by Wong Wai Pong, BPhty (Hons)

This article was published in the Volume 15 (Supplement), May 1994 issue of the Journal of the Singapore Physiotherapy Association.

Thirty years ago, an act of kindred spirit sparked off a series of events that would lead to the birth of the Singapore Physiotherapy Association (SPA). While there have been many changes to the membership and the profession at large, the same spirit is still strong, keeping the hearts of the members still aglow with the same intensity of aspirations and hopes.

The year was 1963. A physiotherapist’s letter fired the imagination of its recipient, Lim Peck Ngoh. Mrs Yew Gaik Merrican, today better known as the Datin Merrican, wrote to lobby for Singapore’s support for the then Malaya in forming the Pan-Malaysian Physiotherapy Association. The idea was to have Malaya, Sarawak and Singapore to join as an alliance or a confederation (1). In true grit, a handful of women professionals initiated dialogues and legal processes necessary for the formation of the SPA. By May the same year, the first committee was elected, with Lim Peck Ngoh as president, Kathleen Chou as vice-president, Chew Swee Liang as honorary secretary and Geraldine Tay as honorary treasurer. On May 4, 1964, the SPA was officially born as it was granted registration with the Singapore Registrar of Societies.

The Pioneers

The Pan-Malaysian Physiotherapy Association never materialized; but the SPA survived. One of the founding members mused in retrospect. “Whichever way you look at it,” wrote Geraldine Tay, “there is no doubt that SPA has grown from strength to strength” (2).

In the beginning, the SPA’ s formidable task was to strengthen the rapport with the medical community, as well as to foster close ties with fellow physiotherapists both locally and internationally. When the pioneers have laid a strong foundation of camaraderie among the physiotherapists and good working relationship with medical community, the SPA moved into a period when there were bustling continuing education activities and community services.

The SPA then entered into the present period of professional awakening and re-discovery. There has been changing focus over the years, but as Geraldine Tay rightly pointed out, “the original aspirations remain” (2). With these aspirations, the pioneers set the example of self-sacrifice and devotion to the fledgling profession. Traditional cultural values might clash with the concept of self-help, functional independence and rehabilitation in physiotherapy (3). But dauntless, this handful of brave women, using the SPA as the professional body, worked hard to establish a footing for physiotherapy in the Singapore healthcare system.

Doctors and Physiotherapists – the Sixties and the Seventies

Strengthening ties with doctors and fellow health professionals was the main agenda in the sixties and even into the seventies. There was ignorance among the doctors and nurses even within the hospitals, and those who were aware of the physiotherapists eyed them with suspicion. From the very start, the pioneers recognized the importance of alliance with the medical community. The first medical advisor to the SPA was Mr. V.K. Pillay, an orthopaedic surgeon whose enduring friendship with the association is fondly remembered by the founders.

SPA tea-party attended by Ms Nelson (right). Secretary-General of WCPT in the mid-1960s

During this period, the medical community, particularly the orthopaedic specialty, worked closely with the physiotherapists (4). Besides professional meetings such as official in-service lectures, the guest list for social functions of the SPA almost always found the names of these doctors. From these associations and friendship, doctors came to know and learn about the work of physiotherapists – and the hardship faced by the limited human resources in this area.

The SPA also believes in fostering the espirit de corps among the members and with physiotherapists overseas. In 1964, the membership numbered twenty-two (1); today there are over a hundred members, thirty-five of them are student members (5). Up till 1992, all physiotherapists working in Singapore are trained in various countries (6). The SPA claims representation for the profession and had been active in members recruitment. Most practicing physiotherapists joined the association. The educational and social activities organized by the SPA attracted the members and many came together not only to know one another, but also to learn from one another the diverse art and science of physiotherapy.

Another form of membership also existed. In 1968, remedial gymnasts, occupational and speech therapists were admitted as associate members (1). This was consistent with the SPA’s philosophy to establish ties with other members of the health professions. In I 984, members of the SPA, however, voted against the associate membership, and so it was removed from the constitution during an extraordinary general meeting that year.

The first SPA Annual Dinner held at the Spastic Centre. Ms Lim Peck Ngoh (right) with Dr V K Pillay sitting next to her.

Our pioneers had not been parochial with a vision limited by the shores of this island-nation, but they looked beyond and even internationally. Cheng Siew Lan, former president of SPA, returned in 1974 from the Montreal VIlth World Confederation for Physical Therapy (WCPT) Congress full of ardent hopes and a vision to enter the SPA into the international scene. She was so impressed by the fellowship she experienced in Montreal that she was keen for SPA to be affiliated to the WCPT (1). Sadly there was no support from the members. But in 1979, the decision was changed in favour of affiliation.

