one-off during outbreaks only.
.Currently, to ensure stagnant-water-free drains, various town councils and agencies have to deploy hundreds of workers to clean and flush them regularly.
.This is not an efficient way to optimise resources, notwithstanding the fact that such jobs create employment.
.While this may suffice as a stop-gap measure, the permanent solution is to do a thorough review and re-design or revamp of all those drains that do not have sufficient gradient to allow good drainage.
Choked Drain in front of PUB Jurong Pumping Station near Jurong Lake
Reply from PUB on 28 Oct 2005:
Subject: Re: Choked Drain in front of PUB Jurong Pumping Station near Jurong Lake 1800 X DENGUE (7B6FCF1C59)To: denguealert@yahoo.comCC: PUB One , PUB WSOC PUB_WSOC@pub.gov.sg,MCYS Feedback Unit Feedback_UNIT@mcys.gov.sg,NEA dengue dengue@nea.gov.sgFrom: Ming Hwang CHAN CHAN_Ming_Hwang@pub.gov.sgDate: Fri, 28 Oct 2005 18:05:48 +0800Dear Mr Jeff,Thank you for your email. We noted that the drain in front of PUB Jurong Pumping Station near Jurong Lake have a tendency to collect stagnant water.We agree with you that stagnant water poses a risk to public health due to its potential for mosquito breeding and dengue outbreak. Thus, PUB has immediately mobilised manpower to clear the choke and stagnant water for this particular instance. Thereafter, we will request our colleagues in NEA to increase their frequency of their regular cleansing this particular drain. As you know, NEA has done a remarkable job in ensuring the overall cleanliness in Singapore which is leading to the high standard of public health, which we all enjoy currently. In addition to the increased cleansing frequency, PUB will shortly evaluate the necessity for further re-grading for this drain. We have previously re-graded this particular drain on 27 Dec 04. Nevertheless, there is a limit to steepen the gradient, due to fixed levels both upstream and downstream. We will optimise the gradient as far as is possible. Lastly, you may be interested to know that an inter-agency Taskforce is reviewing the design and maintenance standards for drains in Singapore currently. Their findings and recommendation will be presented to the Dengue Coordination Committee by end-year. In conclusion, we wish to thank you for making the effort in bringing this matter to our attention. And we look forward to working together in assisting NEA in ensuring the high standards of public health, for the best interest of the nation.Sincere thanks and warmest regards.Chan Ming Hwang
Mystery of the widespread water stagnation at drains across Singapore solved?
To: Feedback Unit - MCYS
cc: Prime Minister Lee Hsien Loong
Minister for the Environment and Water Resources - Dr Yaacob Ibrahim
Further to my 21 Oct email below, attached please find photos taken today (24 Oct) at the flyover ramp entering the PIE from Adam Road coming from Farrer Road.
You will note that there is water stagnation at the drain there, possibly because of the lack of gradient to allow water flow. This is most puzzling because not only did the flyover engineers not make use of the "natural" gradient of ramp when constructing the drain (to allow drainage), they had chosen instead to "level" the drain (hence the "steps" that can be
seen from the photos), causing water stagnation - potential breeding grounds for mosquitoes. It is bad enough when drains constructed are not sloping, but to "level" a naturally sloping drain, I fail to understand the rationale behind such designs.
(By the way, I've noticed all these entry/exit ramps to/from expressways have similar "stepped-up" almost-level drains, so all potential mosquito breeding grounds).
As I've previously mentioned on numerous occasions (
refer my 2 Aug 2005 posting - http://denguealert.blogspot.com/2005_08_01_denguealert_archive.html), in addition to the weekly cleaning of the drains (to remove water stagnation), why not do a thorough review to see the need to re-design all these drains that do not have sufficient gradient to allow water flow. This was a common observation in the many drains I've seen across the island (not just those at the flyover ramps mentioned above), the drains are almost level, hence water collected does not drain easily, resulting in water stagnation. That's why there are so many mosquito breeding spots in the drains across Singapore.
Isn't it better to fix the "source" of the problem, rather than the "symptoms"?
Jeff
Perpetual stagnant drain water at Owen/Dorset Road junction (corner at Chr Outreach to the Handicapped premises)
The following sent to NEA:
========================================================
I've noticed this drain seems to be perpetually choked. As previously suggested, this might be due to the fact that there is hardly any gradient to allow flow (perhaps common with many such drains throughout Singapore - public or private).
