Friday 13 May 2016

Finance Minister Heng Swee Keat suffers stroke








Heng Swee Keat's 'miraculous, quick recovery'
Discharged from hospital six weeks after a stroke, he says doctors in Cabinet saved his life
By Rachel Au-Yong, The Sunday Times, 26 Jun 2016

Finance Minister Heng Swee Keat was discharged from hospital yesterday, six weeks after collapsing from a stroke that saw him placed in intensive care, in what was described as a remarkable recovery.

In his first public statement since then, he said: "Home! The last few weeks were the toughest of my life." He acknowledged the outpouring of concern from the public, the work of doctors and nurses, as well as the help of the paramedics who had rushed him to hospital.

"I could get through this time because of the strong support from my family, great medical care, and the kindness from all of you," he said yesterday in a Facebook post.

A minute-long video accompanying the post shows a slimmer Mr Heng looking cheerful as he walks around thanking his medical team.

In announcing his discharge, the Prime Minister's Office (PMO) said that Mr Heng "has made an excellent recovery".



Foreign Minister Vivian Balakrishnan echoed this, writing in a Facebook post: "I would not have dared to hope for such a miraculous quick recovery on that fateful evening as we discussed the emergency treatment options."

He had, together with Defence Minister Ng Eng Hen and Minister of State Janil Puthucheary - all doctors - attended to Mr Heng when he collapsed during a Cabinet meeting on May 12 from a stroke due to an aneurysm, a localised weakening of a blood vessel.

In a text message to his fellow Tampines GRC MPs, Mr Heng said that he has "recovered most of his functions".

But he is still on medical leave as he continues his rehabilitation, and Deputy Prime Minister Tharman Shanmugaratnam will continue to cover his duties in the Finance Ministry, said the PMO.

Doctors who spoke to The Sunday Times said it would typically take three to six months for a stroke patient to recover fully.

Mr Heng underwent successful endovascular coil embolisation - surgery to seal off the aneurysm on the same day of the stroke - said the PMO. He was also treated with antibiotics for a lung infection.

In his Facebook post, he said he was grateful for all the help he had received. "If not for the critical help of many people, including my colleagues in Cabinet on the day of my stroke, I wouldn't be here now."

He also singled out the staff of Tan Tock Seng Hospital, the National Neuroscience Institute and the Singapore Civil Defence Force.

He added that he was touched by the various religious groups that organised prayer sessions for him and the people who sent him messages, cards and flowers.

"It was not just about medical care. One more thing made a difference... all your prayers and good wishes," he said adding that he had received their wishes and gifts.

To his Tampines GRC MPs and colleagues, who pitched in to make sure that residents in his ward were cared for, he said: "This is true team spirit, thank you."

News of his discharge was welcomed by colleagues and Singaporeans, who took to social media to ask him to focus on his recovery.

Prime Minister Lee Hsien Loong, who had provided updates on Mr Heng's condition over the weeks, said in a Facebook post: "I know from personal experience that recovering from serious illnesses takes time. I have advised Swee Keat to take things step by step. No constant checking of his e-mail or his phone!"

Mr Lee recovered from prostate cancer last year, and lymphoma in 1993.

President Tony Tan Keng Yam said he had heard from Mr Heng in a personal letter and was glad he was doing better.

Mr Heng said: "I look forward to when I can see everyone again."








Minister Heng Swee Keat lucky to get immediate attention
Private doctors attribute good outcome to rapid diagnosis and solid care at hospital
By Salma Khalik, Senior Health Correspondent, The Sunday Times, 26 Jun 2016

The speed and nature of Finance Minister Heng Swee Keat's recovery from a stroke six weeks ago which required emergency surgery have surprised the medical community, with doctors paying tribute to the immediate attention he got and the care he received at Tan Tock Seng Hospital (TTSH).

It is a "spectacular recovery, given the bad shape he was in when admitted", said Dr Lee Kim En, a neurologist in private practice, after watching the video posted on Mr Heng's Facebook page showing him thanking TTSH staff. Mr Heng was discharged from hospital yesterday.



Around half of those who suffer bad bleeding in the brain would never leave hospital, Dr Lee said. Only about 10 to 15 per cent would recover well enough to return to a normal life. Fellow neurologist Ng Puay Yong agreed that the recovery was "very, very good", especially given the possible complications.

He believes that the help Mr Heng was given when he collapsed during a Cabinet meeting on May 12 was vital in his recovery, since four minutes without oxygen could mean permanent damage to the brain.

Dr Janil Puthucheary, Minister of State for Education and Communications and Information, who was present during the meeting, began resuscitation efforts while waiting for the ambulance. He is a paediatrician who became an MP in 2011.

Foreign Minister Vivian Balakrishnan, who was an eye surgeon before he entered politics, and Defence Minister Ng Eng Hen, a cancer surgeon by training, also tended to Mr Heng when he collapsed.

The team from the Singapore Civil Defence Force responded within seven minutes of the 995 call.

Dr Lee said other factors that helped Mr Heng recover were the "rapid diagnosis, decisive treatment to secure the rupture... and solid neurocritical care in the first weeks". A second bleeding would have been dire, he said.

It is likely that Mr Heng was put into an induced coma, to reduce brain activity and the need for oxygen. Dr Lee said in general, this could be anything from one to three weeks. During this time, his organs, such as the heart, lungs, liver and kidneys, needed artificial support to keep them oxygenated and healthy.

