Monday, June 13, 2005
Free Condoms And Needles For Addicts Not A Waste- Chua
KUALA LUMPUR, June 13 (Bernama) -- The cost of providing free condoms and syringes to drug addicts is expected to cost RM145 million annually but will help avoid 90,000 new HIV infections, Health Minister Datuk Dr Chua Soi Lek said Monday.
He said the government was seriously thinking of introducing the measure (free provision of needles and condoms to drug addicts) as the cost of treating HIV patients had exceeded RM500 million yearly.
"That is the cost of medication only and does not include other costs," he told reporters after opening the Millennium Development Goals Seminar organised by his ministry and the World Health Organisation (WHO) here.
Dr Chua said almost 40 per cent of drug addicts who were HIV positive also contracted other illnesses like tuberculosis and pneumonia which further added to the cost of treatment.
"In short, providing the needles and condoms is not a waste of the people's money ... in terms of savings, it is triple the amount," he said.
Earlier this month, Dr Chua announced that the government was seriously considering providing syringes and condoms for free to drug addicts to stem the spread of HIV.
However, the proposal received various reactions, with ulamas and religious organisations fearing the move would lead to indiscriminate sex while non-governmental organisations lauded the move.
Dr Chua added that he and Minister in the Prime Minister's Department, Datuk Dr Abdullah Mohamed Zin would meet with ulama groups soon to clarify the issue.
-- BERNAMA
Sunday, June 12, 2005
The Illiterate Surgeon
The Illiterate Surgeon
From the New York Times
By NICHOLAS D. KRISTOF
ADDIS ABABA, Ethiopia
Just about the worst thing that can happen to a teenage girl in this world is to develop an obstetric fistula that leaves her trickling bodily wastes, stinking and shunned by everyone around her. That happened four decades ago to Mamitu Gashe.
But the most amazing thing about Ms. Mamitu is not what she endured but what she has become.
Ms. Mamitu's story begins when she was an illiterate 15-year-old in a remote Ethiopian village unreachable by road and with no doctor nearby. She married a local man, became pregnant and after three days of labor, she lapsed into unconsciousness and the baby was stillborn.
"After I woke up, the bed was wet" with urine, she remembers. "I thought I would get better after two or three days, but I didn't."
That's typically how an obstetric fistula arises: a teenage girl, often malnourished and with an immature pelvis, tries to deliver her first baby. The fetus gets stuck, and after several days of labor it is stillborn - but some of the mother's internal tissues have been damaged in that time, and so to her horror she finds herself constantly trickling urine or sometimes feces from her vagina.
Soon she stinks. Her husband normally abandons her, the constant trickle of urine leaves her with terrible sores on her legs, and if she survives at all she is told to build a hut away from the rest of the village and to stay away from the village well. Some girls die of infections or suicide, but many linger for decades as pariahs and hermits - their lives effectively over at the age of about 15.
Fistulas were common in America in the 19th century. But improved medical care means that they are now almost unknown in the West, while the United Nations has estimated that at least two million girls and women live with fistulas in the developing world, mostly in Africa.
This should be an international scandal, because a $300 operation can normally repair the injury. A major effort to improve maternal health in the developing world should be a no-brainer, for it could prevent most fistulas and reduce deaths in childbirth by half within a decade, saving 300,000 lives a year.
But maternal health is woefully neglected, and those suffering fistulas are completely voiceless - young, female, poor, rural and ostracized. They are the 21st century's lepers.
Ms. Mamitu was exceptionally lucky in that she was brought to a hospital here in Addis Ababa that offered free surgery by a saintly husband and wife pair of gynecologists from Australia, Reginald and Catherine Hamlin. Reg is now dead, while Catherine is the Mother Teresa of our time and is long overdue for a Nobel Peace Prize.
After that operation, 42 years ago, Ms. Mamitu was given a job making beds in the hospital. Then she began helping out during surgeries, and after a couple of years of watching she was asked by Dr. Reg Hamlin to cut some stitches. Eventually, Ms. Mamitu was routinely performing the entire fistula repair herself.
Over the decades, Ms. Mamitu has gradually become one of the world's most experienced fistula surgeons. Gynecologists from around the world go to the Addis Ababa Fistula Hospital to train in fistula repair, and typically their teacher is Ms. Mamitu.
Not bad for an illiterate Ethiopian peasant who as a child never went to a day of school.
A few years ago, Ms. Mamitu tired of being an illiterate master surgeon, and so she began night school. She's now in the third grade.
The Fistula Hospital where Ms. Mamitu works is nicknamed "puddle city" - because patients stroll around dripping urine - but it abounds with joy and hope.
President Bush has increased aid to the developing world generally and to Africa in particular, but a few days ago he rejected Tony Blair's appeal for a further dramatic increase in assistance for Africa. The real stakes in that rejection will be measured in lives like Ms. Mamitu's. I hope that Mr. Bush will reconsider - for the sake of people like those girls with fistula living in huts alone on the edges of hundreds of thousands of villages.
Ms. Mamitu shows us what a tragedy it would be to write them off. A couple of Australians once gave Ms. Mamitu a break, and so today Ms. Mamitu is not a victim at all, but an inspiration.
And, I hope, an inspiration to us to be more generous.
