Centre for integrative medicine by Narpal Singh

Centre for Integrative Medicine

A criticism of Singaporeâ&#x20AC;&#x2122;s medical infrastructure Thesis project done by: Narpal Singh Thesis supervisor: Mr Kazuhiro Nakajima

Research and analysis

Phototherapy treatment for jaundice (Source: kliniknuraida.com)

The big picture Narpal Singh S/O Jigeet Singh The heritage of medicine, just until a century ago has been that akin to a primitive sort of empiricism. Stumbling upon the guesswork of pracitioners, it has finally reached a stage of accurate diagnosis and prognosis through major advancements in the processes of biochemistry. As a result,over the years we have seen an overspecialization of medical professionals in this field. Today, we stand on the threshold of the next big advancement in medicine, biophysics. Through the processes of biochemistry, medicine has always taken the position of the problem solver. If there is an illness, then there will be drugs to eradicate theproblem, with a couple of side effects thrown into the mix. There is an old chinese proverb that goes, â&#x20AC;&#x153;The superior doctor prevents sickness; The mediocre doctor attends to impending sickness; The inferior doctor treats actual sickness;â&#x20AC;?

It seems like even though the medical processes we have in this world have come a long way in the past century, there is a long road ahead of the industry in terms of satisfying the message set forth in the above proverb. The question then to ask is, where is this ship heading towards? Where is the next step going to land in this industry? These are essential questions that have to be answered as architects, especially when designing for infrastructure. There is a very strong indication that in the future, the processes of biochemistry in its entirety will be replaced by that of biophysics. I will attempt to describe what biophysics is in a nutshell. In 1953, Dr Reinhold Voll reasoned that each organ of the body produces or consumes energy and that health is an energetic equilibrium that can be influenced through this medium. It is a completely different view of medicine and treating the human body. There is no use of drugs or medication. Conversely, it uses energy in the form of waves to combat existing or impending illnesses. Discoveries in quantum physics have shown that all particles of matter share the characteristics of both waves and particles. This indicates that all matter, including all cells, parts of the body, viruses, bacteria, pollen, toxins etc. emit electromagnetic Centre for Integrative Medicine A criticism of Singaporeâ&#x20AC;&#x2122;s medical infrastructure

Interactions between electromagnetic waves and the human body (Source: https://staceylovenlife.files.wordpress.com/2013/06/shutterstock_65181187.jpg)

waves. Depending on their nature, all substances have a unique wavelength or frequency with highly individual characteristics. This is known as frequency pattern. How medicine finds itself between this theory is that, if the frequency patterns of different ailments can be mapped being emitted from the human body then very early detecttion and diagnosis can be put in place for treatment of the problem. Also, this form of treatment also argues that exposure to varying frequencies (through the BICOM device or different wavelengths of light) can put the body back in balance, hence treating the person completely of their ailments. One example of this type of treatment is photodynamic therapy, in the treatment of cancer.

Photodynamic Therapy (PDT)

Photodynamic therapy (PDT) is a treatment that uses a drug, called a photosensitizer or photosensitizing agent, and a particular type of light.When photosensitizers are exposed to a specific wavelength of light, they produce a form of oxygen that kills nearby cells. Each photosensitizer is activated by light of a specific wavelength.This wavelength determines how far the light can travel into the body.Thus, doctors use specific photosensitizers and wavelengths of light to treat different areas of the body with PDT. In the first step of PDT for cancer treatment, a photosensitizing agent is injected into the bloodstream. The agent is absorbed by cells all over the body but stays in cancer cells longer than it does in normal cells. Approximately 24 to 72 hours after injection, when most of the agent has left normal cells but remains in cancer cells, the tumor is exposed to light. The photosensitizer in the tumor absorbs the light and produces an active form of oxygen that destroys nearby cancer cells.In addition to directly killing cancer cells, PDT appears to shrink or destroy tumors in two other ways. The photosensitizer can damage blood vessels in the tumor, thereby preventing the cancer from receiving necessary nutrients. PDT also may activate the immune system to attack the tumor cells.The light used for PDT can come from a laser or other sources. Laser light can be directed through fiber optic cables (thin fibers that transmit light) to 03

Photodynamic therapy only exposing affected parts of the body to radiation (Source: http://i.ytimg.com/vi/C-VFTCjOBKM/maxresdefault.jpg)

deliver light to areas inside the body. For example, a fiber optic cable can be inserted through an endoscope (a thin, lighted tube used to look at tissues inside the body) into the lungs or esophagus to treat cancer in these organs. Other light sources include lightemitting diodes (LEDs), which may be used for surface tumors, such as skin cancer. PDT is usually performed as an outpatient procedure. PDT may also be repeated and may be used with other therapies, such as surgery, radiation, or chemotherapy. From this study, we can see that light itself plays an incredible part in the treatment procedure. This begs the corelation to architecture and the design of spaces that could hold the potential of healing people. We will get to that later.

Centre for Integrative Medicine A criticism of Singaporeâ&#x20AC;&#x2122;s medical infrastructure

Singapore’s branding as a healthcare hub

(Source: http://archives.thestar.com.my/archives/2007/8/27/business/p15-cartoonibig.JPG)

The medicine nation In the setting of a developed economy, the healthcare industry in Singapore is known as one of the best in the world. The industry is made up of a few different medical center typologies. In public health, there are government run hospitals, for the use of people who need in-patient services and polyclinics for outpatient services. Both are facilities run at a subsidized rate. In private health, it is the same, except that the prices are higher. We will evaluate the public health system. The Ministry of Health (MOH) believes in ensuring quality and affordable basic medical services for all. At the same time, the Ministry promotes healthy living and preventive health programs as well as maintains high standards of living, clean water and hygiene to achieve better health for all. However, if we look deeper into the services provided, year after year, majority of the funding goes into sick care services. To examine this further, let’s look at the breakdown of the existing industry. Structure and Budget The main goal is to ensure that every individual has access to the various tiers of existing healthcare services in a cost-effective and timely manner. Compatible prices and efficient distribution of resources are of equal importance. Primary healthcare Polyclinics Professional, like general practitioners and nurses are the main points of contact in this sector. Following the consultation with them, patients will then be referred to medical specialists in hospitals for further diagnosis and treatment. There is an island network of outpatient poly and private practitioner clinics. There are a total of 18 polyclinics throughout the island. According to Singhealth, “The 18 polyclinics – “one-stop” healthcare centers - supplement some 1,500 private medical clinics in providing primary healthcare, which includes primary medical treatment, preventive healthcare and health education.” The important aspect to spot in this statement is preventive healthcare. 20% of the nation’s primary healthcare demands are met by these polyclinics. Patients can be referred from the polyclinics to hospitals, where they can receive more specialised treatment and be warded if necessary. Hospitals In 2012, there were a total of about 10,756 hospital beds in the 25 hospitals and specialty centres in Singapore, giving a ratio of 2.0 beds per 1,000 total population. About 85% of the beds are in the 15 public hospitals and specialty centres with bed complements between 185 to 2,010 beds. On the other hand, the 10 private hospitals tend to be smaller, with capacity ranging from 20 to 345 beds. The Government’s role as the dominant health care provider allows the 05