Dr Lee said Mr Heng was fortunate that the bleeding could be stopped with a coil, which requires minimally invasive treatment, rather than open surgery.

Both doctors noticed a plaster on Mr Heng's throat and believe he had a tracheostomy, or a cut in the windpipe, to keep his lungs ventilated. Dr Ng said this is usually done if the patient needs a tube down the throat for more than five days, to save the vocal cords. Damage to the cords could result in a hoarse voice. Once the tube is taken out, the hole will heal itself, but a scar might remain.

Mr Heng developed a lung infection in hospital, but Dr Ong Kian Chung, a respiratory specialist, said this is not surprising.

In patients who are unconscious for more than two hours, saliva may settle to the bottom of the lungs, causing pneumonia, which would be treated with antibiotics.

But this could leave scarring in the lungs. "The scars may or may not be permanent. A year from now, they may be smaller, or even have disappeared totally," Dr Ong explained.

Dr Lee said most patients will need three to six months to recover from a stroke. During this time, they would need physical, emotional and cognitive rehabilitation. He said Mr Heng would have lost muscle mass, and this needs to be recovered.

Dr Ng added it is difficult to assess how well the brain has recovered, but said cognitive ability can continue to improve over two to three years. Both neurologists said Mr Heng will need to go for six- monthly MRI scans to check for a possible second aneurysm. But Dr Ng said the risk is low, at about 1 per cent over 10 years.

All three doctors, who have clinics at Mount Elizabeth Medical Centre, were not involved in Mr Heng's treatment.






* Heng Swee Keat recovering well and making steady progress: PM Lee Hsien Loong - 30 May 2016




Heng Swee Keat undergoes surgery after stroke
He collapses during Cabinet meeting; Tharman will cover as Finance Minister
By Charissa Yong, The Straits Times, 13 May 2016

Finance Minister Heng Swee Keat, 54, underwent emergency brain surgery at Tan Tock Seng Hospital (TTSH) last night after collapsing suddenly from a stroke during a weekly Cabinet meeting.

Deputy Prime Minister Tharman Shanmugaratnam is covering his duties as Finance Minister, said the Prime Minister's Office (PMO) in a statement yesterday.

His sudden stroke was due to an aneurysm, which is a localised weakening of a blood vessel.

He underwent initial neurosurgery to relieve pressure in his brain due to the bleeding. The aneurysm was successfully closed, the statement added.

Mr Heng will remain under close monitoring in the intensive care unit at TTSH.

Earlier, Cabinet ministers in Facebook posts described what had happened when he collapsed.

He was immediately attended to by three doctors in Cabinet: Defence Minister Ng Eng Hen, Foreign Minister Vivian Balakrishnan and Minister of State Janil Puthucheary. Dr Ng, a former cancer surgeon, later said they managed to resuscitate him.

An ambulance then took him to the hospital where a CT scan showed he had a stroke.




Law and Home Affairs Minister K. Shanmugam, who had been working closely with Mr Heng, said he had looked very tired.

"I have been telling him that he was overworking so much that it will affect his health,'' he added.

The announcement of Mr Heng's stroke triggered an outpouring of good wishes online by MPs, politicians from across the political spectrum, businessmen and ordinary Singaporeans.

"Hope Swee Keat will be alright - he is a valuable member of my team," wrote Prime Minister Lee Hsien Loong on Facebook.

Mr Tharman said: "Let's hope and pray for Heng Swee Keat. He is one of Singapore's finest sons, and a leader with much promise."

Said DBS chief executive officer Piyush Gupta: "Swee Keat has had a close association with the banking industry, through his role as managing director of the Monetary Authority of Singapore and now as Minister for Finance.

"His ideas for transforming the future economy of Singapore are bold, and we wish him a speedy recovery."



Parliamentary Secretary Amrin Amin told The Straits Times that Mr Heng "appeared to be in good health" when they met around 3 to 4pm, before the Cabinet meeting.

His sudden collapse in Cabinet at 5.34pm was announced in a brief statement at 6.57pm by the PMO.

Fifteen minutes later, PM Lee said on Facebook that doctors at TTSH were attending to Mr Heng.

Doctors contacted yesterday declined to comment, saying it would not be appropriate as they had no information on the situation.



Mr Heng, a core member of the fourth generation of political leaders, has been identified as a potential prime minister by some analysts, who pointed to the major initiatives he has undertaken and the heavyweight ministries he has helmed in the past few years.

"Minister Heng is widely regarded as being among the front runners to succeed PM Lee," said law don and former Nominated MP Eugene Tan, who added: "I don't recall any medical emergency during a Cabinet meeting. A poignant reminder of the demands placed on office-holders."



Mr Heng entered politics about five years ago and, in a rare move, was appointed a full minister on being elected in 2011, holding the education portfolio.

After last September's general election, he was made Finance Minister and presented his maiden Budget on March 24.

He also chairs the crucial Committee on the Future Economy that is charting ways to restructure the economy to keep Singapore competitive and thriving.

He has led several major initiatives, including heading the committee that oversaw the events to celebrate Singapore's 50 years of independence. He also headed the Our Singapore Conversation series of dialogues to get people to talk about the kind of Singapore they want in 20 years' time.

At Tampines GRC, other MPs will look after his ward, said fellow MP Masagos Zulkifli, the Environment and Water Resources Minister.

Mr Heng has two children with his wife Chang Hwee Nee, a deputy secretary at the Ministry of National Development.

