In some wards, Singaporeans were a minority; more than half the nurses were from the Philippines and China, with a handful from India and other countries.

Asked how long she had been here, a Filipino nurse replied: “Two years. Our country is producing too many healthcare workers.”

Doctors from Malaysia, male lab technicians from the Philippines and Hong Kong, attendants from Bangladesh, and so on. Take them away and there will be a breakdown of service at the Singapore General Hospital.

In recent years, a number of Caucasian doctors were recruited to make up for the growing number of local doctors who quit.

Their benefits to the health service are tremendous. The foreigners are helping to keep costs down and efficiency up.

Lean and hungry, they work hard and put pressure on any laid-back locals to be more conscientious.

My next first-hand lesson was the poor health of many senior citizens, discernible only to hospital workers. Take the case of a diabetic who was wheeled in at 3.30am groaning in discomfort from an attack.

He was in his 60s – like most of the others in this renal section. From across the room, I saw him brought in by his wife. I was there for severe abdominal pains.

They came in, most with big stomachs from not exercising regularly. Some are smokers, nipping into the hospital toilet in the dark of night to steal a smoke or two.

These men and women, mostly in their 60s and 70s, were being brought in with dysfunctional bodies to be patched up.

This was independent Singapore’s first generation, not-too-well-educated but hard working, whose efforts allowed the country to overtake advanced nations like Britain, Canada, France and Germany in per capita income.

Today they are paying the price.

A world war, regional conflicts, riots and an endless life of economic struggles have resulted in broken bodies and neglected health. Many have succeeded in bringing up – and educating – a new generation of children and grandchildren.

Most spoke no English, only dialects.

One operated his own air-condition repair business and was always in a hurry to leave. “I have to get back to work. There’s a lot of work waiting for me,” he pleaded with the nurses.

Another dialect-speaking patient described himself as a full-time taxi-driver and part-time gambler. He spoke freely about his woes to his fellow patients.

Some 11 percent of Singaporeans – or 1 in 9 – are 60 years or older, a figure that will double to 21percent in 2020. Only in Japan (25 percent) Hong Kong (15percent) and Taiwan (12percent) is the spread of the silver tide worse.

That means that each economically inactive senior Singaporean will have to be looked after by two working adults.

This is one of the major problems facing the ruling People’s Action Party (PAP) which has governed here for 40 years – ensuring how the aged can retire with financial means (at age 62) and keeping health costs low.

More than half the Central Provident Fund (CPF) members do not have enough cash savings to retire on, according to official studies.

Most of these senior citizens are traditional supporters of the PAP, so the party’s – and the nation’s – fortunes will depend on how it handles this issue.

It is a tough act given its refusal to resort to welfarism – even “back door” subsidies. It is the children, not the government, who should care for the elderly, it says.

In hospital, one could gauge the welfare of the patient by an unfailing criterion – visiting time.

If he gets regular visits from lots of family members, chances are he is all right. If there is none, then trouble.

Happiest of all was the Malay grandfather who seemed to be always surrounded by a sea of family members who’d kiss his hand when they visited him.

In contrast, a 70-year-old kidney patient with poor skin and a poorer attitude was always giving the nurses hell.

He refused to eat his morning bread until the nurse spread jam on it. He would sit up in bed several times during the night and shout for the nurses, asking for one thing or another, refusing to use the buzzer.

Not a single person visited him during the two days I was there.

In recent history, however, perks for the above-60s have been increasing. They include cheaper public transport when travelling in trains and buses between 10am and 4pm.

On weekdays a cinema ticket costs them S$3.50 instead of S$7; for “night safari,” for example, it was S$9.25 instead of S$15.45.

And now the government is building special public studio apartments for elderly couples that are smaller and cheaper (S$47,800 to S$71,700) with a shorter 30-year lease.

The scheme allows them to downgrade from their larger Housing Development Board flats so that can live better.

The poorer seniors are getting other official help in the form of free conservative charges, subsidised healthcare and free meal coupons given by hawkers.

In addition, social workers regularly visit to clean up and refurbish their one-room flats.

The recession is hitting the elderly harder than others. Younger workers can be hired for less pay; older ones often get the sack by employers seeking to reduce their payroll.

The only jobs available for the aged are in unskilled services – fast-food outlets, petrol kiosks, retail sales and cleaning.

Many senior citizens are unable to cope with a modern high-tech world. Almost half the Singaporean workers, most of them aged 50 and older, have less than six years of education.

For this globally-competitive city, many of these senior citizens will have a hard time finding a meaningful job from now on. They will have to depend more on their children.

For the next 15 to 20 years, Singapore’s welfare will depend on the health of the family unit.

Seah Chiang Nee is a veteran journalist and editor of the information website littlespeck.com