PPE for COVID-19

Challenging times call for action.

I am posting this in face of the potential (read "likely") shortage of PPE (personal protective equipment) that my healthcare organization will face given that we are only at the beginnings of the COVID-19 curve here in Metro Vancouver, B.C., Canada.

In our clinical managers meeting today (March 24th 2020), the company's COVID-19 response team has told participants that if we are able to source for PPE supplies, to buy them (if the amount is small) or place a hold on the supply (and inform Directors/COVID-team to complete the bulk purchase). This includes overseas suppliers!

And thus today, I sent out an email to a supplier of the ST Engineering designed NIOSH standard N95 masks. In the current situation where there is a global shortage, I am not holding high hopes; but still "if we don't ask, we won't get", right? *fingers crossed*

Some side notes:

1. Singapore's response to the COVID-19 challenge has been impressive when seen from Canada where I am. The only areas of improvement I can think of are:

• COVID-19 testing booths akin to the South Korean approach to increase public assess to testing.
• Encourage the population to use washable/reusable fabric face masks when in public spaces, e.g. those commonly seen being worn in Hong Kong, Taiwan, and South Korea. This may help to reduce the risk of asymptomatic spread in the community and also build the mindset to reserve the disposable surgical masks for healthcare workers.
• Possibly close schools and/or non-essential services for a period of 14 days to support social distancing and reduce risk of community spread. After all, the June school holiday period can be shortened to cover the short-term loss of school days.

2. Canada is a big country with multiple levels of governance and a strong emphasis on human rights/freedoms (including rights to personal privacy). Canadians have not seen the worst of SARS, and some may have prejudicial/out-dated views about Asia. Occasionally, I want to *facepalm* the official message(s) sent to the public, not to mention some chaos I hear about the behind-the-scenes situations. Pros-and-cons, we can't win it all, eh?

And so, back to PPE for the current COVID-19 situation in Canada. Here's hoping someone, somewhere, with the right connections to some higher authority, sees this message and is able to (re-)direct some supplies our way.

Meanwhile, take care and stay safe, everyone!

[Update on 24-Mar-2020]

If anyone has PPE to donate, please contact SafeCare BC - "Operation Protect". Quote from their website: "SafeCare BC is an industry funded, non-profit association working to ensure injury free, safe working conditions for continuing care workers in BC". Operation Protect is a donation drive to raise PPE given the current COVID-19 challenge, and SafeCare BC will work with BC's Ministry of Health to distribute these supplies to various healthcare sites.

http://www.safecarebc.ca/operationprotect/

Official numbers/news not always right

A friend shared this news article on Facebook. It does not matter which country you are in the world, the fact remains that without independent news, research and sources of data, "official" numbers and/or news can spin the tale whichever way the political wind blows. Something to think about when anyone in authority chides one to only trust the official narrative, and attempts to censor other data/news sources.

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[Source: CBC News 

http://www.cbc.ca/news/politics/apprenticeship-ad-s-claim-of-skilled-trades-shortfall-open-to-question-1.2890500

Note: Bold and other emphasize added by WD.]

Apprenticeship ad's claim of skilled trades shortfall open to question

Lack of labour market data casts doubt on forecast of jobs needed over next decade

By Susana Mas, CBC News 

Posted: Jan 11, 2015 5:00 AM ET Last Updated: Jan 11, 2015 11:50 AM ET

A government ad to promote the new Canada apprentice loan program claims the Canadian economy will need "one million skilled tradesmen and women" over the next decade.

But independent forecasts and even the government's own projections tell a different story.

The government pointed CBC News to "a combination of industry estimates," several of which were written by Rick Miner, the president of Miner & Miner Ltd., a management consulting firm specializing in labour market issues.

Miner concluded that Canada will face a "major problem" with skilled worker shortages if nothing changes over the next 16 years.

But he told CBC News his projections are for overall labour and for skilled labour, not specific to the trades. 

"I think you'd have a tough time finding somebody who is going to back that unless they have a real broad definition of both the trades and a broad definition of what they define as shortage," Miner said.

"If somebody said … right now there's a shortage of a million workers in the trades in Canada, I'd say that's an inflated number. That's not true."

Asked if he could point to labour data showing Canada would face a shortage of "one million skilled trades" workers over the next decade, Miner said he could not.

The government also pointed to a 2013 estimate by the Canadian Chamber of Commerce. But Sarah Anson-Cartwright, the chamber's director of skills policy, told CBC News those forecasts originated from Miner's older reports, which are not specific to the trades and have since been reviewed.

"The Canadian chamber does not cite the forecasts from Miner's 2010 and 2012 reports since they are out-dated now."

Skilled workers vs. trades

The government also pointed to a 14-year-old Conference Board of Canada report that found the labour shortfall could reach nearly a million workers by 2020.

But the non-profit think-tank revisited the report a little over a year ago and publicly said the so-called "million worker shortfall" was "not possible" and widely "misunderstood."

"In that same report, we explained that a worker shortfall is 'logically impossible,'" wrote Pedro Antunes, the deputy chief economist at the Conference Board of Canada, in a commentary published on Nov. 11, 2013.

"Essentially, the economy has to operate with the workers that are available — by substituting labour for capital and reducing production," he wrote.

Antunes told CBC News the Conference Board of Canada saw fit to revisit the 2000 report because "we were seeing the number bandied about and it was an old forecast that was done over a decade ago."

He also said the decade-old report was about overall employment and not just about the trades.

"Trades is absolutely part of it but when we talked about skilled workers, it was in general … it was not specific to trades."​

Shortages in 'high-skilled' jobs

In announcing the new loan in B.C. this week, Prime Minister Stephen Harper was more careful, citing "one million additional skilled workers" — not a shortfall of "trades" workers.

Even the government's most recent projections, by Employment and Social Development Canada, show that labour shortages over the period of 2013-22 are projected "mostly in high-skilled occupations."

According to the government's outlook, 47 occupations are expected to face shortages by 2022, with the majority of those in the health sector.

Only six of the 47 occupations facing labour shortages are in what the government calls "trades, transport and equipment," which includes electrical trades, heavy construction equipment crews and welders, among others.

The government does not give a projection for workers in the trades, but it does provide a forecast by different skill levels. 

Occupations with significant health and safety responsibilities, such as firefighters, police officers and nurses, are assigned to skill level B, a category that also includes chefs, electricians and plumbers.