Housewife Leong Choi Van, 61, a long-time Tampines resident who was shocked at the news, said: "Mr Heng has been an MP here for six years, so we know him well.

"I really hope he gets well soon."

Additional reporting by Chong Zi Liang and Rachel Au-Yong






* Heng Swee Keat recovering well and making steady progress, says PM Lee Hsien Loong
By Sanjay Nair, The Straits Times, 31 May 2016

Finance Minister Heng Swee Keat, who suffered a stroke earlier this month, is recovering well and making steady progress, Prime Minister Lee Hsien Loong said last night.

Mr Heng was "fully lucid, communicative, and cheerful", he said in a Facebook post after visiting him at Tan Tock Seng Hospital's (TTSH) intensive care unit in the evening.

PM Lee said doctors "are happy too" but had advised Mr Heng not to receive visitors yet so that he can get as much rest as possible.

"I told him we had made arrangements to look after his residents in Tampines while he recuperates. He gave me two thumbs up," he wrote.


Mr Heng, 54, is an MP for Tampines GRC.

"Swee Keat wants to thank everyone for their support. He especially sends his greetings and best wishes to his Tampines residents and volunteers, who have been asking after him," Mr Lee added.

Mr Heng collapsed during a Cabinet meeting on May 12 after suffering a stroke. He was taken to TTSH where doctors successfully closed a ruptured aneurysm that caused bleeding in his brain.

Ministers and MPs were relieved to hear Mr Heng is recovering well.

Minister in the Prime Minister's Office Chan Chun Sing said he updated activists helping Mr Heng on his condition, and thanked them for taking care of the residents.

Tampines GRC MP Baey Yam Keng, who was with activists from Mr Heng's Tampines Central ward when Mr Lee shared the good news, said on Facebook: "We are relieved and happy to learn that Minister Heng is recovering well. Two thumbs back to wish him all the best!"






























Heng Swee Keat carrying 'incredible load' as key Cabinet player
Finance Minister's many responsibilities include charting S'pore's economic future
By Rachel Au-Yong, The Straits Times, 13 May 2016

Finance Minister Heng Swee Keat, who suffered a stroke yesterday, had been shouldering an "incredible load" as a key figure in the Cabinet.

In a Facebook post yesterday, Prime Minister Lee Hsien Loong described him as a "valuable member of my team".

Deputy Prime Minister Tharman Shanmugaratnam called Mr Heng "one of Singapore's finest sons, and a leader with much promise".

Home Affairs and Law Minister K. Shanmugam pointed to the heavy workload Mr Heng was shouldering, which included charting a path for the country's economic future.

In a Facebook post, Mr Shanmugam noted that Mr Heng "was carrying an incredible load, handling the Finance Ministry, various important projects, including SG50, and the Committee for Future Economy (CFE) - this Committee has the crucial task of charting our economic future". He said he could see that Mr Heng "was very tired", adding: "I have been telling him that he was overworking so much that it will affect his health."



A key member of the fourth generation of leadership, Mr Heng joined the Government after the 2011 General Election and helmed the weighty Education portfolio before moving to Finance in the new Cabinet formed after the 2015 General Election.

Dr Gillian Koh, the Institute of Policy Studies' deputy director for research, said: "Mr Heng has made valuable contributions not only to the Government, but also to many in society, like the business groups.

"They would recognise his contributions to their lives and certainly look forward to more of that."

Mr Heng delivered his maiden Budget statement in March, which observers said provided boosts for small and medium-sized firms in an uncertain economic climate. And as head of the CFE, he is responsible for looking into Singapore's next stage of economic development.

Mr Heng was in Frankfurt, Germany, last week to attend a three-day meeting of finance ministers and central bank governors of Asean, China, Japan and South Korea.

Mr Liang Eng Hwa, who chairs the Government Parliamentary Committee for Finance and works with Mr Heng, said that despite his busy schedule, Mr Heng "made every effort to attend engagement functions organised by both business leaders and the grassroots, to know the ground better".

Observers have said Mr Heng was earmarked as a potential prime minister from the start.

After he was elected, he was immediately appointed a full minister - only the second time a new MP had been catapulted straight into Cabinet. He was also given other high-profile appointments on top of his heavyweight portfolios.

Last year, he headed the steering committee that oversaw the SG50 Jubilee celebrations. He also led the year-long Our Singapore Conversation series of dialogues in 2013.

Within the People's Action Party, he was one of two fourth-generation leaders given key roles after last September's General Election. PM Lee tasked him with analysing the party's GE2015 performance, and he was also alternate chairman of the party headquarters' executive committee.

Mr Heng is the anchor minister for Tampines GRC, chairing monthly GRC meetings and the advisory board for an upcoming sports and lifestyle hub in Tampines.

Fellow GRC MP Desmond Choo said Mr Heng's residents will be taken care of by the other four MPs.

"Tampines GRC advisers have always worked as a team. While Mr Heng recovers, we will take care of his residents," he said, adding that a pre-school education fair this weekend that Mr Heng started will continue."That is what he would want."





























Wishes for a quick recovery from all quarters
By Tham Yuen-C, Assistant Political Editor, The Straits Times, 13 May 2016

Get-well messages poured in from Singaporeans and politicians yesterday for Finance Minister Heng Swee Keat, after news broke that he had suffered a stroke and collapsed at a Cabinet meeting.