Government to influence the supply of hospital beds, the introduction of high-tech/high-cost medicine, and the rate of cost increases in the public sector which sets the bench mark in terms of pricing for the private sector. The 8 public hospitals comprise 6 acute general hospitals (SGH, NUH, CGH, TTSH, KTPH & AH), a women’s and children’s hospital (KKH) and a psychiatry hospital (IMH). The general hospitals provide multi-disciplinary acute inpatient and specialist outpatient services and a 24-hour emergency department. In addition, there are 6 national specialty centres for cancer, cardiac, eye, skin, neuroscience, dental care and a medical centre for multiple disciplines. The Government has restructured all its acute hospitals and specialty centres to be run as private companies whollyowned by the government. This is to enable the public hospitals to have the management autonomy and flexibility to respond more promptly to the needs of the patients. In the process, commercial accounting systems have been introduced, providing a more accurate picture of the operating costs and instilling greater financial discipline and accountability. The public hospitals are different from the other private hospitals in that they receive an annual government subvention or subsidy for the provision of subsidised medical services to the patients. They are to be managed like not-for-profit organisations. The public hospitals are subject to broad policy guidance by the Government through the Ministry of Health. The Government has also introduced community hospitals for intermediate healthcare for the convalescent sick and aged who do not require the care of the general hospitals. Intermediate and Long Term Care (ILTC) These continuing care facilities are for patients who no longer require the level of care dispensed by a hospital, but nevertheless requires continued care. Residential ILTC services Care is for patients who stay in these facilities both in the day and at night. Community-based ILTC Services Comprise centre-based and home-based healthcare services that are provided to patients during the day. Support Services Support services to hospitals and primary healthcare programmes include forensic pathology, pharmaceutical services and blood transfusion service. Traditional Chinese Medicine (TCM) We base our healthcare services on Western medical science. However, our ethnic groups occasionally consult traditional medicine practitioners for general ailments. Of particular interest is Traditional Chinese Medicine (TCM). Interest in TCM and other traditional or alternative medical treatments is increasing both here and around the world. We are therefore reviewing standards of training and practice of TCM in Singapore. Our aim is to ensure a higher quality of TCM practice, for the benefit of patients who consult TCM practitioners. It is difficult to find another healthcare system in the world that is as efficient as Singapore’s. However, then this begs the question, how can we further improve the system in which the nation’s healing is done. For a small and relatively young nation, the healthcare department has done an exemplary job in providing for services that treat enduring illnesses. They have shown to be great at implmenting the existing biochemical processes of medicine but are there any opportunities to improve this existing system.

Singapore’s healthcare heirarchy

(Source: https://wiki.smu.edu.sg/is101_2008/img_auth.php/thumb/2/26/Singapore-healthcare-overview.jpg/450px-Singaporehealthcare-overview.jpg)

Centre for Integrative Medicine A criticism of Singapore’s medical infrastructure

Geriatric department in Tan Tock Seng Hospital using holistic treatment strategies (Source: http://ttsh-iga.com/wordpress/wp-content/uploads/2015/02/4.2-GMU-press-article.jpg)

In Tan Tock Seng Hospital, there have been steps taken in the Geriatric department to break away from conventional treatments in order to aid the healing of patients with delirium. In addition to introducing different programmes to help treat these patients, they have also included bright light therapy treatment to help patients sleep better at night. This includes exposure to bright light at 2000-3000 lx in a controlled setting.

Chromotherapy There is a rich history in the use of colour in the field of medicine. In fact, the ideology of colour medicine is one that dates back as far as any other denomination of medicine from as far back as 2000BC. One interesting fact to note is that the Russians were developing this form of healing very exhaustively until post-world war two. If we were to engage scientific databases, it becomes clear that there was plenty of interest in this field right until the 1960’s when it seems like all research came to a premature standstill. “Colours generate electrical impulses and magnetic currents or fields of energy that are prime activators of the biochemical and hormonal processes in the human body, the stimulants or sedatives necessary to balance the entire system and its organs.”-EB In modern times, one who has contributed to the rediscovery of this knowledge, in his book titled,The Principles of Light and Colour, is Edwin Babbitt. He held firm toa belief that the union of science and philosophy should not be given the blind eye in the adherence to chaste mathematical derivations. He speaks about a great variety of subjects in his book that comes under the umbrella of “pseudo-science” as we know it today, and one of the chapters he broaches is the healing capacity of colour therapy. He contextualized his claims through applications of his theories on the ailing population. He invented various instruments, for example, a distinctive cabinet that split light into its seven colours and the focalization of this light on burns, stopping excessive bleeding and headaches etc. were extremely effective. One other thing that he utilized was water. Like the Greeks, Babbitt determined an association between colour and minerals, which he utilized to supplement his treatment with coloured light. He developed his medication by irradiating water with sunlight that was filtered through coloured lenses. He asserts that this “potentized water” retained the energy of the crucial constituent within the coloured filter used and worked wonders for the ailing. If we were to analyze what he was trying to explain here, it would most certainly be the fact that water had the ability to store memory. It would be used as a medium to transfer data from one element to another. It is difficult not to draw a correlation to Dr Masaru Emoto’s research on the memory of water. There are many other physicists from the likes of Ghadiali to Klotsche and Messer who have carried on researching after Babbitt trying to scientifically prove the biological implications of colour and they have made baby steps towards their goal. If a system were limited by its existence then the only perspective that is available would be defined through that lens, all else ridiculed as madness. However, today we find major breakthroughs in this once thought of fantasy through the work of Dr Azeemi.