The report shows that while jobs in this wide-ranging category are "overall ... projected to be in balance" over the period of 2013-22, 18 occupations in this category are projected to face a shortage of 846,000 workers.

Other estimates in the mining, oil and gas, and construction sectors predict labour shortages ranging from 116,800 to as many as 300,000 workers over the next decade, depending on the industry.

Miner said part of the reason there is no national data specific to labour shortages in the trades is because there is an absence of good labour market data overall.

Even Employment Minister Jason Kenney has acknowledged a weakness in Canada's labour data and promised to take action, beginning with two new labour market studies at a cost of $14 million.

Apprenticeship loans

The new government ad also claims students registered in a Red Seal trade apprenticeship will be able to apply for "interest free" loans of up to $4,000 per period of technical training, but the terms of repayment make it clear the loan will have to be paid back with interest once the training is completed.

The government said ESDC consulted Advertising Standards Canada before airing the ads and verified that "requirements under the Canadian Code of Advertising Standards were met."

The department would not say how much it was spending on the 30-second television ad.

[Watch the (Canadian government) ad from Employment and Social Development Canada on Youtube here.]

FSWP, FSTP, CEC 1st step = Express Entry

If you're planning to migrate to Canada under the FSWP, FSTP or Canadian Experience Class, please note that these PR visa application process will undergo a major change with effect from January 1st, 2015. The 1st step for any of the above 3 PR visa will be Express Entry, where only the top-ranking candidates from a pool of accepted applications will be invited to apply for PR after each draw.

http://www.cic.gc.ca/english/immigrate/express/express-entry.asp

For those who want to read about another person's FSWP 2014 and Express Entry 2015 application process, you can check out Gobbledegook's blog "We decided to move to Canada".

4 years vs 40 years

We went to watch the Grey Cup finals (Canadian Football League) at BC Place (stadium) today, thanks to a gift from DD's relative. At the game, we sang the Canadian national anthem. It suddenly occurred to me how "O Canada!" is actually moving for me now, just as how "Majulah Singapura" was long, long ago.

[30-Nov-2014: Mom/baby-to-be's 1st Grey Cup game]

Other fleeting thoughts while at the game:

1. Sports is such a big thing here in B.C., Canada, especially hockey and football. Even someone like me who has only attended 1 live football (i.e. soccer) match in a Singapore stadium actually enjoyed going to live hockey and (today) football games at B.C. stadiums. [Note: According to my hubby DD: B.C. folks are not considered huge supporters of competitive sports, when compared to other provinces like Alberta and Saskatchewan.] IMHO, there is no short-cut to developing a thriving sports culture. It requires a package deal: from developing an appreciation of sports in the general public, to encouraging children to participate in various sports from young, to supporting widespread access to sports training (e.g. specialized competitive sports training personnel, facilities and related equipment may be very expensive -- and possibly beyond the affordability of the median Singaporean family), to supporting budding sportsmen in all aspects (financial, academic, etc), to creating sports-centric jobs/industries (e.g. recruiting soccer news anchors from retired soccer players/coaches).
2. Yes, I'm pregnant, less than 1 year into our marriage. We heard at a recent gathering of (ex-)Singapore folks here that another Singapore-Canadian couple here is also expecting, less than 1 year into their marriage too. Perhaps the problem with fertility in Singapore is not with the Singaporeans, but other "environmental" (e.g. social) issues? E.g. Working too many hours to have time/energy leftover for baby-making? Worrying about how one's child/children will cope in a highly competitive social/educational environment with narrow definitions of success and the trend of unforgiving attitudes towards social "failures"? [Click here and here to see the Finnish baby box that drives home the message that “Every child matters. Every family matters.”]
3. 4 years versus 40 years. How did my host country "win my heart" in 4 years and my birth country lose my "love" over 40 years? It boggles the mind. Something for those residing in Singapore to think about, since Singapore has "welcome" a significant proportion (about 40%) of foreign-born onto its soil -- What policies exist and/or are-needed for the foreign-born to feel accepted as part-of-Singapore? [Click here, here and here for related articles.]

p.s. I still appreciate my Singaporean heritage -- from the "old Singapore" which I grew up in, a very different society that Singapore currently is and continues to evolve into. As I've written before, and a couple of my blog readers commented in agreement, the Singapore that we grew up in no longer exists. What is leftover are the flotsam and jetsam of overseas (ex-)Singaporeans who continue to grasp onto the community spirit of the old days and passing on what's left of their heritage to their children and generations to come. To borrow the words from Battlestar Galactica, "All of this has happened before (overseas Chinese back in the 1900's), and will happen again (new wave of emigrants)".

May-2014 FSWP and FSTP

Just a quick note, CIC (Citizenship and Immigration Canada) has released a news on the new caps for FSWP and FSTP for migrating to Canada effective May-2014. Please check out the url below for details.

http://news.gc.ca/web/article-en.do?nid=841339

Acceptance, love, joy and hope

Just saw this on Yahoo! It brings to mind what my friend ASingaporeanSon down south wrote about "Golden Jubilee Babies".

As ASingaporeanSon wrote: "What does a parent really want to give to his or her child? One of them should be hope. The assurances to our next generation that bringing them up in this country is not a mistake, that they will be included and accepted in society regardless or who and what they are in a sustainable manner."

Eden Grace - Don't Give Up from Michelle Nagle on Vimeo.

Miracles, by virtue of their unexpected nature, do not always happen. What if a child with a rare genetic disorder does not overcome his/her limitations? How much hope and tangible support can and will the parents, society and government policies provide for the child to live sustainably and be accepted by society?

As I commented on ASingaporeanSon's blog, some folks asked me why Canada seems to have more children with rare illnesses/disorders (when compared to their countries of origin). My reply is, "If these children were born in your country, what would happen to them?" The answers they give would explain why there are fewer children with rare illnesses/disorders (that survive and/or are seen in public) in their countries of origin when compared to Canada.

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When I got married, a few of my Singapore-based close friends asked out of concern if I plan to have children and (given that I'm already in my mid-40's) the high risk of having a child with problems (e.g. Down's Syndrome) at my age. I told them honestly that we (as a couple) decided to go with the flow; if I get pregnant, we will do whatever standard tests available and then decide from there.