Many, in comments on his Facebook page, wished him a fast recovery, with some also noting that he had been working very hard.

Facebook user DrMo Aris said in a comment on Mr Heng's Facebook page that he had just met the minister "the other day" at a coffee shop in Tampines. Mr Heng is an MP for Tampines GRC. Ms Candice Ling, in a Facebook comment, said: "Get well soon, Mr Heng! Do have a good rest before you return to work."

Ministers and MPs expressed concern for their colleague, with Speaker of Parliament Halimah Yacob saying in a Facebook post: "A thoughtful and patient man, deeply committed to Singapore, let's pray for his speedy recovery."

Parliamentary Secretary for Culture, Community and Youth Baey Yam Keng, who is also an MP for Tampines GRC, said Mr Heng had looked his usual self at lunch yesterday before the Cabinet meeting.

He added: "He's been handling a lot of big projects for the last few years. So it has taken a toll on him."

Marine Parade GRC MP Seah Kian Peng, who had spoken to Mr Heng on Monday, said: "He is a dear friend whom I have known since our school days. Let us all pray for a speedy recovery for Swee Keat."

Opposition parties and politicians, including leaders from the Workers' Party (WP), Singapore Democratic Party and Reform Party (RP), also took to Facebook to wish Mr Heng well. RP secretary-general Kenneth Jeyaretnam, who knew Mr Heng when they both studied economics at Cambridge University, said: "He and his family are in our thoughts and we send our best wishes for a speedy and full recovery."

But Nominated MP Kuik Shiao-Yin noted that some comments online - such as those wondering whether there would be a by-election - were "indecent and appalling".

"So I really appreciate opposition politicians like WP's Daniel Goh and other opposition supporters who have personally stepped into their party's (Facebook) comment sections to call out bad behaviour and uphold standards of civil discourse. That's good leadership and simple human decency," she said.

Mr Heng entered politics in 2011 and had helmed the Education Ministry from then until last year, when he was made Finance Minister. Messages of concern and hopes for his quick recovery streamed in from those who knew him in both roles.

Singapore Business Federation chairman Teo Siong Seng, who had just seen Mr Heng on Wednesday night at a post-Budget meeting, said Mr Heng was "his usual self, very calm, didn't look tired".

Citibank Singapore chief executive Han Kwee Juan, who is on the Committee on the Future Economy Mr Heng chairs, said the minister has been "passionate on exploring all possible ideas and driving the agenda to develop strategies to position Singapore well for the future".

Bert Wong, in a post on Mr Heng's Facebook page, said: "All teachers appreciate who you have been for the fraternity - always giving us the most human side of you and striving for what education truly is!"





Causes and symptoms
By Linette Lai, The Straits Times, 13 May 2016

WHAT IS A STROKE?

Strokes occur when blood supply to part of the brain is cut off, and cells in that part die.

There are two types of strokes. Ischaemic strokes are caused by blood clots in the brain. Haemorrhagic strokes happen when a blood vessel in the brain bursts, leading to bleeding in the brain.

People can also get what is known as a transient ischaemic attack, when blood supply to part of the brain is temporarily cut off. This causes symptoms similar to those of a stroke, which may last for a few seconds or up to a day.





WHAT CAUSES A STROKE?

Chronic conditions such as high blood pressure and high cholesterol can increase the risk of a stroke.

Diabetics and smokers have a higher stroke risk, as do people with a family history of strokes.

Stress can also increase the chances of suffering from a stroke.




WHAT ARE THE SYMPTOMS?

One of the key signs of a stroke is sudden weakness or numbness, usually on one side of the body.

A stroke victim may also have slurred speech and sudden difficulty in seeing out of one or both eyes. Other symptoms include difficulty swallowing, dizziness, a sudden severe headache, or a sudden loss of consciousness.

WHAT HAPPENS AFTER A STROKE?

Those who have had a stroke typically have problems with moving around or swallowing, and will need rehabilitation.

Up to a third of stroke patients make a full recovery. The remaining two-thirds have some residual disability. Most of the recovery occurs in the first three to six months following a stroke, but may continue slowly for many years.

Sources: Health Promotion Board, Singapore National Stroke Association, National Neuroscience Institute




























Prayers and good wishes for Heng's recovery
Many people leave cards and flowers at hospital; religious leaders pray for him
By Calvin Yang and Aw Cheng Wei, The Straits Times, 14 May 2016

Religious leaders of various faiths gathered at the Inter-Religious Organisation (IRO) headquarters yesterday evening to pray for a speedy recovery for Finance Minister Heng Swee Keat, who collapsed from a stroke at a weekly Cabinet meeting on Thursday.

They were among Singaporeans conveying their good wishes throughout the day for Mr Heng, who remains in the intensive care unit (ICU) at Tan Tock Seng Hospital (TTSH). Many had also gone to the hospital to leave get-well cards, flowers and gifts for him.

Mr Foo Check Woo, 60, president of the IRO and a representative of the Baha'i faith, said: "We thought that it was only appropriate for us to come together as an inter-faith community to pray for his quick recovery."

They were joined by Deputy Prime Minister Tharman Shanmugaratnam and Parliamentary Secretary for Culture, Community and Youth Baey Yam Keng.

Mr Tharman described Mr Heng as "someone who has the ability to work with everyone - people of different faiths, people of different ethnic groups, people from all walks of life".

"He represents the best in Singapore - something we all aspire to be," he said.