Centre for Integrative Medicine A criticism of Singapore’s medical infrastructure

Interview analysis with Dr Samina Azeemi (Professor of Physics, University of Balochistan, Quetta, Pakistan) To gather more knowledge on the scientific standing of using coloured light to treat diseases, an interview with Dr Samina Azeemi (Appendix C) was conducted. Dr Azeemi has spent most of her academic career studying the effects of coloured light on people with diseases and its influence on potentizing water. She has written close to ten papers on the scientific journal with the results she has obtained. After going through the interview and looking through her papers and her personal manuscripts it is apparent that the biological implications of chromotherapy are very real. Take for example, in one of her studies, she successfully treated, Cutaneous Leishmaniasis, which is a form of open ulcerated lesion on the exposed part of the body using the electromagnetic spectrum of light. The procedure was simple and extremely cost efficient. All that was needed was an incandescent light bulb or direct sunlight and cellophane paper, which can be purchased at any stationary shop. The results for the treatment are shown below.

At the start

After 7 days

After 30 days

Healing process through chromotherapy (Source: Dr Azeemi)

Fig 1: Successful treatment of young boy through chromotherapy Dr Samina Azeemi, August 2014) After thirty days (Source: of exposure to predominantly green and red light, which were found to be most effective, from a distance of 0.8m for 30 minutes daily, this boy was cured of his disease with no side effects or relapse. (Azeemi, AfterThe thirty of exposure green red light, which Yasinzai, Raza, 2011) moredays mainstream method to of predominantly treating this disease is viaand antimonal injections thatwere take twenty found be exponentially most effective, from a distance of 0.8m 30 minutesindaily, this medication. boy days of daily dosage andtowith higher costs. Side effects are alsoforcommonplace chemical of his disease withhave nobeen sidedone effects or relapse. Yasinzai, Raza, There are variouswas othercured eye opening studies that by her that prove(Azeemi, the efficiency of chromotherapy in curing diseases.2011) In theThe interview, stated “I think colouroftherapy can this be used for treating kind of diseases more she mainstream method treating disease is viaallantimonal but my faith is that it is more useful treatment is given of cost. If theexponentially treatment comes fromcosts. a free source injections that takewhen twenty days of daily free dosage and” with higher of energy like theSide sun,effects then faith is restored to her closing words. Since the biological implications of colour are also commonplace in chemical medication. There are various other can be academically proven, should studies embrace that its contributions the scientific and discover techniques of in which eye we opening have beentodone by her realm that prove the efficiency architecture can utilize the power of light through design to provideshe forstated natural “Ihealing the masses. chromotherapy in coloured curing diseases. In the interview, think for colour We have already therapy seen certain more mainstream breakthroughs in some processes where the exposure of can be used for treating all kind of diseases but my faith is that it is morelight to human beings has helped in healing processes. Onefree of these applications is in the treatment for ajaundice useful when treatment is given of cost.” If the treatment comes from free with blue light. Also, source in 1990, there was a report by scientists to the Amercian Association for the Advancement of energy like the sun, then faith is restored to her closing words. Since the of Science during an annual conferenceofthat stated blue light wasproven, used towesuccessfully treat addictions, biological implications colour canthat be academically should embrace its eating disorders contributions and depression.to Red light was realm effective treating techniques cancer, constipation healing wounds. the scientific andin discover in whichand architecture The table on thecan facing page between the design type oftocolour andforillnesses are related. utilize theshows powertheof relationship coloured light through provide naturalthat healing for the masses.

We have already seen certain more mainstream breakthroughs in some processes where the exposure of light to human beings has helped in healing processes. One of these applications is in the treatment for jaundice with blue light. Also, in 1990, there was a report by scientists to the Amercian Association for the Advancement of Science during an annual conference that stated that blue light was used to successfully treat addictions, eating disorders and depression. Red light was effective in treating cancer, constipation and healing wounds. Table 1 shows the relationship between coloured lighting and the treatments that are possible.

Table 1 Red

Warmth, energy and stimulation. Good for energy, fatigue, colds, chilly and passive people. Energizes heart and blood circulation, it builds up the blood and heightens a low blood pressure. Energizes all organs and the senses hearing, smell, taste, vision and touch. Increases sexual desire and activity. Stimulates ovulation and menstruation

Orange

Warm, cheering, nonconstricting. Has a freeing action upon the body and mind, relieving repressions. Stimulates creative thinking and enthusiasm, and helps assimilate new ideas. Helpful in dealing with excess sexual expression. Stimulates the lungs, the respiration and the digestion. Increases the activity of the thyroid. Reliefs muscle cramps and spasms. Increases the amount of mother milk.

Centre for Integrative Medicine A criticism of Singaporeâ&#x20AC;&#x2122;s medical infrastructure

Yellow

Strengthen the nerves and the mind. Excellent colour for nervous or nerve-related conditions or ailments. Energizes the muscles. Dark yellow soothes pains in the nerves (shooting pains) Used for conditions of the stomach, liver, and intestines. Speeds up the digestion and assimilation, and the stool. Helps the pores of the skin and aids scarred tissue in healing itself.

Green

Green can be used for just about any condition in need of healing. Affects blood pressure and all conditions of the heart. Has both an energizing effect and a moderating or soothing effect. Cures hormonal imbalances. Stimulates growth hormone and rejuvenation. Cleans and purifies from germs, bacteria and rotting material. Harmonizes the digestion, stomach, liver, gall. Has a healing effect on kidneys. Increases immunity. Builds up muscles, bones and tissues. Stimulates inner peace. Strengthens the nervous system.

Blue

Cool, electric, astringent. Cools down inflammations, fever, high blood pressure, stops bleedings, reliefs the bursting headaches, and calms strong emotions like anger, aggression or hysteria. Brings tranquillity. Anti-itching. Anti-irritation, anti-stress. Soothes suffering. Can be used for any type of ailments associated with speech, communication, or the throat. Excellent for laryngitis or inflammation of the larynx.