But the most amazing thing about Ms. Mamitu is not what she endured but what she has become.
Ms. Mamitu's story begins when she was an illiterate 15-year-old in a remote Ethiopian village unreachable by road and with no doctor nearby. She married a local man, became pregnant and after three days of labor, she lapsed into unconsciousness and the baby was stillborn.
"After I woke up, the bed was wet" with urine, she remembers. "I thought I would get better after two or three days, but I didn't."
That's typically how an obstetric fistula arises: a teenage girl, often malnourished and with an immature pelvis, tries to deliver her first baby. The fetus gets stuck, and after several days of labor it is stillborn - but some of the mother's internal tissues have been damaged in that time, and so to her horror she finds herself constantly trickling urine or sometimes feces from her vagina.
Soon she stinks. Her husband normally abandons her, the constant trickle of urine leaves her with terrible sores on her legs, and if she survives at all she is told to build a hut away from the rest of the village and to stay away from the village well. Some girls die of infections or suicide, but many linger for decades as pariahs and hermits - their lives effectively over at the age of about 15.
Fistulas were common in America in the 19th century. But improved medical care means that they are now almost unknown in the West, while the United Nations has estimated that at least two million girls and women live with fistulas in the developing world, mostly in Africa.
This should be an international scandal, because a $300 operation can normally repair the injury. A major effort to improve maternal health in the developing world should be a no-brainer, for it could prevent most fistulas and reduce deaths in childbirth by half within a decade, saving 300,000 lives a year.
But maternal health is woefully neglected, and those suffering fistulas are completely voiceless - young, female, poor, rural and ostracized. They are the 21st century's lepers.
Ms. Mamitu was exceptionally lucky in that she was brought to a hospital here in Addis Ababa that offered free surgery by a saintly husband and wife pair of gynecologists from Australia, Reginald and Catherine Hamlin. Reg is now dead, while Catherine is the Mother Teresa of our time and is long overdue for a Nobel Peace Prize.
After that operation, 42 years ago, Ms. Mamitu was given a job making beds in the hospital. Then she began helping out during surgeries, and after a couple of years of watching she was asked by Dr. Reg Hamlin to cut some stitches. Eventually, Ms. Mamitu was routinely performing the entire fistula repair herself.
Over the decades, Ms. Mamitu has gradually become one of the world's most experienced fistula surgeons. Gynecologists from around the world go to the Addis Ababa Fistula Hospital to train in fistula repair, and typically their teacher is Ms. Mamitu.
Not bad for an illiterate Ethiopian peasant who as a child never went to a day of school.
A few years ago, Ms. Mamitu tired of being an illiterate master surgeon, and so she began night school. She's now in the third grade.
The Fistula Hospital where Ms. Mamitu works is nicknamed "puddle city" - because patients stroll around dripping urine - but it abounds with joy and hope.
President Bush has increased aid to the developing world generally and to Africa in particular, but a few days ago he rejected Tony Blair's appeal for a further dramatic increase in assistance for Africa. The real stakes in that rejection will be measured in lives like Ms. Mamitu's. I hope that Mr. Bush will reconsider - for the sake of people like those girls with fistula living in huts alone on the edges of hundreds of thousands of villages.
Ms. Mamitu shows us what a tragedy it would be to write them off. A couple of Australians once gave Ms. Mamitu a break, and so today Ms. Mamitu is not a victim at all, but an inspiration.
And, I hope, an inspiration to us to be more generous.
E-mail: nicholas@nytimes.com
More Medical Seats at IPTAs
Medical Faculties At Varsities Able To Handle Bigger Intake Of Students
KUALA LUMPUR, June 11 (Bernama) -- The government has increased the teaching capacity at the medical faculties of all the public universities to cater to a bigger intake of students, Higher Education Minister Datuk Dr Shafie Mohd Salleh said.
He said this was to prevent a recurrence of last year's problem where 128 Sijil Pelajaran Malaysia top scorers failed to get places to study medicine locally.
Dr Shafie said basic facilities such as teaching equipment had been improved or upgraded and more lecturers had been recruited since last year.
"So far, so good. I am quite sure that what happened last year will not happen again," he told reporters after launching the Career and Education Fair 2005 here.
Last year, after a public outcry, the government awarded the top scorers Public Service Department scholarships to study medicine overseas.
Dr Shafie also said that the announcement of this year's university intake would be made before the end of the month as the new 2005/2006 session begins in July.
In another development, Shafie said he had approved the unpaid leave of University Malaya economist Assoc Prof Dr Terence Gomez who had tendered his resignation after the university did not approve his two-year secondment to take up a research post in the United Nations.
"I only saw the application yesterday and I approved it," he said when asked by reporters to comment on the matter.
Shafie said he had also rejected Gomez's resignation, which means the economist could return to the university after completing his two-year secondment in Geneva.
-- BERNAMA
KUALA LUMPUR, June 11 (Bernama) -- The government has increased the teaching capacity at the medical faculties of all the public universities to cater to a bigger intake of students, Higher Education Minister Datuk Dr Shafie Mohd Salleh said.
He said this was to prevent a recurrence of last year's problem where 128 Sijil Pelajaran Malaysia top scorers failed to get places to study medicine locally.
