Singapore national eye center looks to closer ties with Indonesia

We happened to bump into Winawati Sutisna from Jakarta who was on a visit to the International Patient Service department at the SNEC to consult with an ophthalmologist about treatment for her 10-year old daughter's strabismus, or squint-eye.

"I learnt from an ophthalmologist in Jakarta that the SNEC is the best place in the region to treat my daughter's problem," Winawati said.

She paid S$90 for a consultation which she said was not much more than the fees charged by a senior ophthalmologist at a modern private eye hospital in Jakarta.

Winawati is just one of the tens of thousands of Indonesians seeking quality healthcare or simply having health checkups at government or private hospitals in Singapore.

The latest data from the health ministry shows that last year around 18,000 visitors from Indonesia went to Singapore for medical attention. That's almost 50 per cent of the total number of foreigners who travel to there for health services.

The Indonesian government has been trying to encourage private investment in healthcare, allowing foreigners to hold up to 100 per cent equity in private hospitals in the hope that an increased foreign presence will motivate state hospitals to improve their services.

Despite this expansion, Indonesians who can afford it prefer to go abroad. They are the major contributors to medical tourism in neighbouring countries, notably Singapore and Malaysia

According to the Mayapada Health Care group, Indonesians spend more than US$750 million (S$931 million) annually to travel to Singapore, Malaysia or Australia for medical purposes.

As the most modern, well-equipped specialist in eye care in the region, the SNEC has become increasingly popular for Indonesians from cities other than Jakarta, which do not have modern eye hospitals.

Since its opening in 1990, the centre has steadily expanded and now covers nine subspecialties: in cataract and comprehensive ophthalmology; corneal and external eye disease; glaucoma; immunology and vitreo-; neuro-ophthalmology; ocular inflammation; oculoplastic and aesthetic eyeplastic; paediatric ophthalmology and strabismus; and refractive surgery.

Last year alone, the SNEC managed 275,000 outpatient visits, 20,000 surgeries and more than 13,000 laser procedures.

Doctor Ho Ching Lin, head of the glaucoma department at the SNEC, said as the local and regional referral centre for secondary and tertiary management of glaucoma, her department manages more than 40,000 glaucoma attendances annually.

"About 2,000 of them are visitors from Southeast Asia, including Indonesia," Ho added.

SNEC Medical Director Donald Tan, however, did not see the increasing popularity of his centre as a zero-sum game with eye care hospitals or clinics in Indonesia.

"The SNEC complements eye hospitals in Indonesia. We are actively involved in clinical trials and research into the causes and treatment of major eye conditions such as myopia and glaucoma.

"Thousands of ophthalmologists from the region, including Indonesia, have participated in SNEC courses and meetings, which are organised annually," added Tan, who last year was elected as first non-American president of the US-based Cornea Society.

"I myself and several senior ophthalmologists from the SNEC have visited Indonesia often for lectures or conferences with Indonesian eye specialists. We also cooperate with several eye hospitals in Indonesia like the Jakarta Eye Center and the National Eye Center in Cicendo, Bandung," Tan said.

SNEC ophthalmologists and eye specialists from the region regularly exchange views and best practices through the annual meetings of the Asian Association of Eye Hospitals.

The best competitive advantage of SNEC has is the Singapore Eye Research Institute (SERI), one of the largest eye and vision research institutes in the Asia Pacific region in terms of staff numbers, grant income, research initiatives and innovations and inventions.

SERI director Wong Tien Yin said the multi-ethnic composition of the Singapore population is really an advantage because therapies and diagnoses that have been developed in the West may not be directly applicable to Asia.

"Its ability to test diagnostics and therapeutics with patients of three major ethnic groups positions makes SERI the eye laboratory for the whole Asian market," Wong added

Research at SERI, which is attached to the SNEC complex, has helped the SNEC develop and apply new eye care services, for example, Lasik, a wonders of modern medicine and technology to improve vision and do away with spectacles or contact lenses.

Cataract extraction and intraocular lens implantation is the most common operation performed at the SNEC with more than 10,000 cataract procedures each year, by a team of over 55 full time ophthalmology specialists.

"Those who plan to have laser vision correction can now look forward to a new technique beyond LASIK, with the introduction of SNEC ReLEx," said Cordelia Chan, head of the refractive surgery service.

Chan explained that unlike conventional LASIK which destroys the inner corneal tissues, the new procedure does not create a flap in the cornea and uses only one laser for the entire process, thereby resulting in a much stronger eye and less immediate postoperative discomfort and tearing.

Tan and his team have developed and patented a new technique for cornea transplants, which used to require at least 20 stitches and a recovery of six months. The new technique, called DMEK, already used worldwide, minimizes invasive corneal transplantation, thereby reducing damage to the new cornea's cell.

An increasing number of middleclass and high-income Indonesians, especially those in the resource-rich provinces with direct flights to Singapore, look for quality healthcare in the city state, well known as providing the best healthcare centre in Southeast Asia.