So far, no one in Canada (not even close friends) expressed concern to me about the risk of me having a child with problems at my age. If anything, I have one nursing-trained friend already waiting to be godmother to my yet-to-be-conceived child.

Is this difference between Canada and Singapore due to social attitudes or government policies or both? Which drives which?

p.s. I just have to write about this close-to-heart matter as I've personally seen the difference as a paediatric nurse in both countries.

Schooling in Metro Vancouver

After reading the guest blog entry "Secrets to Success (Part 1)" on ASingaporeanSon's blog, I guess maybe I should share my replies to reader NGS on my other blog entry "Boyfriend-brand dinner" and add a couple more comments. [And I'll litter the blog entry with some school-related photos at random.]

NGS was asking about where to stay in Vancouver, presumably with regards to his/her children's education. See his/her comments dated Thursday, November 14, 2013 9:20:00 PM: 

Hi, thanks for your comments. Actually I was referring more to Vancouver, which we intend to settle now.

A bit of myself, I have two young children, Primary 5 and Sec 1, and 3 teenagers ( two of them will be serving NS, and one of them will be following with the mum to settle in the year 2014.Thanks

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[My reply on Monday, November 18, 2013 6:16:00 PM was as follow.]

Hi NGS,

I do not have any children and thus I have not done any research on education for the young. Here's some info and/or opinions that I've gathered from some locals and immigrants. Disclaimer: Take the info/opinions at your own risk.

For public schools, you will need to reside (i.e. official residential address) within the "catchment area" to enrol your child in a specific school. The school districts, covering each city, in Metro Vancouver, include (not full-list here):

1. Vancouver School Board

http://www.vsb.bc.ca/schools

2. North Vancouver School District

http://www.nvsd44.bc.ca/Pages/default.aspx

3. West Vancouver School District

http://www.sd45.bc.ca/

4. Burnaby School District

http://www.sd41.bc.ca/

5. Richmond School District

http://www.sd38.bc.ca/

6. New Westminster School District

http://district.sd40.bc.ca/

For a full list of B.C. school districts, check Guru Wikipedia and ask Professor Google for details.

http://en.wikipedia.org/wiki/List_of_school_districts_in_British_Columbia

If you're looking for private schools, then it is an entirely different ball-game. Please ask Professor Google about it.

Generally, DTES (downtown East Side of Vancouver) is a poor-men's area, so poverty-related issues do creep up in schools too. West Vancouver is dominated by wealthy households. North Vancouver and Vancouver-west (i.e. Vancouver, west-side of Main street) has a more-even cross-section of the social demographics.

The folks whom I spoke to generally like bringing up their children in North Vancouver or Vancouver, west. That's all the opinions I've gathered.

Once again: Take the above info/opinions at your own risk.

Cheers, WD.

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Yesterday when we were helping our friends (a PRC couple) move to their new home in Burnaby, the wife mentioned that they chose their home's location because it is within the catchment area of a good or highly-ranked school. That's when I heard about school rankings in Metro Vancouver. [Click here and here for more information.] Do note that the rankings are done by Fraser Institute, a research institution whose "research" invariably carries "right-wing" conclusions, so take the rankings at your own risk.

[Nov-2013: Kindergarten registration opens Nov-Jan]

One elderly Singaporean couple whom I spoke to told me that they were not too concerned about which school their children when to when they immigrated decades ago. In fact, they just enrolled their children in the public schools nearby as they were confident of the quality of education in B.C., Canada. Both their children are now adults holding professional/executive jobs. The caveat: They lived in North Vancouver. [See my reply to NGS above about North Vancouver.]

[Sep-2013 Classroom covenant at a private Christian school]

There are also private schools that market themselves to specific niche. E.g. Schools with a strong Christian emphasis. E.g. School with a specific education methodology -- say Montessori. One of my East Asian classmates believes in the value-add of a private education, despite its much more costly academic fees. She came from an East Asian society that is highly conscious of social class and, as a couple, both she and her husband were from the upper-middle class. Those who send their children to private schools should be prepared for endless rounds of donation drives and parent-volunteer activities.

[Nov-2013: Part of a public school compound]

Personally, here's what I have observed amongst the youths at my previous part-time retail job as they discussed about the differences between their school experience. [Note: This is a very small sample size, so please take my comments at your own risk.] Those from private schools were given the mobile phone numbers of their teachers and encouraged to speak to their teachers if they had any issues. At work, IMHO, the private school students/grads tended to "expect to be served" (e.g. "you have to train me for the job"), "treated with respect" and were more willing/confident to speak with (and/or take an issue up with) authority figures (e.g. managers). Those who went to "public schools" (mostly Vancouver, East side) were more likely to be treated as "just another student on the education assembly line" at school. At work, IMHO, they were more ready to adjust to their roles of being "cogs" of the retail chain (i.e. "just shut-up and follow the chain of command, and plot revenge later") and seemed better at the street-smarts of managing inter-personal politics at work.

[Mar-2013 Urban farm program in selected Vancouver public secondary/middle schools]

Some of the Canadians whom I spoke to preferred to put their children into the "French-immersion" public school system. One theory is that private schooling is beyond the average-family's affordability; parents who chose to put their children into French immersion obviously read and found out about the additional steps needed to apply for this "special" stream; and thus they (the parents) are likely to be more interested in their children's education; and thereby more likely to raise their children in "educationally-supportive" home environment which in-turns leads to their children mixing with others from such similar background.

[Nov-2013: Stream of Dreams mural that frequently adorn the fence of public schools]

[Nov-2013: A distant view of a Stream of Dreams mural that frequently adorn the fence of public schools]

I have also come across children who are home-schooled. These generally fall into 2 groups. E.g. Parents who think that "schooling is a form of brainwashing" and refuse to submit their children to be "stripped of their independent minds". The other group is wealthy and/or have "gifted" children; and the parents believe in developing their children's knowledge/skills as fast as they (the children) can learn/absorb.

Since I am not a parent myself, I do not hold entrenched views one way or the other. I think each parent will have to decide on what he/she thinks is in the best interest of his/her child/children. That said, don't be surprised if/when the child grows up and voice issues/disagreement with the parents' choice. There are no guarantees -- individuals can react differently to the same stimuli.