Dr Shafie said basic facilities such as teaching equipment had been improved or upgraded and more lecturers had been recruited since last year.
"So far, so good. I am quite sure that what happened last year will not happen again," he told reporters after launching the Career and Education Fair 2005 here.
Last year, after a public outcry, the government awarded the top scorers Public Service Department scholarships to study medicine overseas.
Dr Shafie also said that the announcement of this year's university intake would be made before the end of the month as the new 2005/2006 session begins in July.
In another development, Shafie said he had approved the unpaid leave of University Malaya economist Assoc Prof Dr Terence Gomez who had tendered his resignation after the university did not approve his two-year secondment to take up a research post in the United Nations.
"I only saw the application yesterday and I approved it," he said when asked by reporters to comment on the matter.
Shafie said he had also rejected Gomez's resignation, which means the economist could return to the university after completing his two-year secondment in Geneva.
-- BERNAMA
Unbelieveable as it is, our MINIster of Higher Education only saw Dr Gomez's application for unpaid leave yesterday. He is probably a non-Malaysiakini reader, a non-blog reader and is deaf to what Opposition Leader, Lim Kit Siang as to say. If he intends to join "The celebration with Dr Terence Gomez", i would gladly sponsor him. The appproval may have come at the 11th hour but there is cause for celebration in GostanLand.
Did the UM VC not revealed Dr Gomez's forced resignation to him? Did they not discuss the issue prior to the VC accepting the resignation? If both the answers are 'No' then he should fire the VC.
Did the UM VC not revealed Dr Gomez's forced resignation to him? Did they not discuss the issue prior to the VC accepting the resignation? If both the answers are 'No' then he should fire the VC.
A Nation Of Healthy People
Govt Acts To Create A Nation Of Healthy People
PORT DICKSON, June 11 (Bernama) -- The government is turning words into deeds in its desire to create a nation of healthy people.
Today it announced a plan to establish a community health promotion centre in every state under the Ninth Malaysia Plan (2006-2010).
The announcement was made by Prime Minister Datuk Seri Abdullah Ahmad Badawi in his speech at the launch of the national-level healthy lifestyle campaign here. The text of Abdullah's speech was read out by Negeri Sembilan Menteri Besar Datuk Seri Mohamad Hassan.
Abdullah said these community health promotion centres would provide health packages that would enhance the people's knowledge and skills in four areas: healthy eating, engaging in physical activity, cultivating a healthy mind, and refraining from smoking.
A pilot project has been established at the Seberang Jaya Community Health Clinic in Penang, he said.
"The establishment of these centres is to realise the government's desire for the people of Malaysia to be healthy and well," said Abdullah.
He said the primary challenge the government faced in building a society that practised a healthy lifestyle at all times was changing the behavioural pattern of the society.
The prime minister said it was not easy to alter the behavioural pattern of society, adding that it could not be achieved overnight.
"We need much time to ensure that society not only changes its behavioural pattern but also maintains the new practice continuously," he said.
He said the government did not wish to have a situation where the people engaged in physical exercise and consumed healthy food for some time and then went back to their old ways.
The prime minister said that understanding the difficulty in changing a society's behavioural pattern, the government was encouraging promotion of a healthy lifestyle by establishing the relevant infrastructure and services.
Abdullah said the government, through the Health Ministry, always gave serious attention to the provision of excellent health facilities for the people.
Up to 2003, he said, the Health Ministry had established 117 hospitals, 864 health clinics, 1,847 rural clinics and 95 maternal and child health clinics in the country.
Abdullah also said that the situation of non-infectious ailments, particularly cardiovascular disease, that the nation faced now was most serious and worrying.
"Therefore, the government through the Health Ministry always strived to enhance health education and promotion among the people," he said.
Abdullah said one cause of cardiovascular disease, diabetes and obesity was the lack of physical activity.
The prime minister said the government's desire to create a nation of healthy people would not be achieved without the commitment of every individual and organisation in the society.
"Every member of society must play his or her respective role in helping the Health Ministry to realise its vision of building a healthy and active Malaysian society," he said.
Health Minister Datuk Dr Chua Soi Lek was also present at the launch of the three-day campaign.
-- BERNAMA
PORT DICKSON, June 11 (Bernama) -- The government is turning words into deeds in its desire to create a nation of healthy people.
Today it announced a plan to establish a community health promotion centre in every state under the Ninth Malaysia Plan (2006-2010).
The announcement was made by Prime Minister Datuk Seri Abdullah Ahmad Badawi in his speech at the launch of the national-level healthy lifestyle campaign here. The text of Abdullah's speech was read out by Negeri Sembilan Menteri Besar Datuk Seri Mohamad Hassan.
Abdullah said these community health promotion centres would provide health packages that would enhance the people's knowledge and skills in four areas: healthy eating, engaging in physical activity, cultivating a healthy mind, and refraining from smoking.
A pilot project has been established at the Seberang Jaya Community Health Clinic in Penang, he said.
"The establishment of these centres is to realise the government's desire for the people of Malaysia to be healthy and well," said Abdullah.
He said the primary challenge the government faced in building a society that practised a healthy lifestyle at all times was changing the behavioural pattern of the society.
The prime minister said it was not easy to alter the behavioural pattern of society, adding that it could not be achieved overnight.