Indigo

Cool, electric, and astringent. A great purifier of the bloodstream and also benefits mental problems. A freeing and purifying agent. Combines the deep blue of devotion with a trace of stabilizing and objective red.

The vision After going through a thorough research process on the different ways in which the medical infrastructure can improve, the next step is then to architecturalize this idea. The main difference between biochemical and biophysical treatment is that the latter has thte ability to prevent people from falling sick. It has the ability to detect diseases far earlier before they become chronic and require the services of drugs and medication. Therefore this is a crucial consideration in its implementation. The main goal of MOH is to ensure that every individual has access to the various tiers of existing healthcare services in a cost-effective and timely manner. It is crucial to first establish that sick care, refers to all the services established in the country to help the diagnosed population whereas healthcare refers to all the services that aid the population in the prevention to falling sick. In an interview with Dr. Justin Morais and his team (appendix A), it is evident that there are many forms of treatment and services already present in countries like Germany which provide for holistic healthcare opportunities. Facilities like these use various forms of complementary medicine treatments to keep the population healthy. One of the ways in which they do it is through the use of a bio-resonance machine (Appendix B) for the pre-diagnosis of ailments in the body which are premature in their effect on the body and using chromotherapy as a form of treatment to bring the body back to the correct vibrational frequency.This prevents the disease from having a stronghold on the body and it protects the individual from any further harm. Therefore, sites that were considered had to be along the island network of healthcare services as it has already proven to be a system that works very efficiently. One of the main components of this project is to most effectively raise awareness within the community that there is a possibility in treating diseases before they incubate in your bodies, therefore the bigger vision is to see this form of integration scattered across the entire island in its totality. There is a certain healthcare typology that is dominant throughout Singapore which comprises of a stadium, swimming complex and sports and recreation hall. Taken from the map of these various parts of Singapore (North, South, East, West, Central), we can see how the public healthcare system is very consistent through the island.

Choa chu kang (North) (Source: Google maps)

Delta (South)

(Source: Google maps)

Bedok (East)

(Source: Google maps)

Jurong West (West) (Source: Google maps)

Toa payoh (Central) (Source: Google maps)

Centre for Integrative Medicine A criticism of Singaporeâ&#x20AC;&#x2122;s medical infrastructure

They are all composed of 3 crucial elements. An existing sports and recreation centre, a public swimming pool and a stadium. Among all these neighbourhoods, the site that was chosen is at Hougang Avenue 10. The main reason why this site was chosen is because it shows great potential in a neighbourhood setting in which an issue as that identified above can be solved through the integration of a certain type of architecture. Also, according to Dr Morais, he has a six month waiting list for his clinic which indicates that the Hougang neighbourhood already has an existing demand for treatments like these. This strategy can then be applied to other nieghbourhoods in Singapore if it is successful. All the major neighbourhoods in Singapore are made from this exact typology that is seen on this site. The long term vision is to see many other forms of complementary medicine being inserted into this existing typology in view of better healthcare services in the country. For example, given the existing demand for chromotherapy in Hougang, this centre for integrative medicine will focus mainly in colour treatment for the body, in the form of light, water and visuals. In a different neighbourhood, another form of complementary medicine can be implemented and designed for. In the future, this gesture will aim to replace the regular hospital checkups that people today go for, more frequently then not, finding out that they already have an ailing illness present. All the existing architectural elements that provide for pre and post diagnosis treatments will then be present on this site. The following images depict the existing site conditions.

site map

(Source: one maps)

Figure-Ground diagram of site (Source: Author)

Centre for Integrative Medicine A criticism of Singaporeâ&#x20AC;&#x2122;s medical infrastructure

Connectivity analysis of site (Source: Author)

Ground level circulation analysis (Source: Author)

Centre for Integrative Medicine A criticism of Singaporeâ&#x20AC;&#x2122;s medical infrastructure

Shadow range analysis of site (Source: Author)

Wind analysis of site (Source: Author)

Centre for Integrative Medicine A criticism of Singaporeâ&#x20AC;&#x2122;s medical infrastructure

Wind and daylight analysis of site (Source: Author)

The main architectural proposition is to design a centre in which chromotherapy and bioresonance treatment are used as an integrative medical device to heal people. There will be other supplementary programmes that will spearhead the vision of a holistic complimentary medical facility, like art therapy and organic cooking workshops. While having this as the primary objective, the design should also seek to better integrate all three existing facilities on an urban level providing for a more steadfast connectivity and accessibility within the site. The project will comprise of both public and private programmes. The private programmes will be mainly focused on individuals who would like to engage in the available treatments in the facility whereas the public programmes will aim to raise awareness among the population with regards to integrative medication possibilities. The design of the facility with regards to accessibility and sound will all be considered and varied according to these programmes. A prototype of a fully working chromotherapy room , functioning between 2000-3000lx through the use of natural lighting will also be explored.

Centre for Integrative Medicine A criticism of Singaporeâ&#x20AC;&#x2122;s medical infrastructure

concept contextual relationships circulation construction and structure environmental control conclusion

Design

Concept

The key idea is to insert a new medical typology in the existing medical infrastructure throughout Singapore. This facility will incorporate integrative medical procedures to work concurrently with existing biochemical procedures. A suitable site was picked in order to encourage island-wide replication. The therapies that will be focused among these various facilities, if implemented, will differ across the integrative medicine spectrum. This facility in particular will focus on light as a healing agent. Also, this project will aim to project architecture itself as the healing agent. There is a very special place for the use of light in architecture. There is a potential in pushing the notion of light in architecture as just contrasts of light and shadow to medicine that treats the people.