The Suay Kuan [The Unlucky Ones]

Just to share a real-life story from Anonymous who commented on Thursday, November 07, 2013 8:14:00 AM on my blog post "It's not so simple". If you want to believe how Singapore's healthcare system is "world class", then perhaps people like Anonymous and I are the just "the suay kuan" [i.e. "the unlucky ones"]. Otherwise, you'd question whether the occasional reports that leak about the aggression and violence faced by healthcare workers (nurses in particular) in Singapore are really the tip of the iceberg of an endemic issue.

Thank you, Anonymous, for sharing your personal story.

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[The following is copied from a comment left by Anonymous on Thursday, November 07, 2013 8:14:00 AM on my blog post "It's not so simple". Changes in font size, bold, italics and underline are added by me for emphasis.]

As a student nurse in Singapore, I bore witness to the most horrifying situation that happened in the hospital. There was a patient which was coding, and there were only 2 student nurses (one of which is myself). The emergency button was pressed. Guess what...a registered nurse (foreign trained) appeared but she took a look and walked off saying she needed to fetch her patient from OT. Needless to say , patient died because there were only 2 of us to do cpr and suction the bloody emesis while yelling for help after she left. Worse timing was it happened during break and the other nurse was in the private room doing a tracheostomy dressing. After she heard us, that nurse ran out of the private room and immediately took action. I reported that foreign nurse.

HO HO HO. I got blacklisted for pushing the matter. The senior nursing officer was telling me to keep quiet if I wanted my career. I stuck to my principles. Worse of all , I was bonded. So you can imagine what happened to me.....

When they made my life a total misery and told me that I was the most useless nurse etc , that I will never make it anywhere else ...etc ....making my rosters 12 days in a row and one day off at each end [checked, I have experienced that]. Even better, making me work when I was having a fever [checked, I have experienced that too], and landing me in ED with a 40 degree fever and a fit. THEN telling me that if I take more than 3 days leave, I can forget about my performance review. That went on for more than 3 months. 

It broke me down. For doing the right thing, I got marked. All the time, I kept it from my family until my father found me at the edge of our study window deciding whether I should jump or not. He decided to buy out the bond. 

Even better when I sent the resignation letter in, matron called me down and asked me if I can 'even afford' to pay off and I would be 'stuck' with the debt as well as saying 'you know....your family is not that rich and you might need to wash the dishes ' when she did not even know my family background. I looked at her and said "cash ,cheque or credit card? Which payment option to take". She retorted at me "how dare you talk to me like that girl [again I have a similar experience]... your family is poor and you want to drive them into debt" [again similar to my experience].

The day after my father came, suddenly I was called down.....the matron met my father. HAHAHAHA She asked me if I told him anything about the hospital and the complaints I was making. I looked at her and informed her that whatever I said to my father is covered under lawyer client privilege and I know my rights. She was frightened. My father's old classmate was the CEO of that particular hospital and he told me while the matron was coming out, the CEO was just walking out to lunch and greeted him. HAHAHAHAHAHAHAHA

Suddenly the matron decided that I was the poor nurse getting bullied by senior nurses and she will discipline them ...and that every ward would be happy to take me in if I decide to withdraw the cheque and my resignation. My final words to her : Go to Hell. 

I was naive and never used my dad as a connection. Had I revealed who my father was sooner, perhaps they would have licked my ass and gone after the incompetent nurse.

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To my readers: The stuff that I wrote on my blog about nursing in Singapore has already been "censored" by me to avoid stuff that may cause lawsuits to my previous employer, etc. So I am not surprised at all by the stuff that Anonymous shared. Nursing in Singapore has a long way to go before it is truly a respectable profession.

A Rafflesia by any name stinks as a corpse

As the saying goes, "A rose by any name smells as sweet."

IMHO, the reverse is true. "A Rafflesia by any name stinks as a corpse."

Poverty exists in Canada. Click here for information from Canada Without Poverty. The cut-off is not known officially as the "Poverty Line" but "Low-Income Cut-Off (LICO)". Click here for the official definition of LICO from Statistics Canada. Or click here for the actual statistics -- ACCOUNTABLE, OPEN and TRANSPARENT for all to see.

Unlike a little red dot with officials who deny the existence of poverty, Canada makes no pretense that poverty exists in this first world nation.

Quote Chan Chun Sing (see online news article below), "other developed ones such as New Zealand and Canada also do not subscribe to official poverty lines."

Canada does not have a SINGLE official poverty line. This is because the reality is that the cost of living varies greatly from province-to-province, from community-to-community. Instead Canada defines a range of LICOs that "vary by family size and by size of community".

So what is the Singapore minister trying to say? Your guess is as good as mine. But as the adage goes, "The first step to solving a problem is to recognize that a problem exists." Thereafter, it is often useful to have a method to gauge/measure the success/effectiveness of a solution/policy -- regardless if the measure is called "Poverty Line" or "Low-Income Cut-Off".

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[Extracted from The Straits Times - Singapolitics on 24-Oct-2013.]

Why setting a poverty line may not be helpful: Chan Chun Sing

Posted on Oct 23, 2013 5:03 PM Updated: Oct 23, 2013 5:03 PM

By Robin Chan

Singapore is not considering having an official poverty line, as it would not fully reflect the severity and complexity of issues faced by the poor, and may also lead to those above the line missing out on assistance.

Minister for Social and Family Development Chan Chun Sing made these points on Monday, amid renewed calls for Singapore to look into having one after Hong Kong set an official poverty line last month.

In a written parliamentary reply, he said the Government's approach is to use broad definitions for the groups it seeks to help, set clear criteria to identify and assess those in need, and come up with tailored schemes.

"If we use a single poverty line to assess the family, we also risk a 'cliff effect', where those below the poverty line receive all forms of assistance, while other genuinely needy citizens outside the poverty line are excluded," he said.

They were the Government's first comments on the issue since Hong Kong's policy change on Sept 30.

Mr Chan said a poverty line would also miss out other issues that poor families face. These include ill health, lack of housing and weak family relationships.

Replying to questions by Non-Constituency MP Yee Jenn Jong and Nominated MP Laurence Lien, Mr Chan said Singapore's assessment process for providing help to those in need is "rigorous but also flexible" to cater to the genuinely needy.

This means that those who do not meet certain criteria in help programmes are also able to receive assistance.

The Government also conducts regular reviews to ensure that ComCare assistance remains relevant to the low-income and vulnerable, he said.