"We need much time to ensure that society not only changes its behavioural pattern but also maintains the new practice continuously," he said.
He said the government did not wish to have a situation where the people engaged in physical exercise and consumed healthy food for some time and then went back to their old ways.
The prime minister said that understanding the difficulty in changing a society's behavioural pattern, the government was encouraging promotion of a healthy lifestyle by establishing the relevant infrastructure and services.
Abdullah said the government, through the Health Ministry, always gave serious attention to the provision of excellent health facilities for the people.
Up to 2003, he said, the Health Ministry had established 117 hospitals, 864 health clinics, 1,847 rural clinics and 95 maternal and child health clinics in the country.
Abdullah also said that the situation of non-infectious ailments, particularly cardiovascular disease, that the nation faced now was most serious and worrying.
"Therefore, the government through the Health Ministry always strived to enhance health education and promotion among the people," he said.
Abdullah said one cause of cardiovascular disease, diabetes and obesity was the lack of physical activity.
The prime minister said the government's desire to create a nation of healthy people would not be achieved without the commitment of every individual and organisation in the society.
"Every member of society must play his or her respective role in helping the Health Ministry to realise its vision of building a healthy and active Malaysian society," he said.
Health Minister Datuk Dr Chua Soi Lek was also present at the launch of the three-day campaign.
-- BERNAMA
Friday, June 10, 2005
NO to Open Debate on Free Needles and Condoms
Health Minister Declines Open Debate On Free Condoms For Addicts
CAMERON HIGHLANDS, June 10 (Bernama) -- Health Minister Datuk Dr Chua Soi Lek said Friday he did not wish to engage in an open debate, including through the media, on his ministry's proposal to distribute free needles and condoms to self-confessed drug addicts to check the spread of HIV/Aids.
"I will not respond to any opinion on the matter because at this stage we are still compiling information on the matter," he said.
Speaking at a press conference after visiting the Cameron Highlands Hospital project in Tanah Rata here, he said he would explain the issue at a press briefing after "all sides had expressed their opinion".
The ministry proposed to distribute free needles, condoms and methadone to a group of drug addicts under a pilot programme as a means of checking the spread of HIV/Aids.
Several state governments, including Perak, Terengganu dan Selangor, had opposed the proposal and Perak Menteri Besar Datuk Seri Tajol Rosli Ghazali had suggested that the issue be discussed at a special meeting of the Council of Muftis.
"The proposal is part of our responsibility to improve the health of the people ... we do not want to be known as a developing nation with a high incidence of HIV," Dr Chua said.
Meanwhile, he said the government's decision to stop building large hospitals under the Ninth Malaysia Plan and to upgrade existing ones was because the existing 125 hospitals were sufficient and that some of the hospitals were not fully utilised.
He said only one or two places still needed a large hospital while at other places smaller hospitals would be built, or existing hospitals would be upgraded.
He added that small hospitals would be equipped with equipment such as X-rays, maternity wards, children's wards and pharmacies.
According to him, the government would from now adopt the tender system for projects under his ministry to reduce costs. Some hospitals cost more than five star hotels to build, and when the cost was calculated per bed, each bed cost RM1.1 million, he said.
On the Cameron Highlands Hospital, he said it would be completed in March next year.
-- BERNAMA
CAMERON HIGHLANDS, June 10 (Bernama) -- Health Minister Datuk Dr Chua Soi Lek said Friday he did not wish to engage in an open debate, including through the media, on his ministry's proposal to distribute free needles and condoms to self-confessed drug addicts to check the spread of HIV/Aids.
"I will not respond to any opinion on the matter because at this stage we are still compiling information on the matter," he said.
Speaking at a press conference after visiting the Cameron Highlands Hospital project in Tanah Rata here, he said he would explain the issue at a press briefing after "all sides had expressed their opinion".
The ministry proposed to distribute free needles, condoms and methadone to a group of drug addicts under a pilot programme as a means of checking the spread of HIV/Aids.
Several state governments, including Perak, Terengganu dan Selangor, had opposed the proposal and Perak Menteri Besar Datuk Seri Tajol Rosli Ghazali had suggested that the issue be discussed at a special meeting of the Council of Muftis.
"The proposal is part of our responsibility to improve the health of the people ... we do not want to be known as a developing nation with a high incidence of HIV," Dr Chua said.
Meanwhile, he said the government's decision to stop building large hospitals under the Ninth Malaysia Plan and to upgrade existing ones was because the existing 125 hospitals were sufficient and that some of the hospitals were not fully utilised.
He said only one or two places still needed a large hospital while at other places smaller hospitals would be built, or existing hospitals would be upgraded.
He added that small hospitals would be equipped with equipment such as X-rays, maternity wards, children's wards and pharmacies.
According to him, the government would from now adopt the tender system for projects under his ministry to reduce costs. Some hospitals cost more than five star hotels to build, and when the cost was calculated per bed, each bed cost RM1.1 million, he said.
On the Cameron Highlands Hospital, he said it would be completed in March next year.
-- BERNAMA
Government Hospitals May Not Accept Patients From Private Hospitals
Government Hospitals May Not Accept Patients From Private Hospitals
TEMERLOH, June 9 (Bernama) -- The Health Ministry may cease the practice of government hospitals accepting patients from private hospitals for post-surgery treatment.