Since news of Mr Heng's stroke broke on Thursday evening, his Cabinet and parliamentary colleagues had also spoken of his commitment to his work.

Mr Baey, Mr Heng's fellow MP in Tampines GRC, told reporters that Mr Heng had been giving out carnations to residents at community events last weekend. "We all know he has heavy responsibilities as a minister. He travels quite a lot and yet, he spends time in his constituency," he said.

Tampines residents Kathy Goh, 31, and Janessa Thng, 30, who went to TTSH after work to leave flowers and a card, were among those who have often seen Mr Heng around the constituency.

Ms Thng, an Institute of Technical Education lecturer, said: "Seeing how hard-working he is, how much effort he has put in... we hope for his speedy recovery."



Prominent businessman A.R. Jumabhoy, from Scotts Group, also went to TTSH. The nonagenarian, who met Mr Heng last week at a meeting, said he was shocked to hear Mr Heng had taken ill.

"He is a very fine man... serving the public (and) serving the people", he said.

Others who showed up at the hospital included Gardens by the Bay chief operating officer Felix Loh and Poi Ching School vice-principal Esther See.

There was also teenager Sean Bay, who thanked Mr Heng for his work as Education Minister from 2011 until last year.

"You did a very good job... especially encouraging teachers not to be too strict (with) their students during exam time. I will do my best to do well in my studies and to be hard-working," he wrote on a get-well card.

The outpouring of good wishes continued online, with Facebook posts from opposition parties such as the National Solidarity Party and SingFirst, and politicians, including Singapore People's Party's Chiam See Tong and his wife Lina Chiam.

Foreign Minister Vivian Balakrishnan said on Facebook: "Glad that Swee Keat is stable after the successful procedures yesterday.

"But these are early days and he will need close monitoring in the ICU for quite some time more. His wife and children are holding up well and grateful for your prayers and support."





Tampines GRC MPs will help care for all residents
By Lim Yan Liang, The Sunday Times, 15 May 2016

All four other MPs for Tampines GRC will step up to take care of residents in Finance Minister Heng Swee Keat's ward while he recovers from a stroke, Environment and Water Resources Minister Masagos Zulkifli said yesterday. Former Tampines GRC MP Sin Boon Ann will also be helping out, he added.

"We all pray for his recovery," Mr Masagos told residents and reporters at a pre-school education fair in Tampines. "In the meantime in Tampines, my colleagues - Yam Keng, Li Hui and Desmond - and I will be serving the whole of Tampines, particularly also to cover for Mr Heng while he is recovering."

The other MPs are Parliamentary Secretary for Culture, Community and Youth Baey Yam Keng, Mr Desmond Choo and Ms Cheng Li Hui.

Meanwhile, Mr Sin, who was a Tampines GRC MP from 1997 to 2011, will be made second adviser to Tampines Central grassroots organisations, Mr Masagos said. Mr Sin will also be named as deputy chairman of the People's Action Party's Tampines Central Branch which Mr Heng chairs, PAP headquarters executive director Alex Yam said in a Facebook post yesterday.

Mr Masagos said Mr Sin agreed to come on board to assist the grassroots groups and some 48,000 residents in Mr Heng's ward, as well as oversee Mr Heng's weekly Meet-the-People Sessions (MPS).

"Mr Heng's branch will continue to operate, and Mr Sin will be there to help oversee the running of the MPS," he added.


The latest update on Mr Heng's condition came from President Tony Tan Keng Yam yesterday.

Dr Tan said he was relieved to find that Mr Heng's condition is stable and that he spoke to Mr Heng's wife and two children when he and his wife, Mrs Mary Tan, visited in the evening.

"We will continue to keep Swee Keat and his family in our thoughts and prayers, and wish Swee Keat a speedy and full recovery," Dr Tan wrote in a Facebook post.

At the Tampines event, Mr Sin told reporters that he was approached by Mr Masagos on Friday.

The 58-year-old deputy managing director at law firm Drew and Napier said he has been busy with his practice since he retired from politics, but stepped forward without hesitation when approached to help. "I see this as a duty, and this is something which I am happy to do so that it will put Mr Heng at ease that the needs of the residents are well looked after," he said.

Mr Sin stressed that as second adviser, he will "support the ongoing work of Mr Heng in Tampines Central". "What's important is to continue with his plans that he's set for the grassroots here and for the community as a whole," Mr Sin said.

Mr Masagos, who will anchor the team while Mr Heng recovers, also said the team will ensure that Our Tampines Hub will be launched on schedule by the end of this year.

The 5.3ha project will be the first integrated community and social facility with a hawker centre, a one-stop centre for government services, a community kitchen for seniors, and sports and retail facilities.

"We will make sure it will run on time and give the facilities and services we've promised residents," he said.

Yesterday, residents said they remained hopeful that Mr Heng will recover fully from his stroke.

Pre-school teacher Alice Yap, 68, remembered Mr Heng for often finding time to attend school functions and meet the teachers.

"He's very friendly. He used to always come to our school concerts and events, and would meet us and shake hands with us," she said.

"I've been praying for him, and I hope he recovers swiftly."








PM Lee commends SCDF officers who came to Heng Swee Keat’s aid
Letter of appreciation sent to SCDF commissioner, saying team is a credit to life-saving agency
By Lim Yan Liang and Chew Hui Min, The Sunday Times, 15 May 2016

Prime Minister Lee Hsien Loong yesterday sent a letter of appreciation to Singapore Civil Defence Force (SCDF) Commissioner Eric Yap to thank the paramedics who responded when Finance Minister Heng Swee Keat collapsed during a Cabinet meeting last Thursday.