I note in today's Straits Times (18 Oct 2005) that the "...PUB would be carrying out minor repairs to about 10 km of drains at some 250 locations islandwide....The repairs are for sections of drains that are sunken or damaged, and will help prevent water stagnation."
Questions:
1. There is however no mention of any improvements/repairs to be done to drains that do not have
sufficient gradient to allow water flow to prevent water stagnation too. Will this (sufficient gradient) be included as part of the repairs?
2. Will drains
inside private & public properties - condos, companies, government entities like schools etc.. be also reviewed (and repaired if necessary) to ensure no stagnation?
3. Is the above stretch of drains at the Owen/Dorset Road junction part of the 10 km to be repaired?
Thanks.
Reproduction of my 24 Sep email to NEA: Why is law not equally applied to Town Councils and govt agencies when their areas are found breeding mozzies?
http://denguealert.blogspot.com/2005/09/why-is-law-not-equally-applied-to-town.htmlhttp://denguealert.blogspot.com/2005/07/welcome-to-dengue-alert-fight-against.htmlReproduced from my 24 Sept posting (in fact, the call to fine town councils and government entities if they are responsible for breeding mosquitoes goes way back to Feb 2005 per my letter published in the Today newspaper of 24 Feb 2005, "Mosquitoes breeding in public places ...If found, fine responsible govt entities, contractors" - visit my introductory blog dated 29 July 2005 for details - link,
http://denguealert.blogspot.com/2005/07/welcome-to-dengue-alert-fight-against.html . It's been 8 months since then but, hey it's better late than never!):
Why is law not equally applied to Town Councils and government agencies when their areas are found breeding mosquitoes?To: Feedback Unit - MCYS
: NEA
cc: Dr Yaacob Ibrahim - Minister for the Environment and Water Resources
Extract of letter published in Straits Times online forum, 23 Sept 2005 by Mr Henry C W Suriya (in Red below or visit link,
http://straitstimes.asia1.com.sg/forum/story/0,5562,342368,00.html ) listing problem areas in Singapore's fight against dengue and suggested improvements.
However, one big area seems to have been "glossed over":
Town Councils.
Why is there double standard in law enforcement - NEA fines households and construction sites who breed mosquitoes but not areas under Town Councils' management (and other government agencies)?
If this anomaly is not addressed, Singapore will never be able to control the breeding of mosquitoes because town councils (who are responsible for a big chunk of the public areas in Singapore) and other government agencies can get away scot-free without punishment when found breeding mosquitoes - NEA should apply the law equally to all, including government agencies like NParks, SLA state land, MOE's schools, PUB, town councils, etc..., not just private residents and corporations whose properties are found breeding mosquitoes.
Town Councils collect conservancy fees from residents (which are quite substantial), and such fees should be used prudently to maintain their areas.
Regards
Jeff
http://www.denguealert.blogspot.com/
Town Councils and other government agencies to be fined if areas under their care found breeding mosquitoes
Reply from NEA on 10 Oct 2005:
=============================================I refer to your email to Feedback Unit dated 24 September 05. 2. We wish to inform you, as announced by our minister, that from next year town councils will also be subjected to fines should mosquito breeding be detected in common areas under their maintenance. 3. With regard to mosquito breedings detected in areas maintained by other public agencies, the agency responsible is also fined. 4. We thank you for your feedback. Best Regards. Sri Hernani Mohamed Affandi Environmental Health Executive Environmental Health Department The National Environment Agency DID +65 67319427 Fax +65 67319749
NEA considering publishing a weekly listing of cluster sites found breeding mosquitoes
Reply from NEA 6 Oct 2005:===========================================================Dear Sir Please refer to your email dated 29 September 05 to Feedback Unit. 2. We will take your suggestion into consideration. 3. We thank you for your feedback in our effort to fight against dengue. Best Regards. Sri Hernani Mohamed Affandi Environmental Health Executive Environmental Health Department The National Environment Agency DID +65 67319427 Fax +65 67319749
===========================================================
Our Environment -- We CareThis message may contain confidential information under the purview of the Official Secrets Act. Unauthorized communication or disclosure of such information is an offence under the Official Secrets Act. If you are not the intended recipient of this message, please notify the sender and delete it. Do not retain it or disclose the contents to any person as it may be an offence under the Official Secrets Act. Find out more about how we can work together to help Singapore keep a clean and healthy environment at http://www.nea.gov.sg
Jeff Ho
29/09/2005 10:07
To: MCYS Feedback Unit/MCYS/SINGOV@SINGOV
cc: NEA dengue/NEA/SINGOV@SINGOV, "Letters@ Today"
Subject: Can NEA publish a weekly listing of cluster sites found breeding mosquitoes?
