Friday, November 21, 2008

NS and medical check up

Will it reduce mortality?

The decision by the National Service Training Department to screen all the 140,000 trainees for the next session of the camp has received mixed reaction from various quarters. On one hand it is encouraging that the department has taken the previous deaths of trainees seriously while on the other hand it is puzzling why it has to resort to such a major step that costs a lot of money and manpower.

So far there have 16 deaths among the National Service (NS) trainees since it was started 4 years ago. From the barrage of comments and criticisms from parents in the media we are aware that the majority of parents have expressed not only their unhappiness, displeasure and anger at the way the NS is being run but also their fears of losing their children in the training process.

Instead of heeding the call of the people to suspend and review the NS, the authorities have suggested medical check-ups for trainees and improving the medical care at the training centres.Certainly these are commendable measures but will these measures reduce the deaths at these training facilities?

The causes of the deaths among trainees fall into 3 categories:

1. Accident and trauma. This includes drowning and severe fatal injuries.

2. Infections due to exposure of the trainees to remote areas which harbor rare strains of virulent pathogenic micro-organisms.

3. Unknown causes. They could have asymptomatic congenital cardiac or vascular lesions in the brain or elsewhere. Others include epilepsy and bronchial asthma. These individuals are apparently healthy and asymptomatic under normal circumstances, only to suddenly collapse and die on strenuous physical stress.

Will routine medical screening detect these abnormalities so as to prevent mortality? From experience we know that such check-ups may not. Even sophisticated examinations like CT scan and MRI may not detect them. To detect congenital heart and cerebral lesions we may even need echocardiogram and invasive procedures like angiography. Do we need to go to that extent to detect pre-existing conditions? Who is going to pay for these medical check-ups?

The number of trainees taken by such serious illness is very small. Placing medical officers and nurses round the clock at training camps to cater for this small number will be just a waste of precious manpower and money. The doctors may spend their whole 3 months in the camps without seeing any serious medical problems among the young trainees.

We are repeatedly reminded of the acute shortage of doctors and nurses all over the country at hospitals and health centers, where major ailments are screened for and treated. Wouldn’t it be better to place them at these hospitals where they can be of greater service to the people who really need them most?

There is no doubt that the NS helps in fostering racial unity among our children of different ethnicity during the period of training and the months that follow. Does it have the desired long-term effects? In the long term it fails in its noble aim as the children soon return to a real life environment of racial segregation and animosity in universities and places of work.

Besides the cost and manpower wastage, there are serious doubts as to the effectiveness of the NS programme to fulfill it primary aim of integrating the youth of all races. If the government insists that the NS is good, it should make it optional for those who want it and are willing to pay for it. By doing so it may alleviate the fear and distress among the many who are skeptical of its benefits.

Dr.Chris Anthony

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