A Public Health Stranger in the Land of Medical Care
Monday, May 17, 2010
If you are flying into Singapore’s gorgeous Changi Airport, you might hear a message like this before you land: “We would like to remind you that Singapore does not tolerate illegal drugs. The penalties for using and trafficking in illegal drugs are severe and may include the death penalty.”
Among the highlights of Singapore’s drug policies are these:
*The Misuse of Drugs Act in Singapore allows the police to search anyone they deem to be suspicious of drug use or trafficking without a warrant.
*Police can demand a urinalysis, and the failure to comply carries an automatic presumption of guilt.
*A conviction for trafficking of drugs (which means anyone carrying a certain amount of drugs such as more than 500 grams of cannabis, 30 grams of cocaine, or 15 grams of heroin) carries a mandatory death penalty.
Thanks to these laws, in 2004, Amnesty International calculated that Singapore had more executions per capita than any country in the world. In 2005, a young Australian was executed for carrying 400 grams of heroin despite rallies and protests in Australia against the execution.
In 2009, 1883 people were arrested on drug charges. This represented a modest decrease of 2% and allowed the Central Narcotics Bureau to claim that it had drug use under control. So obviously, people do use drugs in Singapore. Their prohibition approach is diametrically opposed to that, for example, of the Netherlands, which uses an approach referred to as “harm reduction.”
Those who believe in harm reduction take the approach that drug use will always happen, drug users should be treated not as criminals but as people with social or medical problems, and drug maintenance offers a safer and more beneficial overall model for society than prohibition. For example, the Dutch would treat heroin use as an illness and provide rehabilitation instead of treating them as criminals and providing incarceration.
The Singapore position is that the drug penalty for trafficking is a deterrent and saves many lives. In a much discussed current case, a 22 year old Malaysian, Yong Vui Kong was sentenced to the death penalty in 2008 for having 47.27 grams of heroin (the mandatory penalty for over possession of over 15 grams). His lawyers filed an appeal in March 2010 and a the appeal was denied on May 14.
Recently, in response to questions at an open dialogue sessions, Law Minister K. Shanmugam defended Singapore’s policies in a recent article in The Straits Times. According to the news report, he considers cities that have needle exchange programs (an example of harm reduction) have “given up on it” and he cites the “number of lives that have been spoilt” as a result of drugs. He claims that parents are glad that their children do not have access to drugs in Singapore. In response to criticisms of the Singapore’s policies, he is quoted as having said “You won’t have human rights people standing up and saying: ‘Singapore, you’ve done of great job, having most of your people free of drugs.’ You won’t hear about how many thousands of lives are lost to drugs in other countries” or how many lives have been saved in Singapore thanks to our drug laws. The article mentions that Singapore is a air and sea hub in South Asia near other drug centers and without its strict drug policy it could have been “swamped” with drugs. The Minister added, “Yong Vui Kong is young, but if we say ‘We let you go’, what is the signal were are sending?”
Some think this policy is in keeping with other mandated bans such as spitting and chewing gum, and certain DVDs such as “Borat,” “A Clockwork Orange,” and “South Park.” However, prostitution is legal in Singapore, though brothels, pimps, and public solicitation for sex are illegal. Of course, not all Singaporeans agree with the death penalty for drugs as you can see from the sidebar picture.
The harshness of the drug penalties in Singapore seem to be a sharp contrast to those in the North America, but the U.S. also bans drugs and has mandatory sentencing laws, but not the death penalty. This is called the “War on Drugs” in the U.S. Many claim this “War” has contributed, if not directly caused, the waves of violence that are rampant in Mexico and some U.S. cities today and the ban itself causes more harm than the drugs. However, not even the most fervent drug warriors have suggested the death penalty would work in the U.S. At least not yet.
Thursday, May 6, 2010
If you are an IC student or a college student at most any US college, consider this when you prepare to take your final exam:
You cannot enter the room until 10 minutes before the exam begins.
You will sit in assigned numbered seats.
You are in a room with 200-600 students from many different classes.
You must leave your backpacks outside of the exam room (in an unsecured open area).
You cannot leave the exam room for the first hour of the exam.
You must stay for the entire exam time (2-3 hours) or until the invigilators release you.
If you need to use the toilet during the exam, you will be escorted by an invigilator.
If you are a faculty member who is designated as the chief invigilator, you must read instructions from a prepared laminated sheet that is presented to you by the staff assistant assigned to the exam time. As chief invigilator, you are to supervise the proctoring of the exam by other invigilators. In some final exam sessions, invigilators are not allowed to read, grade papers, or leave the room other than to escort students to the toilet (or use it themselves). Of course, no food allowed.
Such were the rules that the students and I followed during an exam this week at the Nanyang Technological University in Singapore where I teach a class of 18 graduate students in Health Communication. I dutifully followed the instructions since I only skimmed the email that listed them all.
I was fortunate that the Chief Invigilator, whom I had never met before, turned out to be a friendly young faculty member who taught engineering. He misdiagnosed my accent and guessed that my geographical home was Australia. But once he found out I was from New York, he beamed. He told me he was going to spend 4-6 days in New York City and asked me if there was enough to do there for that much time. I suggested 4-6 weeks at least.
So for the next 3 hours, myself and 9 other invigilators (all male) watched, walked, sat, and patiently waited (except one professor did sit down in an empty exam seat and slept for about an hour) for something to happen. It did. Students needed to use the toilet, mostly women at first. Dutifully, the male invigilators followed the women out of the freezing ice-cold exam room out into the hot humid density of Singapore air to the ladies toilet. No, we did not go inside with them. As far as I could tell, no cheating occurred. Thankfully.
The Singaporeans love air conditioning, or “aircon” as they say. They like it very very cold. It’s so cold that often when I leave my office, classroom, or taxis, my spectacles fog up and leave me temporarily blinded. This is a consistent concern for those of us who care about the environment and is also a reason that many of us carry sweaters or shawls around whenever we expect to spend time indoors. It was freezing in this exam room.
Back to the invigilation. At first, it was boring, really boring. So boring that I had to make things up to do. I decided to count the number of students in the room and to visually assess whether I thought they were overweight or not (this is the public health connection to this post for those of you who were waiting). Of 178 students in the room, I counted a total of 10 (at most) who I thought were overweight. I thought that was a remarkable (though not publishable) finding. While overweight issues are considered a pandemic by the WHO, it was not so evident in this classroom.
Finally, we approached the end of the 3 hour exam. The Chief Invigilator gave a 15 minute warning and at exactly the prescribed time, students were told to put their writing utensils away, tie their exam books together with string (provided) and turn them into the invigilator. I brought my collection to the Chief Invigilator who verified and signed off that there were indeed were 18 exams. I was then asked to take an additional thicker piece like shoestring and tie all 18 exams together. It was over and we took a class picture.
All these rules are intended to provide a fair playing field for the students. I must admit that I could become accustomed to the reliability and consistency of this approach. The rules are clear, followed in every exam, in every class. However, not all exams are created equal and not all courses might require an exam, but every class (except the lucky art courses) are required to have an exam of at least 30%.
I wonder if I can bring these procedures back to Ithaca.