In an article in Today (29 Sept 2005 - see below), it was reported that of the 220 mosquito-breeding habitats found over the weekend, some 70% were found in public areas (like scupper drains, discarded recepticles in the open, etc.)
Over the last two weekends when intensive combing for mosquito-breeding sites was done, a total of 329 breeding sites were found. What is more worrying is that some 4,139 potential breeding sites have been found during the these two weekends (Straits Times, 29 Sept - "Shop assistant dies from dengue; third victim this month").
While the decision by the NEA to publish the weekly "Location of Active Clusters" is a step in the right direction, what is equally useful is to include another weekly listing of cluster sites found breeding mosquitoes.
Hopefully, with this new listing, residents will be more vigilant to ensure their areas are regularly maintained. Besides, it can act as a deterrent as I'm sure both residents and town councils will not want their areas to be listed too frequently?
Jeff Ho
Business Times (5 Oct 2005) - Personal accident policy may cover dengue fever: lawyers
Published October 5, 2005
Personal accident policy may cover dengue fever: lawyers
They cite English case law - but most insurers disagree
By DANIEL BUENAS
(SINGAPORE) Amidst the spate of dengue cases in recent weeks, a debate has arisen in insurance industry circles over whether people with personal accident policies are covered against the disease.
Lawyers and industry watchers that BT spoke with said that in a dispute between a policyholder and an insurer, the policyholder could possibly win. Their opinions were based on legal arguments and English case law.
A check with some of Singapore's largest insurers found that at least one, AIA, has a personal accident policy that does provide hospital income benefit for those hospitalised with dengue fever, but that most policies do not.
'Lawyers having looked at the question think, on balance, dengue would be covered,' said Singapore Insurance Institute (SII) president Stanley Jeremiah. 'But, of course, there is no test case yet in Singapore.' Mr Jeremiah, who is a lawyer, said that whether contracting dengue was covered under a personal accident policy depended on the policy's wording.
'The main issue revolves around the definition of an accident which is usually 'violent, external and visible means',' Mr Jeremiah said. 'But the legal argument is that 'violent' simply means the opposite of 'natural' - so the considered view, is that, yes, (contracting dengue from a mosquito bite) will be covered.'
He said there was English case law dating back to the 19th century which had showed that the definition of 'violent' need not include the use of force.
'There are quite clearly cases that support this view,' he said. 'Based on contracts and law, it would seem the insured would have a valid claim for dengue as falling under accident policies.'
Adeline Chong, a partner at Harry Elias Partnership specialising in insurance law, agreed that being bitten by a mosquito and contracting dengue could be construed as an accident under legal terms.
'I haven't seen a case like this yet, but it would be interesting to see how a local court rules,' she said. 'Off the top of my head, I think that these policies might cover dengue . . . but still, at the end of the day, we have to look at how the underwriters determine their scope of cover.'
A check with some of Singapore's largest insurers reveals that they believe that most personal accident policies do not cover dengue fever.
A spokeswoman for NTUC Income, the largest insurer in Singapore in terms of policyholders, said that dengue fever was covered under the company's infectious disease plan, but not its personal accident policies.
'The personal accident plan under NTUC Income covers a person against death and bodily injury caused by violent accidental external and visible means . . . (but) dengue fever is not covered under the plan,' she said. 'However, we will look at the circumstances leading to the person contracting the dengue fever. Where appropriate, we may make a payment to help a policyholder.'
The company did not indicate if it had ever made a payment on a claim like this, but did say that fewer than 10 claims were made a year.
Aviva declined to comment, while Prudential said that their policies did not cover the disease, although AIA said that one of its personal accident policies did.
'Our personal accident plan, AIA Personal Accident 24-Hour Plan, has a hospital income benefit which is payable when the insured is hospitalised due to an injury or illness, including dengue fever,' a spokeswoman of the company said, adding that the company had paid out for dengue claims recently.
According to the company, in the event that an accident or illness causes a policy holder to be confined in hospital, a daily hospital income benefit will be paid up to the maximum of 500 days, and hospital expenses reimbursed up to a maximum of five times the daily in-hospital income or $300, whichever is less, for the same illness or injury.
However, Mr Jeremiah said that a hospital income benefit was a 'given', as it would be payable to anyone who was hospitalised, regardless of why.
He added that if a person were to die from dengue fever, it would be covered by most life insurance policies, but it was unlikely to be covered under critical-illness policies.