"They were competent and confident, a credit to the SCDF, the life saving force," Mr Lee said on his Facebook page, where he shared the letter.

He identified the four officers who attended to Mr Heng in the Istana Cabinet room as staff sergeants Janice Lee Yi Ping and Mohd Imran Abd Samad, full-time national serviceman corporal Ian Lok Yu Hern, and trainee Sheena Chiang Yanpin.



In his letter, Mr Lee gave an account of what happened that day, and how Minister of State Janil Puthucheary was critical in coming to Mr Heng's aid. Dr Janil is a paediatrician who became an MP in 2011 and took office in January as Minister of State for Education, and Communications and Information.

Mr Lee said that when Mr Heng, 54, collapsed at 5.34pm, 995 was called at once. The SCDF team responded within seven minutes.

"When they entered the Cabinet room, Dr Janil was already resuscitating Mr Heng using the bag and mask resuscitation kit that the security team had on hand," Mr Lee wrote.

"Seeing that Dr Janil was already managing the patient with the appropriate equipment, the team supported Dr Janil and performed other tasks as per protocol, recording what happened and monitoring the vitals."

Mr Lee noted that SSG Lee had questioned Dr Janil as she saw that he was not following the standard procedure.

"Janice observed that Dr Janil was deviating from the paramedic SOP and appropriately asked him if he was bagging the patient too fast," he wrote. "Dr Janil shared his presumptive diagnosis and explained that he was hyper-ventilating the patient to relieve pressure on the brain and reduce the swelling."

Satisfied with Dr Janil's explanation, SSG Lee continued to support him in maintaining and securing Mr Heng's airway, including assisting him in inserting a laryngeal mask. The SCDF team then took the lead and transferred Mr Heng to an ambulance, which took him to Tan Tock Seng Hospital, with Dr Janil supporting them in the vehicle.

"My colleagues and I observed how your team kept their cool and were in control throughout the incident, working as a team with Dr Janil. Each knew their roles, and all had the presence of mind to stay completely focused on the patient," Mr Lee wrote.

"It is never easy to attend to a resuscitation, and the active involvement of a clinician already on scene can make it more difficult.

"Your team was highly competent and professional, unfazed by their surroundings or the presence of the ministers. They asserted themselves where necessary and played an important role in stabilising the patient," he said.

"Your officers are a credit to SCDF. They reflected the professionalism and sense of mission that they display daily as they go about their duties to protect and save lives and property for a safe and secure Singapore."


Mr Lee's post drew an outpouring of praise and support for the SCDF.

Said Foreign Minister Vivian Balakrishnan, who was at the Cabinet meeting: "We appreciated SSG Janice Lee's willingness to question Janil. It shows that we are a society that doesn't allow protocol or rank to get in the way of performance.

"Janil deserves full credit for saving Heng Swee Keat's life. I believe those precious early minutes made all the difference."

SCDF posted a photo of the four officers on Facebook, and said its emergency responders attend to some 500 calls a day and work tirelessly round the clock "to go about their duties in quiet but impactful ways to save lives and property".

Dr Janil shared Mr Lee's letter as well as SCDF's post on Facebook, where he added: "#SCDF rocks".











*** Heng Swee Keat's first words when out of coma: Is there a Cabinet meeting today?
He scribbled words on paper as he could not speak yet with a tube down his windpipe
By Tham Yuen-C, Assistant Political Editor, The Sunday Times, 18 Dec 2016

When Finance Minister Heng Swee Keat woke up from his coma six days after a severe stroke in May, he could not speak.

The reason: doctors had slid a tube down his windpipe to help him breathe, as he had a lung infection.

Forced to write what he wanted to say, he turned to pen and paper. Among the first words he scribbled: "Is there a Cabinet meeting today? Where are the papers?"

Mr Heng, well known for his dedication to work, was back.

On May 12, during a regular Cabinet meeting, he had collapsed suddenly from a ruptured aneurysm.

Swiftly, he was taken to Tan Tock Seng Hospital, where he had surgery to seal off the localised swelling in the wall of an artery in his brain.

Almost seven months later, Mr Heng, 55, looked none the worse for wear when he gave his first extensive interview last Tuesday.

He was steady in stride and speech, and relaxed as he recounted his experience.

"I am just very grateful that I can resume my functions and I can go back to work," he said. "I've learnt that it is important to stay motivated and to keep trying, even if it means taking it one small step at a time."



It is hard to tell that Mr Heng has had an aneurysm, which kills 40 per cent of sufferers and often leaves survivors with permanent damage.

He has been back at work since August and has not had to change much of his daily routine, other than avoiding crowded places and large meetings while his lungs, weakened by an infection he caught in hospital, are on the mend.

The only giveaway? Slight weight loss.

Making a light-hearted joke about the pink shirt he was wearing, he quipped: "It's one of the shirts which the tailor made more tight-fitting, so I complained. But now it's okay!"

The hour-long interview ranged from the deeply personal experience of his road to recovery to the work of the Committee on the Future Economy, which he chairs.

He was sanguine even when he spoke of difficult moments, like having to learn to swallow food the correct way: It was initially strange to have someone watching while he ate, but "okay, better be safe".