ComCare is social assistance provided to low-income families.

Mr Chan said different nations tailor their methods to identify and help their needy according to their circumstances, and other developed ones such as New Zealand and Canada also do not subscribe to official poverty lines.

Hong Kong set its poverty line at half the median household income level according to household size, with about 1.3 million, or a fifth of its population, living under it. So the poverty line for a four-person household is HK$14,300 (S$2,300).

Like Singapore, Hong Kong is grappling with high levels of income inequality. Its Gini co-efficient, a commonly-used measure of income inequality, is 0.53, compared with Singapore's 0.47. The closer the number is to 1, the higher the inequality.

Mr Yee also asked what the Government's internal measure of neediness was when it distributed N95 masks to 200,000 needy households in June during the haze.

Mr Chan said that the one million masks were given to households with a per-capita income below $900.

Their income was verified through their membership in the Community Health Assist Scheme Blue Scheme or by self-declaration of income at the community clubs.

Cancelled work-shift

Around noon last Friday, I received a missed call and a phone message from a nurse manager (who was covering for my nurse manager) that my Saturday work-shift has been cancelled with a message that, "Your manager JC is (currently) away and will be following up with you."

When I received the message, the first questions on my mind were if there was a change in my client's condition and/or some changes to the family's plan -- which are the most common reasons why work-shifts get cancelled for home health nursing. Then I remember that if a shift was cancelled for those reasons, the manager usually does not have to follow-up with the nurse.

Thus it got me wondering. That shift was with a particularly challenging client and I had been charting (i.e. writing down in the nursing notes) about my client's condition and our interactions. I guess my nurse manager wanted a discussion with me to gather how I feel about the issues/situation. I am actually looking forward to speak with my nurse manager to hear what she has to share.

I am generalizing here, but therein lies the difference between nursing in Singapore and nursing in B.C., Canada. In Singapore, when a nurse manager wants to speak with the nurse, it is often "bad news" or "blame fest". In Canada, I can expect that my views be heard and my needs attended to, even as a lowly cog in the work-wheel.

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[Update on Tue 10-Sep-2013]

I've spoken with my nurse manager today. I will be taken off this client's case and re-assigned to other cases. I am so thankful for the support from my nurse manager and others from the company.

SG Nursing Board - To be or not to be?

I received the renewal letter for my registration renewal with the Singapore Nursing Board recently. 

[SNB letter sent to my Canadian postal address]

Previously, I have maintained my Singapore nursing registration (just in case I need a Plan B) while working towards my Canadian (i.e. British Columbia) nursing registration. Now that I've obtained my B.C. nursing licence, the question is whether to continue with my Singapore registration.

I do not see myself returning to nursing in Singapore, given the very different work and/or nursing culture there. [IMHO, it is a rather inhumane and inequitable work culture. Click here to see what FrugalIntrovert wrote about the Singapore work and lifestyle norms.]

That said, it is hard to give up on one's roots. Similarly, on the issue of "to be or not to be a Singapore citizen" -- as per my comments on ASingaporeanSon's blog entry.

Recycling-net on waste-bins

When I first arrived in Vancouver, I wondered why their waste-bins typically have a separate net for "bottles/cans".

More impressive was that people actually bothered to set aside their recyclable bottles/cans in the separate bins provided.

Then as I walked down the streets one day, I noticed that there were poor and/or homeless folks collecting bottles/cans from these nets. Thus, it reduces the need for them to dig through the dirty waste bins. These bottles/cans can be taken to the recycling depot and exchanged for 5 cents (a nickel) per piece. Although there are still some poor/homeless folks who would pull out the tops of the waste-bins to search for recyclable bottles/cans, I noticed that they were less likely to do so if the "harvest" from the recycling net was good, moving on to the next bin instead.

If only waste-bin designs in Singapore take the poor/homeless recyclers into consideration. The short video below, although fictional, shows the Singapore situation. Actually, I have personally seen scavengers digging through dustbins with their bare hands -- I guess not much of a choice when survival is at stake.

Can -- by Linus Koh

Privatized healthcare vs universal access

While chatting with my boyfriend DD today, he mentioned that one of the factors (amongst several) of his decision to return to Canada was the way healthcare system works in USA (pre-Obamacare). [Note: USA was a country with better job prospects in his industry compared to Canada at the time of his relocation.]

I shared with DD that, IMHO, the Singapore healthcare system is even more "right-wing" than USA's. E.g. A couple, who despite having bought insurance for their child and both holding well-paid professional jobs, going into credit card debts to pay for healthcare for their child with congenital issues. E.g. An elderly childless-woman who was told to sell the remaining lease of her 3-room HDB apartment (leaving her with no home of her own and having to live under her niece's equally small HDB) before she could apply for Medifund funding for her repeated acute hospital care.

As I am currently working in paediatric home health nursing in B.C., Canada, I can see the difference in the kind of support (from the provincial government) given to parents with children who lucked out on rare, chronic or deadly illnesses. In addition, Uncle Wing's (bless his soul) own experience is testimony to how the B.C. healthcare system takes care of its seriously ill elderly. [Click here to see my year-2009 blog entry about BC nurses petition against healthcare underfunding and Singapore's privatization of healthcare.] While I do not deny that Canada's system has its weaknesses, I feel that it caters well to “不怕一万，只怕万一。” ["Not afraid of the common scenarios (that one can plan for), but fear the exceptional scenarios."] After all, how many of us would choose (for the sake of maximizing our usage of universal healthcare): 

• to be involved in major road traffic accidents (and thus requiring extended intensive care and probably repeated restorative surgery and extended rehabilitation); or
• to have children with rare, chronic and/or deadly illnesses; or 
• to have elderly parents with chronic, debilitating and/or incurable illnesses?

Yet there will always be Singaporeans who would defend that the Singapore healthcare system is better (e.g. more efficient and/or more cost-effective, or more equitable because specific-user-pays instead of risk-sharing) than Canada's, Australia's, UK's, etc. [Just check out the comments on those blog posts.] I hope that these "loyal", "patriotic", defensive Singaporeans will never have to encounter any major/repeated healthcare issues personally and/or amongst their loved ones.