Final design of red chromotherapy room (Source: Author)

Centre for Integrative Medicine A criticism of Singaporeâ&#x20AC;&#x2122;s medical infrastructure

Concept Urban strategy 1. removal of canopy to facilitate insertion of more points of entry 2. inclusion of sheltered pathways to create network for healthcare facilities 3. design for public spaces to raise awareness and distribute knowledge

Contextual Relationships

Birdâ&#x20AC;&#x2122;s eye view of the site (Hougang ave 10) (Source: Author)

Serial vision of the site (Source: Author)

Centre for Integrative Medicine A criticism of Singaporeâ&#x20AC;&#x2122;s medical infrastructure

Contextual Relationships Urban strategy From the study of the site, it was clear that these three existing facilities were built at different times as there was no clear circulation path connecting them. This could be a contributing factor to the underutilization of the facilities at the site. There is only one access point into the swimming pool and the only circulation path connecting the Sports and Recreation Centre, at the foreground, to the stadium, at the background is the road which is catered for vehicular use. Most of the surrounding buildings on the site are low lying and there is almost no major shadow cast on the entire network. In my study, I found that the factor that contributed most to this inaccessibility to the site was the canopy that surrounded the swimming pool. The site could be open to many more opportunities in terms of connectivity and dynamicism if this canopy was reconsidered and redesigned. Therefore, on an urban level, this was one of the key motives of the architecture,that is to, provide acessibility through the site by replacing the canopy but still maintain the privacy of the patrons of the swimming pool facility. The diagrams below show the process of the design that was put in place to spearhead this.

Diagrams to show process of urban strategies undertaken (Source: Author)

Urban strategy The rectangular canopy at the ground level was first fragmented and three additional access points into the swimming pool. An entire patheay network was designed to allow for easy circulation through the three facilities. There were also building height with programme type considertations imposed. The first 6000mm of the facility was dedicated solely to public use. Therefore, all the cafes, libraries, art galleries and green spaces were designed within this threshold. On the existing ground floor level, the changing rooms for the public swimming pool was relocated to adhere to the design intention. A series of other changing rooms were designed within the facility to cater to the needs of the patrons of the facility. Given that this is a public swimming pool and noise would be a contributing factor to spaces like the library and chromotherapy rooms, buffer spaces of 3000mm were included in the design as a control for the environment.

Perspective from under designed centilevering canopy (Source: Author)

Centre for Integrative Medicine A criticism of Singaporeâ&#x20AC;&#x2122;s medical infrastructure

27 01 (Source: Author)

Site plan showing urban strategies implemented

Level 1 plan planning for public amenities (Source: Author)

Centre for Integrative Medicine A criticism of Singaporeâ&#x20AC;&#x2122;s medical infrastructure

Level 2 plan planning for public amenities (Source: Author)

Circulation Architecture 1. architecture working as a tool for recovery 2. progression of spaces 3. patient circulation vs public circulation

A great deal of importance was placed in the circulation of the people through this facility. For example, since the use of colour is paramount in the healing process of this centre, all the spaces that are not related to a specific colour therapy are all in monochrome colours. White polycarbonate is used on the facade and steel that is painted black is used as the main structure. All the interior spaces are either treated with a white or grey finish. In order to maintain the purity of the patients journey through the facility, this was deemed as an important gesture. However, once the colour treatment begins, then the path in which they take is calculated to the smallest degree. For example, if a patient were to receive treatment that is of orange light, then as they leave the neutral white space of the reception and bio-resonance diagnosis area, they will first have to walk through a pre-designed circulation path through the green room and the red room. It gets even more detailed than that. Since orange is composed of 3/4 red and 1/4 green, the exposure time of the patients journey through the two respective spaces will also be governed by that standard. The plan below shows this intention diagrammatically.

Centre for Integrative Medicine A criticism of Singaporeâ&#x20AC;&#x2122;s medical infrastructure

4th floor plan Circulation diagram into the coloured therapy (Orange room) (Source: Author)

Circulation This logic is applied to all the other coloured room spaces. Besides this, all the circulations that were planned for the patients are closed loop. The begin and end at the bio resonance room are which is located on the third floor. There are two programmes that are available for the use of the the patients. The first is the quick fix programme and the second is the full immersion programme. The spatial progression is shown below. quick fix 1. reception 2. bio resonance 3. chromotherapy 4. water therapy 5. exit (bio-resonance) full immersion 1. reception 2. bio resonance 3. chromotherapy 4. water therapy 5. organic cooking studio 6. yoga/meditation 7. art therapy 8. exit (bio resonance) The rest of the floor plans are shown next.

Centre for Integrative Medicine A criticism of Singaporeâ&#x20AC;&#x2122;s medical infrastructure

3rd floor plan patient circulation (Source: Author)

Circulation

5th floor plan patient circulation (Source: Author)

Centre for Integrative Medicine A criticism of Singaporeâ&#x20AC;&#x2122;s medical infrastructure

Circulation

Section showing the segregation of public and private programmes (Source: Author)

Centre for Integrative Medicine A criticism of Singaporeâ&#x20AC;&#x2122;s medical infrastructure

Circulation

Section showing the looping circulation of private programmes (Source: Author)

Centre for Integrative Medicine A criticism of Singaporeâ&#x20AC;&#x2122;s medical infrastructure

Construction and strcuture

The construction of the centre is majorly composed of the use of 2 materials (steel structure with polycarbonate cladding), except for the chromotherapy rooms where the structural system become a hybrid steel and precast concrete system. The reason for this is because, a lux level of 2000-3000 is required for the space to function optimally. Therefore the introduction for skylights were necessary. In order to cool the roof at times that the temperature would become very high, the idea of a roof garden was also implemented within that framework. The drawings below show the final detail drawings of the hybrid construction.

Chromotherapy room roof detail (Source: Author)

Centre for Integrative Medicine A criticism of Singaporeâ&#x20AC;&#x2122;s medical infrastructure

Chromotherapy room floor detail air-conditioning integrated at ground level (Source: Author)

Sectional perspective of chromotherapy room (Source: Author)

Centre for Integrative Medicine A criticism of Singaporeâ&#x20AC;&#x2122;s medical infrastructure

Environmental control

A great deal of time was spent on controlling the environment of the chromotherapy room such that there is an even distribution of light throughout the day. When the sky is overcast, LED lights which are designed inside the diffusers will be activated to compensate for the lack in light levels in the treatment space. Since the conditions that were necessary were very clear, 2000-3000lux and and even distribution of light, running a few simulations with regards to the size of the skylight was enought to determine a design for the roof detail. With regards to the geometry of the precast beams, a regular analysis and elimination was done. For example, a rectangular beam would deflect light in a far less uniform manner than a curvilinear one. Therefore, a curvilinear beam was implemented in the final design. The simulations on the next few pages show the relationship between the lux levels recorded in the rooms related to the size of the skylight. Two sizes are shown. One is 500mm and the other is 250mm. The latter was chosen in the final design, given the results that were recorded. The simulation was done through a regular day, along the time intervals of 9am, 12pm, 3pm and 5pm.