A stroke can damage muscles in the face, throat and neck, and it is not uncommon for stroke patients to experience difficulty swallowing. It can lead to food entering the airway and lungs, causing pneumonia.

But Mr Heng was, however, most at ease when he spoke on the state of the economy, an issue close to his heart.

While he did not return to his office at The Treasury immediately after he was discharged from hospital on June 25, six weeks after his stroke, he had kept abreast of current events in what has turned out to be a challenging year with global terrorism on the rise and a general slowdown of the world economy.

He acknowledged the creeping anxiety among Singaporeans, and pledged to "turn that anxiety into action that will prepare us better for the future".

When he took ill, many wondered if it was excessive work that caused his stroke, with his fellow ministers and MPs pointing to his punishing schedule.

Asked if Prime Minister Lee Hsien Loong had promised to give him less work since the episode, he said: "I won't say that he gave me too much work. That won't be a correct characterisation. He was very, very supportive."

His own doctors had been somewhat surprised about his stroke, given that he had exercised regularly and never exhibited typical risk factors like high blood pressure.

"Whether it's overwork, personally I don't think so. But then, it's difficult to be definitive about such things because some of these things, you may not even feel it," he said. "Some aspects of life are just, you know, unpredictable."

His family had borne the brunt of his stroke during the most difficult moments, when he was "totally unaware of what was happening", he said. But they too had not pressured him to stop working.

"They encourage me to do whatever that I find meaningful... It was not a long discussion on whether I should get back to work," he added.

The minister, identified by PM Lee as a key member of the future leadership team, is tipped to be among the contenders to be the next prime minister, and his stroke had put the spotlight on Singapore's leadership succession plans.

Mr Heng declined to be drawn into discussing whether he would accept the top job if his colleagues wanted him to, saying: "This is a hypothetical question."

He, however, said that to stop serving was never an option.

Helping Singapore to do well is where his priorities continue to lie, and his health scare has not changed that.

"I'm very grateful for what I have in Singapore, and I think it's important that we do our part and continue to create a better future for our people."





Get-well wishes spurred Heng Swee Keat on

By Tham Yuen-C, Assistant Political Editor, The Sunday Times, 18 Dec 2016

People across Singapore and from all walks of life sent wishes for a speedy recovery to Finance Minister Heng Swee Keat after he collapsed from a stroke in May.

Flowers and hampers of chicken essence packed the Heritage Museum at Tan Tock Seng Hospital (TTSH), messages were left on his Facebook page and there were cards and framed artwork by children and adults alike.

The good wishes played a significant part in helping him get well.

Opening up for the first time about his road to recovery, Mr Heng said at an interview on Tuesday: "The support and encouragement I got, from my immediate family members to members of the public whom I don't know personally, were very touching."

"It helps. It made me feel 'Oh, you're a part of something bigger', and that was quite meaningful. It was quite amazing."

In fact, the cards and messages were used to get him back on his feet. Mr Heng was unable to stand on his own after the stroke and he had to do daily exercises to build up strength in his body.

His physiotherapists at the hospital turned to the get-well cards to spur him on. They placed them at eye level so that he could read them only when he stood up.

Another motivator was a miniature of the lion statue that was part of the Future of Us exhibition last year to mark Singapore's 50th year of independence. It was given to him by the team that worked with him on the exhibition.

"I must say, my colleagues, family and friends and the hospital crew were quite creative," he said.

"Initially, it was difficult just to walk a few steps, so my wife used the mini-statue as a medal to motivate me. I got it every time I reached a target she set."

Mr Heng had suffered a ruptured aneurysm on May 12, during a weekly Cabinet meeting.

He said he did not suffer great damage, as fellow office-holders who are trained doctors had begun resuscitation efforts while waiting for the ambulance to make sure his heart continued pumping and he did not stop breathing.

Just four minutes without oxygen could mean permanent damage to the brain.

He was taken to TTSH where he was given a scan right away. Neurosurgeons then performed endovascular coil embolisation on him, a surgery to seal off the aneurysm.

Doctors who spoke to The Straits Times said it would typically take three to six months for a stroke patient to recover fully, but Mr Heng was discharged after being warded for six weeks, and was able to walk unaided by then, albeit unsteadily.

Now, almost seven months on, there is no slur in his speech and no wobble in his gait. Striding in for the interview last Tuesday, Mr Heng appeared fresh and energetic. His was a recovery many have described as miraculous, and Mr Heng is thankful to all who had part in it.

"I was very, very lucky. I'm very grateful to my colleagues in Cabinet, especially Dr Janil Puthucheary, the ambulance crew and the medical team," he said. "I'd also like to thank the many people who have been so warm in their good wishes to me."

While he could remember the initial baby steps he took lucidly, he was at a loss about what happened on the day he had taken ill.

"Actually, I don't remember what happened. It was only later that I began to piece together what happened from what my colleagues, wife and doctors related," he said.

The only thing he remembered of that day was having a headache before the Cabinet meeting, and taking a Panadol tablet for it. "I thought it's just one of those things, maybe I didn't have a proper rest."

But doctors later told him they believe that was the start of his stroke. Severe headaches are one of the symptoms when aneurysms bleed.

The episode was scary for his Cabinet colleagues and especially difficult for his family. Not least because he developed a lung infection in the hospital, which complicated his treatment.

The six days he lay unconscious were the hardest moments, he said, but not for himself as he was "totally unaware of what was happening".