Another issue I have with the way private healthcare works in Singapore is that until recently (see below), there was little control on the runaway costs/mark-ups in private healthcare. Note: I have met a significant number of private specialists who would waive/discount their fees to help the "needy" patients, thus it would not be fair to tarnish all kind-hearted doctors because of one black sheep. Nevertheless, IMHO, it is human nature to compete to be the better paid specialist. After all, it is so very much in Singapore's culture to judge people by the size of their income.

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[Extracted from The Straits Times Online website.]

Dr Susan Lim loses appeal against SMC's guilty verdict

Published on Jul 01, 2013 1:39 PM

By Selina Lum And Kc Vijayan

The highest court in Singapore on Monday dismissed an appeal by general surgeon Susan Lim against her conviction on charges of professional misconduct over the amount she charged a patient from the royal family of Brunei.

In a 109-page written judgment, the three-judge Court of Appeal said Dr Lim's case was "clearly one of the most serious cases - if not the most serious case so far - of overcharging in the medical profession in the local context". The court dismissed her claims that she was justified and there was no ethical obligation to charge a fair and reasonable amount and pointed out her approach showed she had shown no remorse.

In the judgment, the court ruled there is an objective ethical limit on medical fees that operates outside contractual and market forces, The court found that, given a doctor's specialised knowledge and training, there arises an ethical obligation on the part of a doctor not to take advantage of his patient. And this ethical obligation to charge a fair and reasonable fee is not superseded by a valid agreement between the doctor and his patient, the court held.

In 2012, Dr Lim was found guilty of 94 charges of professional misconduct by a Singapore Medical Council (SMC) disciplinary committee for charging about $24 million for the services provided to Pengiran Anak Hajah Damit Pg Pemancha Pg Anak Mohd Alam for 110 treatment days from January to June 2007. Dr Lim was then given a three-year suspension and fined $10,000 - which was upheld by the appeal court.

IEN dreams of migrating to Vancouver

I received a question from an IEN originally from The Philippines. My long reply to her is below. I will appreciate if other IENs (who happen to read my blog) can share their opinions, views, or suggestions to this Anonymous commenter. Thanks!

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Anonymous wrote on Tuesday, June 04, 2013 11:27:00 AM:

hello Winking Doll, 

I am a registered nurse from Philippines and currently working here in Saudi Arabia as ICU nurse. I am contemplating to submit my documents for CRNBC as i am planning to register for CRNE finger crossed. Since going to Canada to sit for my SEC (as i know i will surely be advised for SEC by CRNBC) is very steep (tourist visa) i decided to enroll for a 10 mos program in vancouver. Though the program is quite expensive but i still got enough bucks on my pocket to finance the said schooling. I saw this avenue as the easiest way to visit Canada legally and hence sit for my SEC. Do you think part time jobs for IEN awaiting for their SEC report are available in Vancouver Canada? like janitor, waiter or jobs that are blue collared but worth trying for daily survival?..

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Hi Anonymous at Tuesday, June 04, 2013 11:27:00 AM,

My answers will not make you happy, but I will state the facts, my observations and opinions, so that you can make an informed decision.

Canada closing door to immigrants
By Al Jazeera (English channel), published on 10-Jun-2013

Firstly, based on the May-2013 new Federal Skilled Workers Programme immigration visa list of wanted skills, Canada has enough nurses.

http://winkingdoll.blogspot.ca/2013/05/canada-has-enough-nurses-re-fswp.html

You can read the GNIE: RN Job Search Update series to see how challenging it is for my cohort of GNIE students (i.e. IENs who have Canadian permanent residency, completed 1 year of "Canadianization" nursing training, passed CRNE and obtained full, current practicing RN licence with the CRNBC) to get RN jobs in Metro Vancouver.

http://winkingdoll.blogspot.ca/2013/05/gnie-rn-job-search-update-4.html

Secondly, there are a lot of paper-mills in Canada, especially in Vancouver. I am not sure which program you've signed up for, but please check the facts and accreditation so that you don't end up tossing good money and time on a useless venture. [I was ever advised by someone here to stick to the publicly-funded institutions and/or a few globally highly-ranked private universities if I want to pursue any Canadian paper qualifications to avoid ending up with a useless piece of paper.] I have met an IEN from South Asia who came on a (non-nursing related) student visa, lived here for a couple of years, attempted and passed the SEC and but failed the CRNE twice. She is heading for her 3rd and final attempt at the CRNE. IMHO, I do not think her approach is wise and I've told her as such, but she has decided to throw in her towel on her migration dreams should she fail this final attempt.

As for getting part-time jobs in Vancouver, (I may be wrong but IMHO) foreign students are the lowest on the pecking-order when it comes to job opportunities. Besides the Canadian youths and retirees, there are many professional immigrants (with permanent residency status) here who are actively seeking part-time/temporary survival jobs while they undergo the process of getting their qualifications accredited. You can read about my initial attempt at job search in Canada here, including the rejection of my job application as a janitor back in 2010.
http://www2.macleans.ca/2013/01/16/the-new-underclass/

http://winkingdoll.blogspot.ca/2010/11/1st-rejection-email.html

In fact, some of the employers and/or job agents are unscrupulous knowing that foreign temporary workers (e.g. foreign students or working-holiday visa holders) are desperate for income for survival. They may try ways and means to squeeze such vulnerable employees beyond what is fair/legal. Do NOT trust anyone without analyzing the issues for yourself critically, not even if they are your "own countrymen". Also be forewarned that what is the "norm" in one's country of origin, may or may not be legal in Canada. [Click here for another blogger's personal experience.]

http://winkingdoll.blogspot.ca/2013/01/migrant-workers-part-3.html
http://lostidentity1984.blogspot.ca/2013/06/bcontract-colours-of-people.html

Just FYI, from what I know, the 2 peak seasons for getting casual (i.e. on-call) jobs are summer and the year-end seasonal holidays. Apply for such jobs early. E.g. start looking out in early/mid October for job hirings for the Christmas season. In addition, you will need certain certifications even for the "blue collar" jobs. E.g. Waiters need "Food Safe Level 1 Certification" and perhaps also "Serving It Right" (for premises that serves alcohol). E.g. Even volunteers at summer camps may need a current CPR Level C Certification from an approved B.C. authority.

Now that we get most of the negatives out of the way, the question is what is your ultimate goal? It sounds like to live/work in Canada. 