'I think this issue is not something that insurers have thought about,' he said. 'But as far as the insured party is concerned, he clearly will view it as an accident, while the insurers are unlikely to do so.'
© Copyright
Singapore Press Holdings 2005. Co. Regn. No. 198402868E
Privacy policy
If quarantined, dengue patients have less than 20% chance of infecting others
To: Feedback Unit - MCYS
cc: NEA
On Channel News Asia's report of 1 Oct 2005, "Singapore's dengue outbreak has peaked: experts" (
http://www.channelnewsasia.com/stories/singaporelocalnews/view/171227/1/.html )... "quarantining dengue patients was not recommended by the panel because symptoms appear 24 to 48 hours after infection. It is therefore possible for mosquitoes to bite the person and spread the disease to others during this period." Presumably, such "symptoms" include fever.
However, in the "The Vicious Circle" pictorial of The Straits Times dated 20 Sept 2005 ("No need to quarantine dengue patients"), it was stated that "He (the infected man) can pass the dengue virus to the female Aedes mosquito only during the period when he has fever, which can last from three to seven days". This contradicts with the experts' opinion that transmission can still occur during the first 24 to 48 hours of pre-symptomatic feverless infection period.
Nevertheless, even assuming most dengue patients have an infection period of about 10 days (including the frist 1 to 2 days of the feverless stage), quarantining them upon the onset of fever will still mean the risk of infecting others (through being bitten by the Aedes mosquitoes which then infect others) is reduced by 80 to 90% (taking into consideration that symptoms may not appear for 24 to 48 hours after infection, as the experts are led to believe - I am however curious to know if this has been medically and scientifically proven to be the case as the experts have themselves admitted a lot of their previous assumptions are no longer valid. I am now very sceptical of what is to be believed unless it is medically and scientifically proven recently to be the case - not based on studies done 50 years ago).
Therefore, if it means decreasing the odds of transmission, it may still be worthwhile to consider the option of quarantine to minimize infection.
Jeff
=============================================================
SINGAPORE : Singapore's dengue outbreak is finally on the decline -- that is the assessment of international experts who are here to review its current anti-dengue measures and to make recommendations. After a record two months of dengue cases, the disease is finally on the decline. This is because the epidemic is coming to the end of its two-month cycle and the peak season is over. The latest outbreak coincided with a global resurgence. But the government's efficiency at controlling the disease probably made the country more vulnerable. Said Dr Paul Reitner, Professor of Entomology at the Pasteur Institute, France, "Singapore really is the outstanding example; throughout the world there is no country in the world that has been so successful in suppressing this virus. So successful, the population born over the last 20 years has a very low herd immunity. In other words many people are susceptible." The panel of local and international experts called for research to guide mosquito control operations. One area that needs studying is where people catch the disease. Said Dr Duane Gubler, director of the Asia-Pacific Institute of Tropical Medicine and Infectious Diseases, "If they are being infected in the home then we need to focus more on finding those mosquitoes. But it's very likely that some of them or many of them are being infected outside of the home." Fogging also needs more research to determine how effective it is in Singapore's urban setting. Said Dr Reiter, "Indoor fogging undoubtedly has an impact, it kills the mosquitoes dead. Outdoor fogging will depend on the obstructions, the air movements so it's really hard to say until you've evaluated." The current search and destroy approach to reduce breeding sites will continue. But with Singapore's low mosquito population, the expert panel recommends using trap and destroy methods as well, such as Ovitraps, which are the perfect size and colour to lure the aedes mosquito. The female mosquito comes in, lays its eggs then flies off again. The eggs are so small they actually slip through a wire mesh into the water below, where they hatch into larvae and eventually turn into mosquitoes. By that time, though, they are too large to escape so are trapped inside. Now the Environmental Health Institute is working on a more advanced model that traps both the mosquito as it lays its eggs, as well as the eggs and the larvae. Quarantining dengue patients was not recommended by the panel because symptoms appear 24 to 48 hours after infection. It is therefore possible for mosquitoes to bite the person and spread the disease to others during this period. The expert panel says public education and community involvement remain the key to controlling dengue, along with efforts by the private sector. Meanwhile, the number of dengue cases dropped slightly between 3pm on Friday and 3pm on Saturday. A total of 74 cases were reported, down from 86 the previous day. This is the third day in a row the numbers have not passed the hundred mark. The weekly total has fallen significantly from 714 cases last week to 541 this week. - CNA /ct