Minister Datuk Dr Chua Soi Lek said the co-operation between government and private hospitals, established on mutual understanding and on humanitarian grounds, had long existed.
He added that it was unfair to put the blame on government hospitals if patients from private hospitals who were brought there died.
Dr Chua was referring to a complaint by family members of a rubber tapper who died at the Sungai Petani Hospital Wednesday.
They claimed that P. Rajamah died due to the hospital's delay in admitting her.
A report in a newspaper Thursday said that Rajamah was supposed to undergo an operation to reduce a swelling in the brain at a private hospital but was sent to a government hospital because the Intensive Care Unit at the private hospital was full.
Speaking to reporters after a working visit to the Temerloh Hospital today, Dr Chua said it had become a trend for private hospitals to send their patients to government hospitals on the excuse that they did not have ICU facilities or the patients could not meet the high cost.
"After getting the payment (for the surgery), patients are sent to government hospitals and, when the patients die, we (government hospitals) are blamed," he added.
Dr Chua said he did not want the government hospitals to be blamed for the death of patients from private hospitals.
"We are being accused of not attending to the patients, making them wait too long .... We have to review this and, perhaps, will cease the co-operation with private hospitals like in the case of accepting their patients for post-surgery treatment," he told reporters after a working visit to the Temerloh Hospital, here Thursday.
Earlier, in his speech, Dr Chua said the government had no plans to build new hospitals under the Ninth Malaysia Plan.
However, he said, several hospitals would be upgraded to ensure quality service for the people. He said the ministry would increase the number of health clinics, adding that there were 4,000 clinics nationwide.
-- BERNAMA
The job of the MOH is to see that there is a win-win utilisation of both the public and private medical services in order that the patients benefit. Just like gomen hospitals and health facilities, private medical clinics and hospitals come in all shapes and sizes with varying equipments, staff, expertise and facilities. Often gomen health clinics and smaller hospitals are not properly nor fully equipped to handle all kinds of patients and often patients have to be transferred for them to receive optimal medical management or followup intensive treatment after initial stabilisation. Often this is faced by the smaller private hospitals and clinics. To deny patients further treatment in gomen hospitals just because they have been initially treated in private hospitals is to deny them proper treatment. What the MOH should do is to come up with a protocol for proper and safe transfers of such patients when the private hospitals do not have the expertise or equipments or facilities to properly manage the patients. Private medical practitioners should also liase with their counterparts in gomen hospitals to ensure that when the need arises, there is proper and safe transfers of these patients between facilities. Communication breakdowns and mis-communications should be reduced to the minimum.
Just because of the recent case of Rajamah the established co-operation between gomen and private hospitals based on mutual understanding and on humanitarian grounds should not be cast aside. The MOH should instead fully investigate this case and apportioned blame correctly. In the case of Rajamah, interventions by none other than MIC president Datuk Seri S. Samy Vellu and state executive councillor Datuk V. Saravanan were said to be needed before Rajamah could get admited to the ICU of Sungai Petani Hospital.
Just because of the recent case of Rajamah the established co-operation between gomen and private hospitals based on mutual understanding and on humanitarian grounds should not be cast aside. The MOH should instead fully investigate this case and apportioned blame correctly. In the case of Rajamah, interventions by none other than MIC president Datuk Seri S. Samy Vellu and state executive councillor Datuk V. Saravanan were said to be needed before Rajamah could get admited to the ICU of Sungai Petani Hospital.
Of Free Needles & Condoms
June 02, 2005 15:23 PM
Govt Mulls Needle Exchange, Free Condoms To Addicts - Dr Chua
KUALA LUMPUR, June 2 (Bernama) -- The Health Ministry is seriously considering providing needles and condoms to drug addicts to reduce the spread of HIV, the AIDS-causing virus, Minister Datuk Dr Chua Soi Lek said Thursday.
As an initial step, he said, the ministry would embark on a six-month pilot project to supply free needles and condoms to 1,200 injecting drug users (IDUs) besides methadone, a drug substitute.
Under the Harm Reduction Programme, the needles and condoms would be supplied through 10 selected government and 10 private clinics nationwide in October after the medical staff have been given proper training.
"We've to consider the needle exchange approach. We are providing them the needles so that they will not share needles. In many countries, the results are good in reducing HIV infection rate," he told reporters.
Dr Chua said 61,486 HIV infections, including 8,955 AIDS cases, were reported as of September last year, with 7,083 deaths.
He said 75 per cent of the HIV infections or 46,292 cases were IDUs.
Dr Chua said his ministry's effort was merely a "clinical and medical initiative" as the existing programmes have failed to reduce the infection rate.
"Morally, we're neutral. Actually, in medical reality, without condoms, HIV will spread," he said, expressing the hope that the public would give their feedback and support for the programme to be implemented.
He said the Cabinet Sub-Committee on Drug Addicts Treatment and Rehabilitation headed by him had considered all available data, including a study conducted in 26 drug rehabilitation centres in 1998.
The study on 6,326 inmates showed that 65 per cent of them were IDUs, with 77 per cent of them injecting drugs more than three times a day and shared needles with more than five people, he said.