If I get it right, then my 2 cents suggestion is to think beyond Vancouver. Based on my observations, many IENs in Vancouver rely on an extensive social support network and/or have deep pockets in order to survive the long and arduous road to returning to their professional practice. You can check the CNA website for a list of nursing boards and see which Canadian province is easier to get into.

http://www.cna-aiic.ca/en/becoming-an-rn/regulation-of-rns/regulatory-bodies/

As for the BC, CRNBC (i.e. the BC nursing board) will provide you with an official letter for you to come to Canada as a visitor for the SEC. Besides the CRNBC letter, I understand from some IENs that Filipinos may need to show the Canadian immigration officers proof of sufficient funds and/or status of full-time employment in another country to actually obtain a visa for entry. The timing of all these applications can be a bit tricky. But should you choose to do it, the process should be:

• apply for credential evaluation with the CRNBC, 
• get their (CRNBC) reply that says you'll need to do the SEC, 
• schedule the SEC (I heard it is a 3-6 months wait now), and 
• then apply to CIC (Canadian Immigration) for short-visit visa.

IMHO, it is a good idea to start now, if you are sure that you want to live/work in Vancouver because life moves at a different pace here (i.e. it takes months for each of the above steps). Btw, I don't think I understand what your situation is since you wrote that "Since going to Canada to sit for my SEC ... is very steep (tourist visa)" and yet a "10 mos program in vancouver" as a foreign student within your affordability.

I have met other IENs whose ultimate goal was to obtain Canadian residency/citizenship status. A few did it by the long, slow, arduous route of first becoming a live-in caregiver, spend a couple of years to get their Canadian residency status approved while planning their return to nursing. The con is that they lose their skills during the long process, but the pro is that it is a stable route for those with limited finances and are willing take a long-haul view.
http://winkingdoll.blogspot.ca/2013/07/how-to-become-live-in-caregiver.html

http://winkingdoll.blogspot.ca/2013/01/canadian-live-in-caregiver-maid-policy.html

Frankly, the times have changed since the boom hey-days of pre-2005 when international nurses can get employment easily, and job opportunities have declined significantly especially after the 2007 Financial Crisis. Immigrants coming to Canada should enter with their eyes wide-open and consider what their options are in the worst-case scenario before arriving. Otherwise, one may find oneself as one of the immigrants languishing long-term at jobs that are not fulfilling (and/or minimum wage survival jobs) and yet are unable to save enough to return/re-establish oneself in one's country of origin either. [Note: I am not kidding you, I've met such immigrants.]

http://winkingdoll.blogspot.ca/2013/03/crnbc-removes-ien-canadian-reference.html

http://en.wikipedia.org/wiki/Financial_crisis_of_2007–08

Best Regards, WD.

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p.s. The following is an old video which has been around since the early 2000's. That said, I felt that having watched it (and read the now-defunct website of NotCanada.com) before coming to Canada helped me to be realistic in planning for my worst-case scenario when I planned for immigration. [Note: Click here for blogger Annares' post questioning the reality behind the NotCanada.com website.]

Not Canada

p.p.s. Coincidentally, I mentioned to an American stranger today (whose attempt to obtain Canadian residency/citizenship failed) that there are always pros-and-cons to every policy depending on one's vested interests. I respect that Canada tightened its immigration policies given that the recent unstable global social/economic prospects have already impacted the job opportunities for its existing youth and elderly workers. IMHO, foreigners looking to live/work in Canada owe it to themselves to sniff out the realities of the Canadian economy and employment prospects instead of relying on hearsay, especially hearsay from those with vested interests (e.g. migration agents, job agents and/or private "paper-mill" schools).

• http://www2.macleans.ca/2013/01/16/the-new-underclass/
• http://www.cbc.ca/news/canada/british-columbia/story/2013/04/05/bc-rbc-foreign-workers.html
• http://www.cbc.ca/news/canada/edmonton/story/2013/04/09/edmonton-foreign-workers-fast-food.html
• http://ca.news.yahoo.com/blogs/canada-politics/americans-moving-canada-record-numbers-report-161857845.html
• http://ca.finance.yahoo.com/blogs/insight/canucks-value-job-security-more-salary-hikes-191946682.html
• http://ca.finance.yahoo.com/news/canadians-ok-higher-taxes-fight-153959095.html

SG steps closer to China and North Korea online

Sometimes reality is strange, even stranger than fiction. See the following news story extracted from the Associated Press.

See also commentary on the policy by LIFT (who emigrated to UK and is now a British citizen) and ASingaporeanSon (who emigrated to Australia). This Canada-based Singapore-citizen has nothing to say, except *face-palm*.

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SINGAPORE TO REQUIRE NEWS WEBSITES TO BE LICENSED

By HEATHER TAN — May. 29 4:40 AM EDT

SINGAPORE (AP) — Singapore's government says a new policy will require online news websites to be licensed, a move that is being criticized as a form of censorship in a country where media outlets are already strictly controlled.

The policy will require websites that report regularly on Singapore news and have at least 50,000 visitors a month to obtain annual licenses, the city-state's Media Development Authority said in a statement Tuesday. They also will be required to remove content found to be in breach of MDA standards within 24 hours of notification.

"This is censorship, plain and simple," said Lee Kin Mun, a Singaporean social and political blogger who is more popularly known by his Internet persona, "Mr. Brown."

"Trying to regulate the Internet is like trying to grab jelly; the tighter your grip on it, the faster it leaks out of your hand," he said.

The MDA said the new policy, which takes effect Saturday, would place news websites "on a more consistent regulatory framework with traditional news platforms which are already individually licensed."

It said it would "impose financial penalties or suspend or revoke" the licenses of any websites that do not comply with any of the conditions.

The MDA singled out 10 websites, nine of which are state-owned, with the exception being Yahoo Singapore. It said the new policy also may be extended to netizen websites and foreign news sites covering Singapore news.

To receive a license, a website will have to post a performance bond of 50,000 Singapore dollars ($39,400). This is similar to current requirements for niche TV broadcasters in Singapore.

"Our mainstream media are subjected to rules. Why shouldn't the online media be part of that regulatory framework?" said Communications and Information Minister Yaacob Ibrahim. "I don't see this as a clamping down. If anything, it is regularizing what is already happening on the Internet and making sure that they are on par with our mainstream media."

