Development of Small Animal Veterinary Practice in a Rapidly Developing Country (The Singapore Experience 1965-2002)
SHORT HISTORY OF SINGAPORE
Singapore is an island situated at the tip of the Malayan peninsular. Its strategic position, bisecting the Straits of Malacca and the South China sea made it an important trading post since the 12th century. However the modern history of Singapore is accepted to have begun in 1819 with the founding of the colonial trading outpost for the British by Sir Stamford Raffles. It rapidly developed as trade increased between the east and the British in the 19th and 20th century. After World War II and with the changing world political climate and the movement for independence, Singapore with Malaya, Sabah and Sarawak shed their colonial past and gained independence under the flag of Malaysia in 1963.
Unfortunately after a short turbulent relationship Singapore became an independent island state Republic in 1965. We have therefore been an independent sovereign state for only about 40 years.
The population of Singapore is made up of people who migrated from the South East Asian region, India and China. The present ethnic composition is approximately 70% Chinese, 15% Malays, 8% Indians and the rest Eurasians and Europeans. The composition of the population and the type of early migrants had an influence on the demand for veterinary services in the early 60's and 70's.
FROM TRISHAW TO BMW's (1965-2002)
Singapore in 1965, at the time of independence was economically dependent on entreport trade and the provision of services to the British armed forces. These were the naval base in Sembawang and the air force, based in Changi and Seletar.
The income generated from servicing the British accounted for 20-25% of our annual income.
The country in the 1960's had an unemployment rate of 15%, low literacy rate and one of the highest birth rates in the world.
The Per Capita income was US$ 500/Per Annum in 1965.
The social and economic divide between the rich and poor was very wide and contributed to political instability and negligible economic growth.
It had all the normal profiling of a 3rd world society and economy. The tallest building in 1964 was the Asia Building that dominated the skyline with a total 12 storey height.
Within 40 years, Singapore in 2002 had a Per Capita income of US $20,000/annum. The skyline has changed. The economy is now very diversified.
The literacy rate in Singapore in 1965 was about 45%. Literacy rate in 2002 is 90%. In 1973 there were 21,000 licensed dogs in Singapore. This does not reflect the total dog population but only the ones that the public had bothered to register and also probably those that would be sent for treatment. Veterinary work in the 60's and 70's was almost 90% performed on dogs. The feline patients were not that many. In the 60's and 70's there were 3 veterinary practices providing for veterinary care for domestic pets in Singapore. 2 were private practices and the other was the Animal Infirmary. The Animal Infirmary saw about 75% of all the cases and the other 25% were seen by the other 2 private vets.
The Animal Infirmary started work under the colonial city council. It was started on the behest of wives of the Colonial Civil Servants. In 2002 there are about 40,000 licensed dogs in Singapore and about 20 veterinary practices. There are about 35 veterinarians in practice. The cat population is not registered but in most practices felines make up about 30-35% of our patients.
FISHING NYLON TO PDS
The early 70's saw a rapid change in the economic development of Singapore and the GDP was growing at a rate of 12-15%. The general population was moving from a subsistence level to one with disposable income. With rising living standards, Companion Animals also benefited.
The pet owning population are now able to afford to pay more for medical and surgical treatment. Likewise with the rising veterinary fees it was possible to invest in better equipment and more lab tests and medical procedures. For example clinics could afford to invest in proper autoclaves instead of using pressure cookers. Black & Decker drills were replaced by Synthes air drills. Fishing nylon used for stitching were replaced with PDS. At the same time with better education owners became more demanding of the quality of veterinary care.
At the present there are 18 practices in Singapore with about 40 veterinarians involved in Companion animal work. Singapore does not have a veterinary college and students are sent abroad for veterinary training. In the 1970's all the vets were trained under a scholarship scheme paid for by the government. There were practically no private students as the cost of a veterinary education overseas is very expensive and very few families would have been able to afford the send their children abroad. Today the majority of veterinarians returning are privately funded students. We are expecting about 6-10 students graduating annually in the next 5-8 years.
With this growing pool of professional talent we should expect growing competition and with it an improvement of veterinary care. In the 1960-80's it was basic medical care that was being provided. Common infectious diseases like distemper, hepatitis and the tick borne diseases were rife. Today there is more and more concentration on preventive medicine and in the past few years geriatric medicine has become important as pets live into ripe old age. Average life span of dogs was about 8-9 in the 1960's and 70's.Today it is not uncommon to see patients well past 14 years old.
THE FUTURE OF SMALL ANIMAL PRACTICE IN SINGAPORE
The veterinary profession is today a recognised and well accepted profession in Singapore. Companion animals are no longer pets but now members of the family in a growing number of homes in Singapore. The veterinary care demanded of the profession is constantly being challenged. Most families in Singapore today are linked to the internet and with this tool are able to gather information on the latest medical and surgical care available for their pets.
Singapore has a disadvantage of having only a small pool of practising veterinarians. With the present number of about 35 the total number is but only a third of a normal graduating class in any veterinary college. This disadvantage is compensated by the fact that they are trained and graduated from established veterinary schools. These are mainly from the UK, Australia or USA. For the next 5-10 years we should see on average about 8-10 Singaporeans returning to join the profession. We will then see a move similar to that in the developed countries where vets will see less patients but there will be more thorough work up for each patient. The better management of patients will see a corresponding increase of veterinary costs. However the demand for quality veterinary care will expedite this trend. More use will be made of the internet and teleconferencing will become the norm. Referrals will be made in this way to specialists globally.
Specialist surgeons will make routine visits until such time that we can develop a team of specialist surgeons. This is in fact already happening and the next hospital that I hope to design and build will be taking into account this trend.
The challenges for the veterinary profession in Singapore will be great in the 21st century but I am confident the young vets will be able to help carry this noble profession forward.