He said the study also showed 77.6 per cent of the IDUs were sexually active, with only 18.7 per cent of them using condoms during sex.
He said the same study revealed the risk of contracting HIV among IDUs was six times higher than among non-IDUs.
"The risk of being infected with HIV among those sharing needles is seven times higher than those not sharing needles," he said.
It has been projected that by the year 2015, HIV carriers would escalate to 300,000 and drug addicts to about one million.
Dr Chua said the committee also considered other studies such as the global review of needle and syringe exchange programmes implemented between 1993 and 1998 in 29 cities worldwide.
He said they showed HIV prevalence among IDUs dwindled by an average of 58 per cent a year while the number of IDUs did not increase.
By contrast, he said, in 52 cities where no such programmes existed, HIV infections increased by six per cent annually.
He also cited the study in Belarus which showed such programmes had prevented over 2,000 HIV cases. Similar successes were also reported in Australia under the same programme.
Dr Chua said the government was aware of the public sensitivities on the move to provide free needles and condoms to addicts but the Health Ministry's stand was clear -- to discourage free sex.
"We only want the high-risk groups to use condoms. When a person is diagnosed to be HIV-positive, we do not encourage him or her to be every where.
"Using condoms is only one of the safeguards to prevent others from contracting HIV," he said.
In this regard, Dr Chua urged political parties and non-governmental organisations not to exploit the plan for their own agenda.
"Don't exploit the plan for political mileage. It has nothing to do with politics but for the interests of HIV sufferers and to protect Malaysia's image.
"We do not want Malaysia to be known as a developed nation but with the highest number of HIV carriers in Asia," he added.
-- BERNAMA
Free Needles And Condoms Less Expensive, Says Dr Chan
The Sarawak Perspective
KUCHING, June 7 (Bernama) -- It would be less expensive for the government to supply free needles and condoms rather then spending tax payers money trying to cure the HIV carriers and drug addicts.
Sarawak Deputy Chief Minister Tan Sri Dr George Chan said the Health Ministry's proposal might sound absurd, but as far as the medical side was concern, that would be a better measure to curb the problem of drug addicts and the spreading of HIV virus in the community.
"It would be much more expensive if you try to cure them... this people are not productive anymore, so this is a small price (for tax payers) to pay," he said.
Dr Chan was asked to comment on Health Minister Datuk Dr Chua Soi Lek's statement that the ministry would embark on a six-month pilot project to supply free needles and condoms to 1,200 injecting drug users (IDU's) beside providing them with methadone, a drug substitute.
"The moral side I would not want to comment...but as far as medical side is concern, that is a better thing to do rather than letting them to use needles and pass them around, which will then increase the chance of people being infected," he said, relating to his personal opinion as a medical doctor.
On the state government's stand of the issue, Dr Chan said so far the Cabinet had not discussed the matter.
Dr Chan's opinion was echoed by the president of the Federation of Kuching and Samarahan Division Chinese Association Dr Chou Chii Ming, but felt that there should be strict control as to who should get the free needles and condoms.
"Providing free needles and condoms will not be sufficient as we do not know who around us are drug addicts of HIV carriers. So, those people who get these things must register themselves," he said.
The ministry's proposal was also lauded by a community leader, Kapitan Lim Sin Khee, who believed that prevention was better than cure.
"It is good because we have to prevent the AIDS-causing virus from spreading. More importantly, drug addicts have to appreciate what the government is doing.
"As the number of drug addicts and HIV carriers is increasing, it is imperative that the government take stringent measures to stop the spread of the virus," he said.
-- BERNAMA
Perak Backs Free Condoms Plan But Only For Married Addicts
The Perak Perspective
IPOH, June 8 (Bernama) -- The Perak government will support the Health Ministry's plan to give free condoms to drug addicts to check the spread of HIV/AIDS if the distribution is restricted to married addicts.
Menteri Besar Datuk Seri Tajol Rosli Ghazali said the state would have a problem with the plan if condoms were given to unmarried addicts as well.
"It is okay if you want to give condoms to husbands but if you give it to bachelors, it is not appropriate since Islam prohibits sex between unmarried couples," he told reporters after the State Exco meeting.
He was asked to comment on a statement by Perak mufti Datuk Seri Harussani Zakaria Tuesday that opposed the ministry's plan to distribute free condoms and syringes to addicts.
Tajol Rosli said the state government supported the distribution of free condoms to married couples because it encouraged the use of condoms by Muslim couples with HIV/AIDS.
Perak required Muslims intending to get married to be tested for HIV/AIDS and those found positive would be given counselling and advice to use condoms if they wanted to continue with their marriage, he said.
He called on the Health Ministry to review the plan and hold discussions with religious leaders and non-governmental organisations to find the best way of implementing it.
On the plan to give free syringes to drug addicts, Tajol Rosli said the Perak government would not object to the plan but the ministry must first study its effectiveness.
He also called on the Council of Mufti to hold a meeting to discuss the issue and arrive at a common stance because the states now had varying views about it.
-- BERNAMA
Govt Mulls Needle Exchange, Free Condoms To Addicts - Dr Chua
KUALA LUMPUR, June 2 (Bernama) -- The Health Ministry is seriously considering providing needles and condoms to drug addicts to reduce the spread of HIV, the AIDS-causing virus, Minister Datuk Dr Chua Soi Lek said Thursday.
