21 April 2019
In commemoration of Podiatry Day 2019, Podiatry Association Singapore presents a short production on ‘Podiatry Beginnings’.
In lesser known history, the War in Diabetes lower limb salvage efforts began almost 30 years ago when local doctors supported an allied health field unknown to many in Singapore at that time. We are deeply grateful to pioneers and mentors who helped podiatry in our early days. In this accompanying write up, we focused on two persons who have contributed greatly to the founding days of the podiatry profession in Singapore – Dr Shanta Emmanuel and Mr Tye Lee Tze.
Dr Shanta Emmanuel’s interest in chronic diseases especially diabetes, started around late-1980s to early-1990s when she noticed the incidences of lower limb amputation in Singapore were at alarming rates. She carried out the first National Health Survey in 1992 which established the baseline prevalence of common chronic conditions and cardiovascular risk factors such as diabetes mellitus, hypertension, dyslipidaemia and obesity in Singapore. These surveys became the prototype for future national health surveys (College of Public Health & Occupational Physicians, 2018). Under the Ministry of Health, Health Manpower Development Programme, Dr Emmanuel visited diabetes centres in Australia and sought advice from Prof Paul Zimmet (Monash University), who is a renowned international expert for diabetes control. Based on the survey findings and international best practices, Dr Emmanuel drew up the plan for the good control of diabetes in Singapore, with the aim to prevent complications and slow down disease progression. A podiatry service was integral in the plan for diabetes lower limb salvage efforts and foot health management. As Director of government polyclinics in period 1996-2000, Dr Emmanuel inaugurated the diabetes footcare nurses course to support the work of podiatrists, as part an overarching programme for enhanced diabetes control. The diabetes footcare nurse course was coordinated by nursing officer, Matron Lai Yee Khim and conducted by resident podiatrists of the various hospitals:
Mr Tye Lee Tze, Senior Podiatrist Tan Tock Seng Hospital
Ms Virginia Bower, Singapore General Hospital
Ms Helen Crawford, Singapore General Hospital
Mr Matthew Cichero, Toa Payoh Hospital
Mr Adam Jorgensen, National University Hospital
Mr Daryl Du Preez, Tan Tock Seng Hospital
Ms Jill Walsh, Tan Tock Seng Hospital
Ms Ina Farrely, Private Practice
Dr Emmanuel transited to become CEO of National Healthcare Group (NHG) polyclinics in 2000-2005. As majority of diabetes patients received healthcare at local polyclinics, Dr Emmanuel ensured that all polyclinics were able to deliver targeted and purposeful comprehensive diabetic foot care programmes.
Mr Tye Lee Tze, who had an interest in moving to Singapore, spent his student days and early career years knocking on doors to introduce podiatry to the local hospital scene. Initially, it seemed nothing had come out of it. A couple of years later, the stars aligned, and Tan Tock Seng Hospital was ready to hire their first podiatrist. Mr Tye Lee Tze was remembered as the podiatrist who came by on several occasions to promote and speak about the profession. Mr Tye’s determination and endurance were rewarded when he was recruited as the pioneer podiatrist to Singapore on 7 February 1993 at Tan Tock Seng Hospital.
Podiatry service was first established in Singapore with the underpinning aim of reducing lower limb complications associated with diabetes. Mr Tye was instrumental in the setting up of diabetic foot screening and education programmes in polyclinics and the various hospitals. Through the hard work and unwavering support from the late Dr John Tambyah, Matron Lai Yee Khim, Dr Shanta Emmanuel, Prof Chee Yam Cheng, Dr Judy Lim, Dr Loh Keh Chuan and Prof Fong Kok Yong, the first local Diabetes Centre was established at Tan Tock Seng Hospital in the early 1990s.
Some 26 years later, in March 2019, Podiatry Association Singapore organised a reunion for Mr Tye and Dr Emmanuel to catch up and celebrate the progress of podiatry in Singapore. On behalf of Podiatry Association Singapore, we presented Dr Emmanuel and Mr Tye cactus gifts, as a symbolic token of their endurance, tenacity and thriving in spite of challenges during the early days. A cactus in an inspiration in the desert – when there was yet nothing, they saw something.
We are grateful to the pioneers who made podiatry happen in Singapore. Thank you.