They weighed heaviest on his wife, Ms Chang Hwee Nee, 53, who is deputy secretary at the Ministry of National Development, as she had to make some "very difficult decisions" about his treatment, such as whether doctors should proceed with inserting a tube into his lungs.

"It was very stressful for her, but I must say she's quite resilient. And, of course, my children and family members were supporting her, and friends and colleagues also stepped forward to offer help," he said.

Mr Heng has a son and a daughter, who are in their 20s.

The days immediately after he woke up were hazy. "I do have vague recollection about wondering where I was and why I am not allowed to get out of my room... I was told I was struggling to get up, but I don't know what was on my mind," he said of waking up in the hospital's intensive care unit.

"My wife told me they had a hard time explaining to me that I was in a hospital. I thought I was in some office at a meeting... I asked to have coffee," he added.

For the first week or so, he communicated through writing, not able to speak with tubes inserted down his windpipe to help him breathe. "The first few pieces I wrote, the handwriting was not very good. After a few days, it got a lot smoother," he said.

Mr Heng was also put through speech and balancing exercises daily, as part of his rehabilitation.

In a Facebook post after he returned home in June, he described the six weeks in hospital as the "toughest of my life".

But now, he exudes a Zen-like calm when speaking about his experience. "I must say I felt okay. By the time I was conscious, the focus was on regaining my strength," he said.

While he was weak, and it took gargantuan effort just to perform routine tasks like sitting up, the encouragement of those around him helped to make it easier.

"At every stage, there was something to strive to do better, and that kept me going. I knew that if I did it properly, I'd be back to my normal self, so I was quite focused on that."

It also helped that he paced himself during the rehabilitation, and spent his free time catching up on the news. After his discharge, he read all the cards, notes and e-mail messages he received, and also followed news about the United States presidential election campaign.

Now, he is mostly well, except for his lungs, which are still recovering from an infection.

To make sure it does not recur, his doctors have asked him to avoid crowded places, including even meetings with more than 10 people.

This means Mr Heng has not been able to return to his grassroots work in Tampines GRC, which he helms.

But he has been back at work at the Finance Ministry since August, busying himself with the Committee on the Future Economy and next year's Budget.

Asked if the near-death experience had changed his life's priorities, he said: "In a way I would say, 'No'. I have always believed that in whatever we do, we should do our best. And so now that I am able, I will continue to do my best."

But the scare has made him pay more attention to his health. He tries to sleep earlier now, at 10pm, instead of past midnight.

Also, instead of working long stretches non-stop, he now sets an alarm in his mobile phone to remind him to take a break every hour and just walk around. "Sometimes I forget," he quipped. "But I decided I needed to pace it, do it in a more gradual way."

Has the experience made him think more about life's purpose?

"Do I think there may be a bigger purpose in life? One must never dismiss this. Life is full of mystery. It's quite amazing how things turn out."





Heng Swee Keat says succession is all about teamwork

By Tham Yuen-C, Assistant Political Editor, The Sunday Times, 18 Dec 2016

His name has often surfaced as a front runner to take over when Prime Minister Lee Hsien Loong steps down. So when Finance Minister Heng Swee Keat had a stroke, it inevitably stoked discussion about his role in the future leadership team.

During an interview last Tuesday, Mr Heng declined to discuss who would lead Singapore next.

"That is a hypothetical question. I will not go into that," he said when asked if he would accept the position if picked.


He, however, suggested that steering Singapore is about teamwork.

"A lot of it is really to make sure that we all pitch in and we all support one another, not just the fourth-generation leaders among ourselves, but also with all fellow members of the Cabinet and with the broader institutions in Singapore," he said.

Succession planning took on a renewed urgency after PM Lee repeated several times his plans to retire some time after the next general election, which must be held by April 2021. Concerns were raised when Mr Heng had a stroke in May and PM Lee almost fainted when delivering this year's National Day Rally speech in August.



Mr Heng said the younger ministers have been getting their feet wet in the various ministries they have been rotated through, part of the preparation to take over. "I think they have all done well."

Mr Heng himself held the education portfolio before his current appointment, and was also put in charge of key assignments such as the 2013 feedback exercise Our Singapore Conversation, the SG50 celebrations last year, and the Committee on the Future Economy, tasked to come up with strategies to prepare the workforce and economy for upcoming challenges.

"It's not just about your individual work, but it is how we connect with Singaporeans and how we do the right things to make sure we have the right policies that will enable us to navigate to a better future," he said.

In the ruling People's Action Party, each generation decides among itself who will lead its team. Both prime ministers after the late Mr Lee Kuan Yew - Emeritus Senior Minister Goh Chok Tong and PM Lee - had taken on the premiership with the support of their peers.

PM Lee said as much when he pointed out that the fourth prime minister will be chosen the same way. Just three years after taking over, he had said he would not anoint his successor.

Besides Mr Heng, others identified as core members of the next team include Minister in the Prime Minister's Office and labour chief Chan Chun Sing, Minister for Education (Schools) Ng Chee Meng, Minister for Education (Higher Education and Skills) Ong Ye Kung, Minister for Social and Family Development Tan Chuan-Jin and Minister for National Development Lawrence Wong.


Asked if the team had started discussing who should be PM, Mr Heng was tight-lipped. Breaking into a slight smile, he said firmly: "I shall not veer into this." But ultimately, he said, what matters is the trust and confidence Singaporeans have in the team that will lead the country. "If we are united and cohesive and have a sense of direction, we can get there."


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