As an initial step, he said, the ministry would embark on a six-month pilot project to supply free needles and condoms to 1,200 injecting drug users (IDUs) besides methadone, a drug substitute.
Under the Harm Reduction Programme, the needles and condoms would be supplied through 10 selected government and 10 private clinics nationwide in October after the medical staff have been given proper training.
"We've to consider the needle exchange approach. We are providing them the needles so that they will not share needles. In many countries, the results are good in reducing HIV infection rate," he told reporters.
Dr Chua said 61,486 HIV infections, including 8,955 AIDS cases, were reported as of September last year, with 7,083 deaths.
He said 75 per cent of the HIV infections or 46,292 cases were IDUs.
Dr Chua said his ministry's effort was merely a "clinical and medical initiative" as the existing programmes have failed to reduce the infection rate.
"Morally, we're neutral. Actually, in medical reality, without condoms, HIV will spread," he said, expressing the hope that the public would give their feedback and support for the programme to be implemented.
He said the Cabinet Sub-Committee on Drug Addicts Treatment and Rehabilitation headed by him had considered all available data, including a study conducted in 26 drug rehabilitation centres in 1998.
The study on 6,326 inmates showed that 65 per cent of them were IDUs, with 77 per cent of them injecting drugs more than three times a day and shared needles with more than five people, he said.
He said the study also showed 77.6 per cent of the IDUs were sexually active, with only 18.7 per cent of them using condoms during sex.
He said the same study revealed the risk of contracting HIV among IDUs was six times higher than among non-IDUs.
"The risk of being infected with HIV among those sharing needles is seven times higher than those not sharing needles," he said.
It has been projected that by the year 2015, HIV carriers would escalate to 300,000 and drug addicts to about one million.
Dr Chua said the committee also considered other studies such as the global review of needle and syringe exchange programmes implemented between 1993 and 1998 in 29 cities worldwide.
He said they showed HIV prevalence among IDUs dwindled by an average of 58 per cent a year while the number of IDUs did not increase.
By contrast, he said, in 52 cities where no such programmes existed, HIV infections increased by six per cent annually.
He also cited the study in Belarus which showed such programmes had prevented over 2,000 HIV cases. Similar successes were also reported in Australia under the same programme.
Dr Chua said the government was aware of the public sensitivities on the move to provide free needles and condoms to addicts but the Health Ministry's stand was clear -- to discourage free sex.
"We only want the high-risk groups to use condoms. When a person is diagnosed to be HIV-positive, we do not encourage him or her to be every where.
"Using condoms is only one of the safeguards to prevent others from contracting HIV," he said.
In this regard, Dr Chua urged political parties and non-governmental organisations not to exploit the plan for their own agenda.
"Don't exploit the plan for political mileage. It has nothing to do with politics but for the interests of HIV sufferers and to protect Malaysia's image.
"We do not want Malaysia to be known as a developed nation but with the highest number of HIV carriers in Asia," he added.
-- BERNAMA
Free Needles And Condoms Less Expensive, Says Dr Chan
The Sarawak Perspective
KUCHING, June 7 (Bernama) -- It would be less expensive for the government to supply free needles and condoms rather then spending tax payers money trying to cure the HIV carriers and drug addicts.
Sarawak Deputy Chief Minister Tan Sri Dr George Chan said the Health Ministry's proposal might sound absurd, but as far as the medical side was concern, that would be a better measure to curb the problem of drug addicts and the spreading of HIV virus in the community.
"It would be much more expensive if you try to cure them... this people are not productive anymore, so this is a small price (for tax payers) to pay," he said.
Dr Chan was asked to comment on Health Minister Datuk Dr Chua Soi Lek's statement that the ministry would embark on a six-month pilot project to supply free needles and condoms to 1,200 injecting drug users (IDU's) beside providing them with methadone, a drug substitute.
"The moral side I would not want to comment...but as far as medical side is concern, that is a better thing to do rather than letting them to use needles and pass them around, which will then increase the chance of people being infected," he said, relating to his personal opinion as a medical doctor.
On the state government's stand of the issue, Dr Chan said so far the Cabinet had not discussed the matter.
Dr Chan's opinion was echoed by the president of the Federation of Kuching and Samarahan Division Chinese Association Dr Chou Chii Ming, but felt that there should be strict control as to who should get the free needles and condoms.
"Providing free needles and condoms will not be sufficient as we do not know who around us are drug addicts of HIV carriers. So, those people who get these things must register themselves," he said.
The ministry's proposal was also lauded by a community leader, Kapitan Lim Sin Khee, who believed that prevention was better than cure.
"It is good because we have to prevent the AIDS-causing virus from spreading. More importantly, drug addicts have to appreciate what the government is doing.
"As the number of drug addicts and HIV carriers is increasing, it is imperative that the government take stringent measures to stop the spread of the virus," he said.
-- BERNAMA
Perak Backs Free Condoms Plan But Only For Married Addicts
The Perak Perspective
IPOH, June 8 (Bernama) -- The Perak government will support the Health Ministry's plan to give free condoms to drug addicts to check the spread of HIV/AIDS if the distribution is restricted to married addicts.