At the IXth WCPT Congress in Stockholm, SPA was officially accepted as a member. Geraldine Tay witnessed the ceremony with pride as she wrote in 1982: ” … SPA was formally admitted into WCPT as a full member on Tuesday afternoon amidst pomp and ceremony. I watched, with a lump i n my throat, the Singapore flag being ceremoniously carried on to the stage to take its place with those of the other member nations, closely followed by Ann Choo, our voting delegate, as she was escorted to her table. All day Thursday, our Singapore flag fluttered proudly in the breeze on the flag post outside Massan for all to view. It was a good feeling.” (7)

Continuing Education and Community Services – The Seventies and the Eighties

The mid-seventies and the eighties saw a flurry of SPA activities, with the cardinal concern for promoting the profession. While this has been an objective of the SPA prior to this, and still is up till this present day, it was during this period that this objective took to centre stage.

Promoting the profession may mean updating the skills and knowledge of the practicing physiotherapists. The pioneers saw the need to introduce continuing education to the members. Ann Choo was pro-active in filling up the members’ calendars with continuing education programmes. Internationally renowned teachers and clinicians of physiotherapy arrived one after another to this puny South-east Asian nation. Many enthusiastic physiotherapists welcomed Neil Tuttle, Diana Gaskell, Vladimir Janda, Giovanni deDomenico, Roberta Shepherd , Geoffery Maitland , Julia Sundin, only to name a few.

Diana Gaskell, Superintendent Physiotherapist of Bromptom Hospital London, conducting a course on intensive care in May 1981.

Besides courses, the SPA had dabbled with organizing a convention during this period. The Australian Physiotherapy Association’s 75th anniversary celebration was held in conjunction with the first Austral-Asian Physiotherapy Congress here in Singapore in 1981.

With the help of the Singapore Convention Bureau, SPA organized for the first time an international event (8). The congress was opened by Eugene Michels, the then president of the WCPT. While the major theme of the congress focussed on manual therapy and neurology, the grand attraction was the post-congress workshop on acupuncture. Ruth Chia and her committee comprising of Chia Swee See, Ann Choo, Lau Wai Ching and Esther Tan were credited for the successful seminar workshop on acupuncture, with the expertise assistance from the Chinese physicians at the Chung Hwa Free Clinic (9). Lau Wai Ching rose to the occasion as one of the interpreters for the seminar papers. History has shown that the SPA was capable of organizing an international event.

Promoting the profession may also mean serving the community. In the early 1970s, the SPA raised funds for the purchase of wheelchairs and walking aids for the Yew Tee Home. Regular visits to the Home were made by members of the SPA to extend friendship and physical assistance. No payment was involved. These were done on a voluntary basis. In 1976, the SPA donated all its earnings from the annual dinner and dance to various charities. The community services of the SPA in the care of the aged and the disabled continued till this day.

Goh Ah Cheng and Anna Liu represented the SPA on the Budget and Allocations panels of the Community Chest of Singapore in 1986 (1O). Anna Liu was also, and still is, a member of the management committee of the Margaret Drive Special School (1O). Members of the SPA participated voluntarily in activities of the Home Nursing Foundation and the Elderly Day Care Centre, even helping to set up day-care activities and programmes (11). Towards the end of the eighties, the SPA recognized its role in health education in the community. The Singapore Back School, headed by Ng Chai Ming, conducted its first lessons on November 13, 1985, at the National University Hospital (11).

Neil Tuttle from Adelaide conducting an introductory course in Manipulative Therapy in 1980.

In 1992, the SPA organized the first physiotherapy day for public awareness. The theme was physiotherapy and sports. Public lectures were given to an overwhelming attendance (12). This was followed by an afternoon of scientific papers, a number of which were presented by Singaporean physiotherapists and were based on their research activities. Some of these papers were published in the official journal of the Singapore Physiotherapy Association, JSPA. Goh Ah Cheng, in his 1986 editorial, commented that “it is not enough to just provide the clinical service which we are all hard pressed to achieve” (15). Research, which hitherto has been the mirage of many physiotherapists, became a reality during this period.

The JSPA was launched in June 1984, at the height of the busy continuing education frenzy. Preparations were made even before that time but in the form of photocopied handbooks called the Corpus Callosum. “With the launching of the Association’s official journal in this first issue,” wrote its founding editor Goh Ah Cheng, “it is the intention of the Singapore Physiotherapy Association to further advance our professional credibility” (13). Thus the SPA moved up another milestone.

Admission, Registration, and Causes – The Eighties and the early Nineties

Of course, the SPA champions the causes of the profession. It was, however, during this period that the SPA found itself involved in influencing many levels of policy-making authority with regards to the profession. The shortage of physiotherapists has plagued the healthcare system for a long time. Solution by the Ministry of Health was initially sought in the idea of creating and training physiotherapy aides to help carry out the routine work of the busy physiotherapists. but the SPA objected to this proposal in 1971 and again in 1973 (1).

