Prof Alain Pierre-Kahn, Immediate Past President, International Society for Pediatric Neurosurgery (ISPN)

Mr Paul Steinbok, Chairman Education Committee, ISPN

Dr WT Seow, Secretary-General, ASEAN Neurosurgical Society

Dr Keith Goh, Chairman, Organising Committee

Distinguished Guests

Ladies and Gentlemen

There is no better place for a sick child to be taken care of than in a Children’s Hospital. I learnt this fact a decade ago when I was working at the Boston Children’s Hospital. The Children’s hospital was not the most sophisticated hospital in Boston, but I felt there was something unique and special about the way it looked after children. I am happy to say that I have the same feeling about KK women’s and children’s hospital. There is something unique and special about the way it looks after children.

This uniqueness is the result of the missionary zeal with which doctors and nurses here look after each and every child under their care. The environment in the children’s hospital emphasizes the child’s needs. It is designed such that parents remain with the child in the ward and even follow the child to the operating theatre. Radiology and all other services are children friendly. It is no surprise that soon after its opening in 1997, KK children’s hospital became the largest and most comprehensive center for pediatric care in Singapore. Today the hospital sees more than 100,000 outpatient attendances, more than 80,000 emergency patients and has more than 20,000 admissions.

Pediatric neurosurgeons in Singapore recognized very early the value of a children’s hospital and were involved in the planning of the hospital so that full neurosurgical services for children were available from day one when the hospital opened its doors. The neurosugical services have grown under the able leadership of my colleague Dr Seow Wan Tew and last year about 1300 outpatients were seen and more than 180 neurosurgical operations were done. The KK children’s hospital has become the leading pediatric neurosurgical center in the region.

Since it appears clear that pediatric neurosurgery is best done in a children’s hospital by pediatric neurosurgeons, should all pediatric neurosurgery be done only at a children’s hospital? In theory YES but in practice, this will not be the case in the near future.

A children’s hospital requires a certain critical mass of population to support it. Only big cities can have such a hospital. Even so many of the big cities in South East Asia do not have a Children’s Hospital. This means that most of the pediatric neurosurgery in South East Asia will continue to be done in general hospitals designed for adults. Even in Singapore, parents may wish to have the neurosurgery done at a general hospital because of convenience or their wish to have a specific surgeon whom they trust do the operation. The wishes of the parents must be respected.

Neurosurgeons who operate on children in general hospitals should strive to achieve the same standards as pediatric neurosurgeons in the children’s hospital. They should try and create some of the environment and attitude of a children’s hospital in the area of the adult hospital where children are lodged. I urge trainees and neurosurgeons who work in adult hospitals to not only concentrate on learning the technical aspects of pediatric neurosurgery, but to walk around KK children’s hospital and observe how the nurses and other staff look after children so they may carry back with them some ideas on how to create a children’s hospital type environment in a small part of their adult hospital.

Pediatric neurosurgeons working primarily in children’s hospitals have advanced our knowledge and developed new techniques in the treatment of children with neurosurgical problems. Endoscopic third ventriculostomy for the treatment of hydrocephalus is an example of one such treatment. KK children’s hospital has pioneered this treatment in Singapore and patients have benefited from the good results. Hydrocephalus in the past was usually treated with a mechanical devise called a shunt. The child needed to have the shunt for life and sometimes the shunt could obstruct or get infected. Some children have even had more than 10 separate operations because of shunt related problems. Endoscopic third ventriculostomy avoids these problems and is an example where a new technique based on new technology has been effective as well as cost efficient.

Information on advances in pediatric neurosurgery must be disseminated to all neurosurgeons and pediatricians. The ISPN has since it’s founding played a global role in teaching and disseminating information on advances in pediatric neurosurgery. This is the first course they have conducted in South-east Asia. I thank the distinguished faculty for contributing their valuable time to teach in this course. I congratulate Dr Seow Wan Tew and Dr Kieth Goh for opening this course to the ASEAN region under the sponsorship of the ASEAN neurosurgical society and for keeping the registration cost low. This has been possible because the course is not being conducted in a luxury hotel or resort. It is being held in the excellent teaching faculties of the KK Children’s Hospital. My Ministry welcomes endeavors that increase the level of professionalism and expertise and support the KK Children’s Hospital in its role to be a leading teaching center on diseases affecting children.

In line with our goal to become a major center of research in the life sciences, my Ministry supports research in the neurological sciences that form the basis of pediatric neurosurgery. My Ministry through the National Medical Research Council (NMRC) has actively funded and will continue to fund suitable research projects. Currently, The NMRC is involved in the funding of some intricate and interesting projects which include, single unit neurophysiological microelectrode analysis and mapping of human brain during awake stereotactic and functional neurosurgery, studying CSF dynamics and neurochemistry in normal pressure hydrocephalus as well as the genetic aspects of neuromuscular diseases. I urge pediatricians and neurosurgeons to be active in research and make full use of funds from the NMRC to increase our knowledge about neurological diseases in children.

In conclusion, I wish to congratulate the Organising Committee, ISPN and ASEAN Neurosurgical Society for their efforts in bringing this course together. I wish the participants a stimulating and enriching experience at this course. I would invite all our foreign participants and teaching faculty alike, to take some time off, to explore Singapore with its repertoire of multicultural heritage and activities, which is bound to be of interest to you.

On this note, it my pleasure to declare the 1^st South East Asian Pediatric Neurosurgery Course open.

Thank you.

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