Simualtion:500mm skylight (L-R)9am, 12pm, 3pm, 5pm (Source: Author)

Centre for Integrative Medicine A criticism of Singaporeâ&#x20AC;&#x2122;s medical infrastructure

Environmental control

Simualtion:250mm skylight (L-R)9am, 12pm, 3pm, 5pm (Source: Author)

With these simualtions, a general rule of lux to the size of the skylight can be established. In the final design, the size of 250mm was adhered to with the inclusion of diffusers to disperse the direct light coming into the space. The airconditioning was also integrated at ground level to work more efficiently as it would firstly impede any light coming into the system if it were on the ceiling and it would be working less efficiently if placed there.

Centre for Integrative Medicine A criticism of Singaporeâ&#x20AC;&#x2122;s medical infrastructure

conclusion

Working through this project, there were many challenges that were faced in the design process. It was especially difficult to invent a medical typology and a chromotherapy room prototype that has not yet been designed in the world. There were few case studies and many of them were fragmented in the sense that it only applied to a certain characteristic of the study.At the end everything had to be pieced together. With the expertise of my tutor, I feel happy to have completed this scheme to the best of my ability. Without him, this would not have been possible.

References Journals: 1. Azeemi, Samina T. Yousuf. “A Case History of Treatment of Cutaneous Leishmaniasis by Chromotherapy.” Chinese Medicine: 43-46. 2. Azeemi, S. T. Y. “A Critical Analysis Of Chromotherapy And Its Scientific Evolution.” Evidence-based Complementary and Alternative Medicine: 481-88. 3. Azeemi, Samina T. Yousuf, Syed Mohsin Raza, Masoom Yasinzai, and Mujeeb-ur Rehaman. “Absorption of Radiant Energy in Water – A New Conjecture and Theory of Charge Quantization in Chromotized Water Samples.” Science International- (Lahore) 20, no. 3 (2008): 189-96. 4. Azeemi, Samina T. Yousuf, Syed Mohsin Raza, and Masoom Yasinzai. “Colours as Catalysts in Enzymatic Reactions.” Journal of Acupuncture and Meridian Studies 1, no. 2 (2008): 139-42. 5. Azeemi, Samina T. Yousuf, S. Mohsin Raza, Masoom Yasinzai, and Abdul Samad. “Effect of Different Wavelengths on Superoxide Dismutase.” Journal of Acupuncture and Meridian Studies (2009): 236-38. 6. Azeemi, Samina. T. Yousuf. “Effects of Different Colours in the Visible Region on Leishmania Tropica.” Advances in Bioscience and Biotechnology: 380-84. 7. Azeemi, Samina T. Yousuf, Syed Mohsin Raza, and M.Ashfaq Ahmed. “Newly Developed Recursive Relationship for Fractional Quantum States and Associated Energy Eigen Values.” 8. Azeemi, Samina T. Yousuf, Rubina Tazayyen Yousuf, and Masoom Yasinzai. “Review of a Case History of the Treatment of Cutaneous Leishmaniasis.” Science International- (Lahore) 25, no. 4 (2013): 749-50. 9. Azeemi, Samina T. Yousuf, Syed Mohsin Raza, and Masoom Yasinzai. “Short Review Effect of Visible Range Radiations (colours) on Superoxide Dismutase and Immune System.” Science International- (Lahore) 25, no. 2 (2013): 285-86.

Centre for Integrative Medicine A criticism of Singapore’s medical infrastructure

List of appendices Appendix A Interview transcript (10/10/14) Dr Justin Morais, Mukhtiar Singh and others Sports Acupuncture Centre (Hougang) Dr Morais: Later on, we will go into the properties of colour. First, I will start with the general overview. The German physicists were working on frequencies and for a long time they were working on aspects not related to medicine. Until recent times, some doctors, the main doctor is Dr. Voll. He thought about bringing frequencies into medicine. So, they started sitting down and started picking out acupuncture points to bring out signals from the body. They started looking at this. This started in 1951. They picked up the acupuncture point of the lung and they started to pick up signals from that organ through a device. He got 3 types of signals. They found that a normal person’s signal is like this (Proceeds to draw a sinusoidal graph) and they found out that the signal is between 10Khz and 100Khz. Then, they though about, what about lungs which are diseased like asthma, pneumonia and bronchitis? And they got a signal like this (proceeds to draw a graph that is distorted from the first graph but still sinusoidal-indicating that disease causes your organs to vibrate at a different frequency) they said, this is interesting. What about a signal for cancer? The Chinese words they use are yin and yang. You heard of this before? Yin is cancer, yang is pneumonia and this is normal (points at the normal graph). They went deeper and they found the vibrating frequencies for all the organs and the diseases that are related to them. For instance, the hormones are around 10 Hz, the liver is 50-58Khz, the brain is 150Khz, and the skin is 100hz. I can only remember these few. So if any organ is not is that range then I can tell you that you have got some problem. Okay so I’ve given you a gist of it. Narpal Singh: In order to evaluate the amount of space I would need in my design, could you share the demographic and frequency of people that comes in during the day? Dr Morais: One patient is given a time of an hour and we can only attend to 12 patients in a day. However, the waiting list for my clinic was 6 months, now with increased staff we have contained it to 3 months. Narpal Singh: Am I right to say that there is a very high demand for treatment like this? Dr Morais: Definitely a need for it. Narpal Singh: Would I have to cater to people who would need to stay for an extended period of time? What would the treatment length be? Mukhtiar Singh: If the patient has mobility, then there is no need for an extended stay. However, dealing with patients with immobility, like cancer patients there might be a need. Generally for the bulk of situations, there is no need. If we are looking at design, then ideally, in the consultation room, I would like to have a bed. Some patients like to be relaxed when doing treatment like this. The room’s attack would be similar to a room in a clinic. We have another colleague who has a clinic with different treatment rooms; I can refer you to them. You could learn more from that. Narpal Singh: What is the severity of treatable diseases? Dr Morais: Cancer? It is very serious. Simple? Asthma. We do everything. Narpal Singh: There have been recorded 100% recoveries? Dr Morais: I dare not use that word. Dangerous. I would be looking for trouble if the ministry heard me say that. Only “doctors” have the ability to cure people. Narpal Singh: This is exactly why in Singapore I find it absolutely stifling that political undercurrents exist in industries like these. When I was doing my research for my dissertation, I realized that German and Russian scientists have been researching on these platforms for decades but I guess we follow the American and British norm. I personally think this has something to do with the economic health of the pharmaceutical industry suffering if treatments like these are proven to work. Others: Yes, you hit it right in the head. There is a lot of politics. Others: In cancer there is this treatment called Photo Dynamic Treatment (PDT) which uses coloured dyes to seek out the cancer cells in your body. After which radiation with red light causes the cells the die. However, if you bring this to Singapore, you will get in trouble with the law.

