By: Marcel Lee Pereira, Daryll Nanayakara & Maurice Quek
HIS boy i s only two, but 38-year-old manager Krishna is ready to pay "any amount needed" for a thorough medical checkup for him when he eventually enlists for National Service (NS).
MEDICAL FOR ENLISTEES
Israel Defence Forces
- Both male and female are liable to serve the military upon reaching age 18 although exceptions can be made based on religious, psychological and physical grounds.
- A medical questionnaire is sent to the pre-enlistee's home to be filled with the help of parents and a physician
- A general urine and eye test should be done before the call-up date.
- Vaccinations for tetanus, meningitis, hepatitis and flu are done on the call-up date itself.
- Soldiers to serve in combat units will be evaluated by a special medical committee on draft day.
Finnish Defence Forces
- A questionnaire is sent to the home of the pre-enlistee upon hitting age 18.
- Physical exams are legally compulsory at call-up age.
- An additional health check-up will be conducted at the actual call-up in autumn.
Singapore Armed Forces
- Male citizen liable to serve National Service upon reaching the age of 18 years.
- A medical questionnaire is provided to highlight any problems in a pre-enlistee's history.
- A few months before enlistment, the pre-enlistee has to go through a Mindef-provided medical screening.
- The medical screening includes chest X-rays, body-fat calculations and resting electrocardiograms (ECGs) to detect heart abnormalities.
- A Physical Employment Status (PES) is given to each pre-enlistee upon completion of the medical screening.
In a my paper poll of 100 parents, Mr Krishna was among the 41 who said they would send their sons for a health screening on their own, instead of relying on the one conducted by the Singapore Armed Forces (SAF) on pre-enlistees.
He admitted that he did not have enough faith in the SAF's screening, adding: "How can you put a price on my son's head? His life is priceless."
In the poll, parents with sons who had not done their NS, or who were just about to enlist, were interviewed.
Of those who said they would take their sons for a check-up, 19 said they would pay only $100 to $500 for it. Six said they would pay $500 to $1,000, and 11 said they would fork out $1,000 and above.
General practitioners contacted by my paper said a check-up consisting of a blood test, urine test, eyesight test, ECG and a chest X-ray would cost between $150 and $310.
Since the recent sudden deaths of two servicemen, Recruit Andrew Cheah Wei Siong and Second Lieutenant Clifton Lam Jia Hao, there have been calls for more comprehensive screening by the SAF for heart conditions with treadmill tests and echocardiograms, for instance.
SYSTEM "CAN BE MADE BETTER"
The Defence Ministry has said its screening procedures were developed with the help of specialists, including cardiologists.
These are also reviewed periodically, the last one only in September last year.
Dr Michael Lim, medical director at the Singapore Heart, Stroke and Cancer Centre, said the SAF is experienced in screening enlistees and the doctors are well-trained and qualified, but "it's a matter of extending the same level of competence to the in-camp medics because they are the ones who deal with the NS men first-hand".
He added: "The system is good, but we can make it better by providing detailed criteria to the doctors and medics containing various patterns and charts and what to look out for. This way, they can flag the moment they notice the patterns that can cause sudden death."
Dr Kenneth Ng, consultant cardiologist at Novena Heart Centre, said the screening could be improved by adding additional imaging modalities such as a plain CT of the heart and an echocardiogram.
He said: "This would exclude most structural abnormalities that are the most common causes of death in young athletes. However, it is going to cost a lot of money. The cheapest is another $500 to $800 per recruit and I am not sure if that will be cost-effective."
Associate Professor Tan Huay Cheem, chief and senior consultant at the National University Hospital's Cardiac Department, said: "Instead of broad based use of echocardiograms, one should target the test specifically for at-risk individuals such as those with abnormal resting ECG or physical findings, or those assuming high-risk vocations."
The poll also found that most parents believe young men today are less rugged than themselves or previous generations.
Out of 100 parents polled, eight in 10 said they thought the youth today was less rugged than before.
But when it came to their own sons, parents were much kinder in their assessment. Half the respondents did not think their sons were less rugged than their predecessors.
They claimed they made sure their sons were active in sports and outdoor life.
Added Mr Roy Anil Prasad, 34, a full-time soccer coach with a seven- year-old son: "I take him to the Tree- Top Walk at MacRitchie Reservoir. The exercise helps condition his heart."
