The Road Less Travelled
After 15 years of rural medical service in Yunnan, China, Dr Tan Lai Yong, with his wife and teenaged children, returned to a more modern and crowded Singapore. He brought home a different perspective of life choices —and his choice is to celebrate each day.
By Kim Lee
Go to the people. Live with them. Learn from them.” This quote from the philosopher Lao Tzu is something Dr Tan Lai Yong appears to live by. Foregoing a predictably comfortable life in Singapore, the medical doctor chose to serve the needy by living among them in the Thai-speaking part of southern China. His one-year volunteer stint in 1996 opened an exceptional chapter in his life, not least because it turned into a 15-year epic. He joined a commune in Yunnan to train its minority ethnic community in basic medical practice as Clinical Lecturer at Kunming Medical Centre. Here, he helped treat the poor, the orphaned, the disabled and the leprous. He extended his work beyond basic medical practice in the community to forge links of friendship between Singapore and China with doctors and other professional groups, initiated a tree-planting programme, and started a mobile library for children. This and more earned him the China National Day Friendship Award in 2004, bestowed on foreign experts for outstanding contributions to the country’s economic and social progress; and the Yunnan TV Good Citizen of Kunming Award in 2007.
Accolades aside, he remains an unassuming if straight-talking individual. He returned to Singapore in 2011, and after getting a scholarship for a year at the Lee Kuan Yew School of Public Policy, he is now an NUS Resident Fellow focused on outreach and community engagement. He continues to volunteer.
SG: Can you describe some of the work that you have done, and the difference you made with it?
Dr Tan: When I was in China, I started the day by looking at all the issues, and they looked huge. For example, when the Singapore medical teams come to do cleft palates, we could get 50 kids coming in with all sorts of problems. You start worrying from the day they leave the village to see you, especially those who are leaving for the first time and have not travelled in a bus before. Then there are infections and undiagnosed tuberculosis among families…. It is tough and I would wonder why I was doing this. But it certainly makes a difference to the patient and his family, and the team learns and grows. And there are the people on the fringe of the team, like the cooks, who see these villagers and visiting medical teams coming in. At the end of the day, they come up to you with one free meal and say: “This is our donation.” So we have to make this work. You are grateful you’ve put to good use the skills and money you have, and changed lives.
SG: What helped you to cross the cultural barriers to develop the community?
Dr Tan: From what people have said, the programme was quite successful. So we got a little bit famous. China in the late 1990s was really developing. All sorts of organisations were coming to run similar programmes. People visited and everybody was always asking me the same things: “What’s the budget? What’s the outcome? What’s the planning process?” I thought they were missing the point — but one Malaysian doctor said, “I can read about the budgets and the rest. Tell me, who are your friends?”
He was the first person who understood that when we talk about community development, the people need to understand that you are not there to do a research paper and disappear after you get your PhD. They need to know that you are there for the long run.
Once they discover that you are loyal, not there to embarrass them or take pictures of the deplorable orphanages or hospitals, but that you are there to go through the difficult times with them and to celebrate life with them, then it works.
With a loyal, trusting relationship, the people will do many things for you. The budgets and the KPIs are secondary.
SG: How does being a Singaporean affect the way you work, your ethics and perspectives?
Dr Tan: It was our aim, when my wife and I were younger, to work with a needy community. The rich can afford access to medicine. With every vacation we took in the eight years I worked as a doctor in Singapore, my wife and I would visit other countries — Sri Lanka, Taiwan — and I would ask, “Can I work here? Three years, five years?” In Singapore, I worked with the prison service, volunteered with the Ling Kwang Home for Senior Citizens, and went to community centres to run clinics. We can do it here, or we can do it in a country that is more needy.
As a Singapore doctor, I have a choice to work with the very poor or the very rich, or a choice to study. I had Filipino doctors who really wanted to work with the poor with me but they didn’t have the financial resources. Really, if you are born in Singapore, you’ve hit the jackpot. If I had been born in China, I would probably be a farmer. The average IQ in the universities is 130 — how am I going to match that? So the fact that I had an education meant I had choices, and it is a privilege for Singaporeans to have that kind of choice. The Singapore government says there is no social safety net, but we have a safety net of economic development. This is important. I was able to go to China because we had this financial base. But the lesson is if you take away some, not all, of the perceived safety nets, you might realise that’s what they were, nets that trap. When we take away some of the safety nets, you realise you can grow. So let us not be trapped by it.