Muktiar Singh: It is the same as mammography. There are actually a lot of treatments out there that do not expose your body to such a high level of radiation, like tomography. Just by scanning the amount of body heat emitted, they can detect a tumor. A clinic in Singapore imported that technology and they were forced to get rid of the technology. There are alternative options available, but it depends on the government to open these options to us. We cannot afford to fight the government. Dr Morais: So we don’t use the word, cure. I don’t say that cancer patients can come here. If they come here, I would tell them to proceed with allopathic medicine first, and if they choose to come here, then I tell them that I will help build up your immune system to fight cancer but not that I will cure you. (it would be politically incorrect, even if it was true.) Narpal Singh: So would you categorize this treatment as alternative or supplementary? Dr Morais: For many years, western medicine has looked at us as supplementary but I would use the word complimentary or integrative. Narpal Singh: Moving on to the topic of coloured lighting and treatment. How effective would it be if we were to transform our windows into a source for this cause? Mukhtiar Singh: What you are raising is actually how colour therapy started. In the old days, they used to place coloured water near windows (through the use of minerals etc). A patient would sleep close to the window with the coloured light shining on his ailing organ. That is how this started. In India they used to do it. The Egyptians on the other hand, they had a point of light coming through, as white light is composed of component colours, and they used to use it for treatment. If I want to do that, it would be equally as effective. But today we have more technology, we do not need that. There is enough equipment out there. If you go to Kampong Senang, they use a light bulb and cellophane (green) and treat people for breast cancer. It is easily done. However, for all treatments we like natural daylight over artificial lighting for treatment. (Varying radiation levels-we will talk about that later) Narpal Singh: The direction in which I was thinking of going is executing something like this with holistic sustainability. Why use electricity when we can get the light from the sun? Do you think this is viable? Mukhtiar Singh: This would actually be great because then you will be able to control the radiation levels in the room, which is key to treatment. Ideally, we can use LED or ecosystem lighting to boot. Everything is a frequency. We live in a time of Quantum Mechanics. When there is interference that is when radiation comes into play. So now in your design it is vital to protect your patients from radiation. Dr Morais: Where you are extremely important. When you are in Bukit Timah, you will be greatly exposed to radiation. You can pick this up. Near Bukit Timah, the houses are horrible houses. People living there always get headaches, sicknesses. I use my radiometer and go to the houses there and the radiation levels are very high. The Singtel Telco tower and Mindef facilities cause it. Mukhtiar Singh: We can share with you architectural strategies that you can take to cut radiation levels in your building. To deatails of even the type of mattress that the patient is sleeping on can be used to control these levels. They are majorly based in Austria. Dr Morais: Actually the guy who is the expert in radiation was not able to make it today. Mukhtiar Singh: You can design your treatment spaces with very very low radiation levels. Recovery becomes much better. Go to Geovital academy to learn more. Narpal Singh: Do you think there is a need for a building like this? Dr Morais: Yes definitely, but it has to come from the government. Like in Germany and all, they are very paticular about things like radiation….but in Singapore, no. Here they put Wifi everywhere. Do you know that Wifi is actually very bad for you? In Germany they are very particular, even in the building design they are made to forfeit Wifi through the use of safe cabling. Mukhtiar Singh: Here we can see that, a problem is already being created internally. Others: Basically you can draw a relationship from people living in attap houses and those in ultra-modern housing. Their life expectancy is shortened by at least 10 years. I think in architecture you’re familiar with the term steel rebar. These are materials that heighten radiation and are actually very very bad for you. They are a source of radiation and affect your health tremendously.

Centre for Integrative Medicine A criticism of Singapore’s medical infrastructure

Dr Morais: This would be a very interesting element for your architecture. Do you know Seletar hills drive? That area I found 4-5 families all getting cancer. They were all working near Woodbridge hospital and were diagnosed with a variety of cancers. That was the time I was in Germany learning about radiation. I picked up my radiometer and went to that area and I picked up massively heightened radiation levels. This has to do greatly with the design and architecture of the building and they should all not be living there. I didn’t know what was the problem. There was a stream there and overhead cables. I have a friend Nixon and I told him to go there to take a look and he found that the cement was the one that amplified and emitted radiation. Mukhtiar Singh: Another source of it is the watercrosses underground. Before you even pick you site and build your building, you have to go down and do a ground survey. You have to make sure that you don’t put a bed above one of these points. You will get cancer over time. It is the node in which north and south poles cross. There are so many factors. Another important factor is that we are north of the equator, in treatment; the head of the patient should never be facing the north. The magnetic fields are amplified in this direction. Everything eventually comes back down to design. Dr Morais: So feng shui is important! Mukhtiar Singh: There was once we went to Germany and saw this person’s house and it is fantastic. Everything is natural. There is almost zero radiation in the house. He uses almost only sunlight and filters. There are certain aspects of it is still applicable even though the population might not be ready for these types of changes. Now you have a site, you can conduct a ground survey very easily. In 1-2 days you can pick out all the crossings on the ground. Check the water table. It can cause rheumatic problems to spaces located one level above it. There are many factors. We did the watercross for one home. She had cancer and I didn’t ask her where she slept but I did a survey of the house and I marked out the area in which there was a sudden peak in radiation. I asked her “ do you sleep here?” and she was shocked at my accuracy. Different types of radiation. There are 6 main factors. Dr Morais: This would be a very interesting element for your architecture. Do you know Seletar hills drive? That area I found 4-5 families all getting cancer. They were all working near Woodbridge hospital and were diagnosed with a variety of cancers. That was the time I was in Germany learning about radiation. I picked up my radiometer and went to that area and I picked up massively heightened radiation levels. This has to do greatly with the design and architecture of the building and they should all not be living there. I didn’t know what was the problem. There was a stream there and overhead cables. I have a friend Nixon and I told him to go there to take a look and he found that the cement was the one that amplified and emitted radiation. Mukhtiar Singh: Another source of it is the watercrosses underground. Before you even pick you site and build your building, you have to go down and do a ground survey. You have to make sure that you don’t put a bed above one of these points. You will get cancer over time. It is the node in which north and south poles cross. There are so many factors. Another important factor is that we are north of the equator, in treatment; the head of the patient should never be facing the north. The magnetic fields are amplified in this direction. Everything eventually comes back down to design. Dr Morais: So feng shui is important! Mukhtiar Singh: There was once we went to Germany and saw this person’s house and it is fantastic. Everything is natural. There is almost zero radiation in the house. He uses almost only sunlight and filters. There are certain aspects of it is still applicable even though the population might not be ready for these types of changes. Now you have a site, you can conduct a ground survey very easily. In 1-2 days you can pick out all the crossings on the ground. Check the water table. It can cause rheumatic problems to spaces located one level above it. There are many factors. We did the watercross for one home. She had cancer and I didn’t ask her where she slept but I did a survey of the house and I marked out the area in which there was a sudden peak in radiation. I asked her “ do you sleep here?” and she was shocked at my accuracy. Different types of radiation. There are 6 main factors.