But The Online Citizen, one of the bigger netizen alternative news websites in Singapore, said it may shut down if the new licensing rules are imposed on it.

"In the event that the new licensing rules are extended to TOC, we will have to reassess the viability of continuing the website in light of the significant financial and legal liability the new rules impose," it said in a statement.

Yahoo Singapore said it would wait to receive the license conditions before commenting on the new measures.

Media is strictly controlled and regulated in Singapore, with lobby group Reporters Without Borders ranking the Southeast Asian city-state 149th globally in terms of press freedom.

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See also The Online Citizen's statement on the new MDA ruling. Yahoo! Singapore also reported on the responses by Singaporeans on the new MDA ruling.

Watching B.C. provincial elections

I can't believe the I am staying up to follow the B.C. provincial elections. Until today, I had the "I am not a citizen" and therefore it is not my issue attitude (albeit I am aware of some of the local political issues discussed). But then logging onto Facebook this evening and watching my Canadian friends' Facebook comments about the election results as they unfold was rather interesting.

Still waiting for the final riding: Vancouver-Point Grey. It is an important one, given that it is the incumbent Premier Christy Clark (Liberal) vs David Eby (NDP, note: not NDP's leader). Interestingly, NDP is leading at this moment, but it is a close fight, pending 2 more polls' reports.

[For the Singaporeans reading this: Imagine PAP securing enough seats to form a majority government (i.e. more than 50% of the parliamentary seats), but PM LHL loses his seat to an opposition challenger (who is not even the leader of his/her opposition party).]

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[Update on 15-May-2013 at 01:08AM based on Yahoo! News.]

NDP David Eby (10,162) won Liberal Christy Clark (9,377) by 785 votes at Vancouver-Point Grey. [Click here for the Metro news report.]

Hmm, is it time for a new Premier? Or will there be a by-election with Liberal represented by Christy Clark (e.g. via "resignation" of a lower-ranking Liberal MLA who won)?

B.C. (Canadian) politics is interesting indeed.

Canadian goose / Volunteerism

Just to share a short video of a Canadian goose that I took last week at Stanley Park.

Yes, I think the goose knew I was there, but it was nonplussed about it. IMHO, it helped that I walked up very slowly, calmly and steadily towards it; and also that I was "down-wind" (i.e. the wind was blowing from the goose towards me). Yes, at one point I laughed in my heart at the mental images that if I were not a vegetarian, this would be a good opportunity to spear* the goose and have roast goose! [*Note: I am not suggesting for anyone to do that, for the Canadians treasure their wildlife.]

Canadian Goose

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Last week, I visited various Metro Vancouver tourist attractions thanks to the free pass I received from volunteering with one of these attractions. IMHO, the free pass (for a fortnight) is such a good way to show appreciation to volunteers during BC's Volunteer Appreciation Week.

[2013 Volunteer Appreciation Week

- A fortnight's free pass]

The spirit of volunteerism is strong in Metro Vancouver. [Note: For an idea of how ingrained volunteerism is in the Canadian culture, see the news article below.] For many young Vancouverites, besides contributing to causes that they believe in, it is a way to get references and community experience for their future resumes and/or take a peek into potential careers.

Many newly-arrived immigrants do not instinctively understand the value of volunteering: 

• how it can open up new worlds/opportunities/careers for them, 
• how it can help them break out of their ethnic ghetto, 
• how it can be a part of their process of learning about the Canadian society and integrating with it, 
• how it may be useful to have some Canadian community contacts (especially since many in such social/charity/volunteer organizations are open-to and supportive-of immigrants), and 
• how it may possibly lead to the hard-to-acquire Canadian experience and/or references.

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[Extracted from Yahoo! Finance Insight, dated Wed 24-Apr-2013.]

Volunteering worth $50 billion to Canadian economy

By Brenda Bouw | Insight – Wed, 24 Apr, 2013 11:29 AM EDT

Volunteering not only makes you feel good, turns out it’s also good for the economy.

A new report from TD Bank has pegged the economic value of volunteering in Canada at $50 billion each year, or about three per cent of Canada’s GDP, which is the same size as the Manitoba economy.

“The economic value of volunteering demonstrates that it is possible to get more than what you pay for,” said the report’s authors, TD economists Craig Alexander and Sonya Gulati.

“Put simply, $50 billion represents a lot of value. It is too large to simply dismiss.”

The report marks National Volunteer Week in Canada, which runs from April 21 to 27, and celebrates the estimated 13.3 million volunteers across Canada.

While some might argue volunteering is just free labour, others see it as a way to advance skills or provide selfless acts that allow them to give back to the community.

TD argues volunteerism provides economic value that is “very real,” yet “seldom noticed and rarely discussed.”

For example, it cites opportunity cost for spending a limited resource, “in this case, time – on unpaid work as opposed to paid work.” An example is gaining a skill that better prepares someone for a paid job in the future. There is also value in the generation of social capital, or the “intangible benefits associated with volunteering,” the report says.

TD came up with the $50-billion figure by calculating the estimated 2.1 billion hours worked at average rate of $24 per hour. The data is based on the 2010 Canada Survey of Giving, Volunteering and Participating, from Statistics Canada .

The $50-billion figure is “conservative,” TD says, because it doesn’t include capital investment, for example. The total is also said to be roughly half of the value of Canada’s non-profit sector, as estimated by Statistics Canada.

“If the value of volunteer work were a company, it would be in the league of the largest firms in Canada listed in the S&P/TSX Composite Index – on the basis of market capitalization – sandwiched between corporate giants like Suncor Energy and the Canadian National Railway,” the report says.

While TD sees the report as a fitting way to celebrate National Volunteer Week, the authors addressed the potential “passionate rebuttal” that putting a dollar figure on volunteerism may be considered “distasteful and/or disrespectful.”

“It is short-sighted not to appreciate this perspective and to flippantly ignore the passionate rebuttal to economic valuation,” the report says.

“Despite the skepticism attached to the exercise, putting numbers to volunteering does help to demonstrate the societal and economic importance … Comparison and context enable us to understand and protect volunteering which is generally overlooked and its importance dismissed at first glance. An economic lens fosters appreciation for a crucial element of the social fabric that binds the community together.”

National Volunteer Week began in 1943 as a way to draw attention to the contribution women made at home during the Second World War, according to Volunteer Canada www.volunteer.ca