Instead, the SPA identified the poor working conditions and terms as the cause of failure to attract the potential students and to retain physiotherapists in the service upon the completion of their bond to the government. The SPA has successfully rallied for the pay rise for the physiotherapists and for a little while, there seemed to be less members leaving the profession.

The limiting factor however was the financial cost in training physiotherapists abroad. Virtually all Singaporean physiotherapists are sponsored by the government. A handful of students were sent each year and this has never been able to meet the rising demands for rehabilitative and physiotherapy services.

Giovanni de Domenico demonstrating the use of interferential current therapy in 1980s

What Singapore needed then was a local physiotherapy school, and the SPA has submitted to the relevant government authority with proposals and the feasibility report for setting up a school. Unfortunately, history tells us, the introduction of physiotherapy aides was inevitable (14).

The SPA was swift to initiate guidelines for the role of the physiotherapy aides. Former president Patricia Tan noted correctly then that there was no “quick and easy solution” to this chronic shortage of physiotherapists”; “the ultimate goal”, said Patricia Tan “would be to establish a school of physiotherapy in Singapore” (14). And the SPA worked hard towards this end, through the recommendations to higher authority and the leadership of the former presidents such as Ann Choo, Patricia Tan, and Chew Swee Liang.

The SPA foresaw the impact of the aides on physiotherapy. A system must exist to screen competent and well-qualified physiotherapists from competent and experienced aides. The Admission Committee was formed in May 1985 (11) with the following aims:

• Establish the standard requirement essential for entry into the SPA.
• Undate the curriculum vitae of the current members of SPA.
• Screen all applicants seeking membership with SPA.

Closely related to the Admissions Committee was the Registration Committee, which was an attempt to establish a registration act for the physiotherapists in Singapore (15). This has been due to an increased awareness of the importance of professional registration (16). The SPA has recently published its statements on competency and standards, this being the efforts of Soh Say Lim and the many ad hoc committees (5).

Conclusion

The history of the SPA showed a change in the focus of the profession but there is only one consistent objective that holds it together through these years, and that is, to safeguard and promote the profession.

In the early days, as the SPA aimed to establish a niche for itself in the Singapore healthcare system, the founders were tireless in forging goodwill and rapport among members of the profession and with the other members of the health profession, particularly with the medical community.

In the next decade, the SPA enriched the professional skills and knowledge of its members through the continuing education programmes. During this period, the SPA used the skills and expertise of its members to help make contributions to better the lives of the aged, the handicapped and the disabled.

The opening ceremony of the 1st Austral-Asian Physiotherapy Congress held in June 1981 in Singapore.

In the last decade, the SPA was involved in an on-going mission to set up a registration board of physiotherapists. This will be impossible without the camaraderie and the united efforts of all the members of the profession. History informs us that this is an unnecessary worry. Three decades down, but there is still only one kindred spirit.

References

• Lim PN, Goh AC. Singapore Physiotherapy Association: 1963 – 1984. Journal of Singapore Physiotherapy Association 1984:6(2): 15- 17.
• Tay G. A message from the president. JSPA 1993: 14(1): 19.
• Lim PN. Physiotherapy in Singapore. Singapore Physiotherapy Association Corpus Callosum 1981:3 (1): 14- 17.
• Lim PN. Personal Communication
• SPA Newsletter 1994: 1 (3):9.
• Henley E. (Editorial). JSPA 1993: 14(2):2-3.
• Tay G The IXth International Congress of the World Confederation for Physical Therapy. Stockholm. Sweden May 23-28, 1982. Singapore Physiotherapy Association Corpus Callosum 1982:40(1): 13 – 14.
• Tay G. Australian Physiotherapy Association 75th anniversary celebrations and first Austral-Asian physiotherapy congress. Singapore Physiotherapy Association Corpus Callosum 1981:3(1):23 -24.
• Chia R. Report on seminar workshop in acupuncture. Singapore Physiotherapy Association Corpus Callosum 1981:3(1):25-26.
• Goh AC. President’s report 1986/1987. Journal of the Singapore Physiotherapy Association 1987: 9(1): 1O- 12.
• Choo A. Singapore Physiotherapy Association President’s report (l985/1986). Journal of the Singapore Physiotherapy Association 1986:8(1): 15.
• SPA minutes of AGM. JSPA 1993: 13(2): 19-2l.
• Goh AC (Editorial). Journal of the Singapore Physiotherapy Association 1984:6(1):3.
• Tan P (Editorial). Journal of the Singapore Physiotherapy Association 1988: 10(1):2.
• Goh AC. (Editorial). Journal of the Singapore Physiotherapy Association 1986:8(1): 1.
• Goh AC. Professional registration – the next step. JSPA 1993 14(1):4-7.