Appendix B Bio resonance therapy: Bioresonance therapy was invented in Germany in 1977 by Franz Morell and his son-in-law, engineer Erich Rasche. Initially they marketed it as “MORA-Therapie”, for MOrell and RAsche. Some of the machines contain an electronic circuit measuring skin-resistance, akin to the E-Meter used by Scientology, which the bioresonance creators sought to improve. Practitioners claim to be able to detect variety of diseases and addictions. Some practitioners also claim they can treat diseases using this therapy without drugs, by stimulating a change of “bioresonance” in the cells, and reversing the change caused by the disease. The devices would need to be able to isolate and pinpoint pathogens’ responses from the mixture of responses the device receives via the electrodes. Transmitting these transformed signals over the same electrodes is claimed by practitioners to generate healing signals that have the curative effect Bio resonance therapy setup:

Centre for Integrative Medicine A criticism of Singapore’s medical infrastructure

Appendix C Interview transcript Dr Samina Azeemi (Over Email) Narpal Singh: Dear Sir/Maam, I am a graduate student from the National University of Singapore (NUS) and am completing my masters in the faculty of Architecture. One of the partial requirements for this course is to complete a dissertation. I am writing my dissertation now and there is a part on it which looks at the biological healing properties of colour. I was looking at some online databases and I chanced upon a paper that you co-authored called â&#x20AC;&#x153;A Critical Analysis of Chromotherapy and Its Scientific Evolution.â&#x20AC;? I thought that the insights and knowledge that you had in the field was very impressive and in fact very encouraging on my end of the line. There are very limited scientific sources online that prove the healing properties of colour. I just wanted to ask if it would be okay for me to interview you through email, given the knowledge you have in this field. It would be a tremendous boost to my paper. I am currently trying to develop healing spaces through sustainable architecture and one of the components is through the use of colour. I look forward to a dynamic discussion. Thank you for your time and I hope to hear from you soon. Dr Samina Azeemi: Dear Singh, It is good to hear about your interest in Colours. You may ask questions pertaining to my work. Narpal Singh: Dear Dr Samina Azeemi, First and foremost, I would like to thank you for your kind gesture of allowing me to interview you with regard to the topic of colour. My main queries are basically to gather knowledge on the premise of the healing properties of exposure to colour, essentially the projection of the spectrum of colours (light) and its implications on a human body through space. I am using diffraction gratings as a tool for my design intervention and in your writing I picked up a fact that stated, Edwin Babbitt in particular had a cabinet that was able to split light into the seven colours of the spectrum and it in turn was able to account for healing properties. Facts like these gives me some promise as for the next step of my project, I would have to design spaces that rely on phenomenon like these for medical causes. So with this brief outline I hope you can understand the basis of my paper with greater resolution. I shall proceed with the interview questions. Question 1. Have there been any scientifically or statistically backed evidence Question 2. Are there any psychological implications from the exposure to the light that forms the spectrum of colours? If no, there are various papers out there that suggest that different colours cause people to have different psychological responses. How do you think the exposure to all 7 colours will impact the human mind? Question 3. In the case of jaundice, the exposure to blue light is effective in combating the disease. Do you think it would be possible to split daylight into its seven colours and in turn contract the light back only to the wavelength that the colour blue comprises and expose a patient with jaundice to that blue light in order to achieve that same medical proficiency? Question 4. I am thinking of designing a medical centre for my thesis project that splits natural light into its spectrum of colours as a form of therapy and treatment for people with illnesses. Do you think this has the potential to be a successful medical strategy? What are the possible illnesses that can be combated with a strategy like this? Question 5. Through your work, it is evident that you have worked with colours to a great extent. As a closing question, I would love to hear about what you have to say regarding the promise of an architecture that splits light into its seven colours and its impact, if any, on people. If not for medical use, what other advantages or disadvantages are there while exposing people to this expression? By giving me the opportunity to ask you these questions, you will be imparting knowledge to me that will be very crucial to my final product. I believe in world of sustainability and I feel that light is one form of free energy we have not used to its greatest potential. I thank you very much Dr Samina Azeemi for your time, expertise and graciousness.

Dr Samina Azeemi: Dear Singh, I am attaching my research manuscripts; I hope they will certainly fulfill your questions. Certainly colours do affect the human mind and a number of psychological diseases are reported which have been cured using colours only. In my research, instead of splitting light by diffraction grating, I have using filters known as cellophane sheets of certain wavelengths. These are easily available everywhere through stationary shops. When you will see my manuscripts, you will find the methodology adopted for curing different diseases. I have worked on this project only because of its simplicity, cost-effectiveness and direct way of treatment. I think colour therapy can be used for treating all kind of diseases but my faith is that it is more useful when treatment is given free of cost.

Centre for Integrative Medicine A criticism of Singaporeâ&#x20AC;&#x2122;s medical infrastructure