SG: What does public recognition mean to you?
Dr Tan: They are an honour and I am very grateful. It is affirmation for the work I am doing, and affirmation for my family and for the team. On the other hand, they are also a sobering reminder.
They say you trained 500 village doctors so China gives you this National Day honour, but in your heart, you realise there are another 5000 who are not trained yet, and this is just within the region I was living. So awards are just awards, lah.
SG: Why did you come back?
Dr Tan: I had been there 14 years. My Chinese is not good enough and the disease pattern had changed — from typhoid prevention and vaccinations to more lifestyle diseases like hypertension and diabetes. You need the right protocols for them and more teamwork. You need to be trainer of the trainers. I’m a doer, not a leader. I can describe a grand vision and go off and do it myself — and I will be happy with that. So a younger team needs to come, with better Chinese, better training in systems and computers. I don’t do spreadsheets or flowcharts, I still use pieces of paper, and cut and paste.
Then there is due diligence. After you have been at something for some time, there is a tendency to take shortcuts. But there are risks in that. It means that I don’t do a proper situation analysis or budgeting, and that habit is not good for the team. You will not achieve excellence and you could get into trouble. It’s why famous musicians keep practising the scales — because it is foundation work. I realised I was not doing the scales, and that was one more reason to come back. Another reason is my children. They have grown up in China and become teenagers, and I had to ask which is their country of adoption, Singapore or China? They wanted to be Chinese. But China would not give them a passport, and I thought they were studying too hard — my daughter went to school from morning to night, spent three to four hours on homework, and six days a week in school. I told her it was time to go back because I wanted her to be more than a bookworm. She asked, “What is wrong? Millions of Chinese do this.” I said, “One of my main reasons for sending you to school instead of homeschooling you is that I need you to have friends for life. You will achieve much better results if homeschooled, but your grades may not carry you through your life. Your friends will.”
This was also the reason I didn’t put them into an international school. It is very good, but every semester there is a farewell or a hello party as parents are reposted. You don’t get friends for life. This is our guiding value as a family.
SG: How do you see the heart and soul of Singapore?
Dr Tan: I think we have lost a bit of the soul because we blame others as a community. It comes from the present mood of malaise in Singapore and I fear that people are using it for political gain — instead of trying to build trust, they are building distrust. It is a good strategy to remove political opponents, but it is not a good strategy to build community.
SG: How much has Singapore changed?
Dr Tan: Singapore today is very crowded — more competition, income divide, ageing population, more strangers within our midst, more cyberspace social media activity. On coming back and looking back, I see that the world is changing, and you may not want a government that prevents inflation or global migration. Look at the US-Mexican border. They tried to close it. There is no migration policy but there is an economic magnet, a dream magnet — and people will come.
SG: What Singapore values do you champion or think we need to change, to learn?
Dr Tan: Singapore has values but we don’t celebrate them enough. For example,
how many countries in the world have so many races living together? I don’t know about integration, but just different races living together and not pointing a gun at each other — we have to value that.
It is one of the reasons why I brought my kids back, because even though they were living in a very international environment — the team was very international because we work with different ethnic races — ultimately it is “Sino-sized”. I want my kids to learn Malay. I want them to have Indian friends, I want them to see a multicultural aspect of life.
SG: Do you see Singapore as a thought-leader or trailblazer?
Dr Tan: No. I think we are just a well-run country.
SG: Do you think social responsibility has a future in Singapore?
Dr Tan: In a settled rural community, character, values and personality will shine because you observe a person for 10 or 20 years. You’ll know if this is a steadfast guy or an honest woman. Social responsibility in a small community hinges on people like that — they are the role models, they set the standards, and community builds around such people. In an urban society, there is high mobility, people move and change jobs, and things have to get done in a short time. We don’t have time to see character surface, so we use performance in presentation and projects as substitutes to determine worth. Social responsibility becomes one of those things that have to get done. So I think it is sensible to have community involvement projects — service learning, social responsibility — and make it part of the habitual DNA of our citizens.
You may complain that people are not doing it with their heart. Well, I see most of my patients with a combination of duty, a sense of reward that they will pay me, a sense of fear if they should sue me, and a sense of compassion…that’s how it comes together. So I think it is decent to get our schools and companies to teach social responsibility and lay the foundation and see where it goes. It is better than saying don’t do it if you’re not doing it from the heart.
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