Profile... National doctor finds shock is the best medicine

Karuppiah Vijayalakshmi is an odd sort of doctor. Not for her the travails of individual patients. She treats an entire population, or at least large bits of it, all at once.

The general practitioner turned social marketer now heads the marketing and communications arm of Singapore’s Health Promotion Board, a Government department founded in 2001 with a mission ‘to build a nation of healthy and happy people’. And in that role she is fast developing a reputation as one of the Lion City’s most creative marketers.

Her job involves persuading more than four million Singaporeans in four different languages that smoking isn’t cool or that chicken rice isn’t the cornerstone of a healthy diet. No easy task in a country that takes health less seriously than one might think.

“The biggest problem we face is that most Singaporeans do not see health as a desirable lifestyle choice,” she says. “Our job is made harder by advertising messages that are contrary to ours.”

With a modest marketing budget, HPB cannot out-shout the likes of KFC, for example, with advertising about the need for a balanced diet. This is a problem complicated by a wide range of health issues, new and old, that cut her budget into small pieces.

“At the beginning of the year we work out the priority health issues and divide the budget accordingly,” Vijaya explains. “Each year presents us with different challenges as the population ages.”

This year, mental health and nutrition are big health issues, while smoking among young women tops the list. Only 12.6 per cent of Singaporean adults smoke - low for Southeast Asia - but the number of girls lighting up is rising.

Singapore’s smoking problem has led to the sort of advertising for which HPB is famous (or infamous). Dr Vijaya is a charming and mild-mannered woman, which is why the ads she often sanctions are all the more surprising. Last year’s anti-smoking campaign featuring a girl’s face grotesquely disfigured by oral cancer was the stuff of nightmares. But Vijaya is unapologetic. “Of course we receive complaints. Children are unable to sleep, so we’ve had to move our TV ads to later time-slots. But that campaign led to a five-fold increase in the number of calls to our quit line - our most effective anti-smoking effort yet. Shock works.”

HPB took scare tactics to another level earlier this summer when it placed a car-sized sculpture of an amputated gangrenous foot at Raffles Place to raise awareness of the dangers of diabetes. “Singaporeans love a bit of a scare,” says Dr Vijaya.

But she is mindful not to stick to one tactic. A softer approach to female smokers recently saw luxury items placed in display cases in shopping malls. The idea being that girls were shown the things they could afford to buy if they gave up.

Images of fruit and vegetables stuck on table surfaces in Singapore’s hawker centres point to a more positive approach to nutrition, too. “We used to tell people what they couldn’t eat. Now we tell them what they can,” she says. HPB is now even tackling HIV in a more creative way, warning young male executives of the dangers of membership to this ‘elite club’ with a pastiche of a credit card campaign.

This new thinking is partly down to a review of how HPB works with its agencies (which include DDB, Ogilvy, Edelman and Fleishman Hillard); it did away with a system that required a formal advertising tender for every campaign.

“It was time-consuming and we didn’t attract the biggest and best agencies. Now, though, the agencies we work with have more time to develop a deeper understanding of the issues. We can now turn around campaigns faster, too.”

The next sector to feel her presence will be the gambling industry. Dr Vijaya will not reveal her views on tackling problem gambling. But it is likely that she will work with casino operators in a similar way to how she has engaged fast-food brands. Subway, McDonald’s and Milo now promote healthier consumption thanks to HPB lobbying.

Dr Vijaya is aware that, without the help of mainstream brands, HPB’s vision, ‘to normalise healthy living in Singapore’, will be difficult. There is a sense that she wants HPB to behave more like a mainstream brand than a finger-wagging Government body.

“We see ourselves as marketers just as much as we are health advisors. Our mission is to make health a desirable brand.”

Dr Vijaya's CV

2001 Director, corporate marketing and communications division, Health Promotion Board
1998 Director, elderly policy and development, Ministry of Health
1992 Director, Healthy Lifestyle Unit, Ministry of Health