Opening Of The KKH 6th Paediatric Annual Scientific Meeting

09 Oct 2003

By Dr Balaji Sadasivan

Venue: KK Hospital

INTRODUCTION

It gives me great pleasure to be able to join all of you for the 6th KK Hospital Paediatric Annual Scientific Meeting. I note that the theme of this year's meeting is "Bridging the Perinatal - Paediatric Divide."

BRIDGING THE PERINATAL-PAEDIATRIC DIVIDE

Indeed, the clinical management of our young patients before birth and the period after has traditionally been the purview of different clinical specialties. Within the span of a few months, care of these little ones passes from the Obstetrician to the Neonatologist, and to the Paediatrician.

Although KK Hospital had historically been a maternity hospital, the departments of Obstetrics and Gynaecology, Neonatology and Paediatrics has worked together under the same roof for many years already. There is definitely much to be gained from greater cooperation between staff of these clinical disciplines. This is due to several reasons:

New Antenatal Technologies

Firstly, the advent of new technologies in antenatal screening and treatment modalities would create new early intervention opportunities. These advances in high-risk Obstetrics will undoubtedly create new challenges and opportunities for Neonatologists and Paediatricians as well.

Foetal Origin of Adult Diseases

Secondly, there is a definite correlation in a person's well-being between the antenatal and postnatal stages of life. I understand that the first plenary lecture is on the "Foetal Origins of Adult Diseases". There have been multiple studies in this area. Epidemiological studies have suggested an association between birth size measures and future development of adult diseases such as Type 2 Diabetes and Coronary Artery Diseases. While there is still some disagreement over the exact pathogenesis, we can all agree that good antenatal, perinatal and neonatal care is indeed the starting point for a healthy baby, child, adolescent and adult.

Health of the Expectant Mother

Thirdly, the well being of the expectant mother is also an important aspect determining the health of the child. The health of expectant mothers and the healthcare that is available to them determines the infant mortality rate to a large extent. This is a sensitive and important indicator of the state of a country's health care system. I am pleased to say that Singapore has consistently had one of the lowest infant mortality rates in the world. This is testament to the good healthcare system we have put in place, and the commitment of our health care professionals.

Continuity of Care

Finally, cooperation between these different clinical disciplines creates an excellent opportunity for continuity of care from the antenatal to the adolescent phase of life. This ensures a holistic approach in the management of the patient.

Diverse Topics at This Year's Meeting

As such, I am very glad to see that KK Hospital is committed to furthering this inter-disciplinary cooperation. The topics that will be discussed at this year's Paediatric scientific meeting are diverse and ranges from Perinatology, management of the challenged child to litigation and medicolegal issues in the brain-injured child. I am also pleased to note that the faculty includes staff from many non-Paediatric disciplines.

MANAGEMENT OF THE CHALLENGED CHILD

While we can do our best to minimise disease and disability through prevention and early therapeutic interventions, there will still be children who suffer from chronic disorders where no definitive cure is available. The management of the challenged child, such as those with cerebral palsy, dysmorphism, educational difficulties and other developmental problems is also an area which should be looked at closely.

Early Intervention and Proper Rehabilitation

For these "challenged children", it is important to determine long-term outcomes for their chronic problems, so that proper rehabilitation and treatment can be planned. Preventive strategies to reduce disability should be put in place. It is also important to engage their parents or caregivers to play an active role in management. This would enable each child to fulfil his or her potential and contribute to society effectively.

Early intervention is important for these children and programmes have been set up for them. An example of an early intervention programme for children with learning difficulties is the Child Development Programme. This Programme identifies these children early and follows them up in a community setting. I am pleased to note that KK Hospital is one of the institutions that are actively participating in this programme. MOH is providing 3 million dollars for this programme this financial year.

Comforting the Sick Child

Finally, in the management of children with chronic problems, we have to acknowledge that in some circumstances, modern medicine can offer no solution or cure. I would like to remind us that as medical professionals, we are called "to cure sometimes, to relieve often, to comfort always". While it is easy to be caught up in the technology and triumphs of modern medicine, we should remember that we are called to be comforters to the sick child, and sometimes, these situations turn out to be the finest and most rewarding moments in the practice of medicine.

CONCLUSION

When dealing with children, we often have the opportunity to make a great impact on the physical, mental and spiritual well-being of the child. I am confident that the staff of KK Hospital would always endeavour to leave a positive impact on these young lives.

On this note, I would like end by wishing all of you a most fruitful and rewarding meeting, and success in "breeching the Perinatal-Paediatric divide".

Thank you.