Menteri Besar Datuk Seri Tajol Rosli Ghazali said the state would have a problem with the plan if condoms were given to unmarried addicts as well.
"It is okay if you want to give condoms to husbands but if you give it to bachelors, it is not appropriate since Islam prohibits sex between unmarried couples," he told reporters after the State Exco meeting.
He was asked to comment on a statement by Perak mufti Datuk Seri Harussani Zakaria Tuesday that opposed the ministry's plan to distribute free condoms and syringes to addicts.
Tajol Rosli said the state government supported the distribution of free condoms to married couples because it encouraged the use of condoms by Muslim couples with HIV/AIDS.
Perak required Muslims intending to get married to be tested for HIV/AIDS and those found positive would be given counselling and advice to use condoms if they wanted to continue with their marriage, he said.
He called on the Health Ministry to review the plan and hold discussions with religious leaders and non-governmental organisations to find the best way of implementing it.
On the plan to give free syringes to drug addicts, Tajol Rosli said the Perak government would not object to the plan but the ministry must first study its effectiveness.
He also called on the Council of Mufti to hold a meeting to discuss the issue and arrive at a common stance because the states now had varying views about it.
-- BERNAMA
It looks like finally the MOH is accepting that the gomen initiatives to deal with drug addiction and the spread of HIV are not producing results. Finally the MOH is seriously considering providing addicts with methadone and introducing free condoms and needles to addicts under the Harm Reduction Programme of combating drug addiction and HIV spread. These initiatives have produced good results in countries using them. Mindful of political, social and religious sensitivities, the MOH has rightly pointed out that the latest move must be seen as a "clinical and medical initiative".
Sarawak seems to have taken to the proposal positively but the Perak MB despite saying that the state gomen would support the MOH latest move, he wanted the condoms given only to married addicts. The reason for this is that "Islam prohibits sex between unmarried couples". The MB appears to be behaving like the proverbial ostrich, does he seriously think that the prohibition is seriously being observe by all single persons or that singles do not become drug addicts or have HIV. What is his view on unmarried non-muslim addicts? The effectiveness of the Harm Reduction Programme has already been shown in many studies and in countries using it for theri drug programmes, does he seriously want the MOH to carry out further studies and reinvent the wheel? It must also be noted that the Perak mufti Datuk Seri Harussani Zakaria also opposes the MOH's plan to distribute free condoms and needles to addicts.
It looks like Dr Chua might not get his pilot run running soon. The moral polis are surfacing once again.
Meanwhile, our rather indecisive PM, when asked about the MOH initiative, said the gomen is still considering the move and had yet to decide on the suggestion. He is saying all despite knowing that HIV/AIDS has reached a critical and dangerous stage. He said he had also asked the Health Minister to hold meetings with religious leaders to give an explanation on the dangers of the disease. Maybe he should be with Datuk Chua when the latter is explaining things to the religious leaders in order to provide moral and religious supports.
Sarawak seems to have taken to the proposal positively but the Perak MB despite saying that the state gomen would support the MOH latest move, he wanted the condoms given only to married addicts. The reason for this is that "Islam prohibits sex between unmarried couples". The MB appears to be behaving like the proverbial ostrich, does he seriously think that the prohibition is seriously being observe by all single persons or that singles do not become drug addicts or have HIV. What is his view on unmarried non-muslim addicts? The effectiveness of the Harm Reduction Programme has already been shown in many studies and in countries using it for theri drug programmes, does he seriously want the MOH to carry out further studies and reinvent the wheel? It must also be noted that the Perak mufti Datuk Seri Harussani Zakaria also opposes the MOH's plan to distribute free condoms and needles to addicts.
It looks like Dr Chua might not get his pilot run running soon. The moral polis are surfacing once again.
Meanwhile, our rather indecisive PM, when asked about the MOH initiative, said the gomen is still considering the move and had yet to decide on the suggestion. He is saying all despite knowing that HIV/AIDS has reached a critical and dangerous stage. He said he had also asked the Health Minister to hold meetings with religious leaders to give an explanation on the dangers of the disease. Maybe he should be with Datuk Chua when the latter is explaining things to the religious leaders in order to provide moral and religious supports.
Tuesday, June 07, 2005
Dr M relative’s drug label monopoly an outrage
From a Malaysiakini letter writer :: Totally Put Off
Jun 7, 05 1:43pm
I was appalled to read the recent expose on the latest example of crony capitalism in Malaysia involving the award of an monopoly concession to label all medicines and drugs before they can be sold in Malaysia.
There was no open, competitive bidding for this concession, no terms of reference, nothing. The company that received the concession, Mediharta Sdn Bhd, is partly-owned by Dr Mahathir Mohamad's sister in law, Saleha Mohamed Ali.
The rationale for the concession? These hologram drug labels will allegedly prevent counterfeit medicines from reaching our shores. But the Western pharmaceutical companies that produce these medicines and who should be cheering such a move are actually criticising it because:
a. the incidence of fake medicine is small in Malaysia and limited to traditional herbal medicines, which is not their concern;
b. the holograms are easily copied anyway and
c. it adds an extra layer of costs with no benefits to the consumer
This issue is not the same as the pirated software (CDs, VCD and DVDs) problem in Malaysia which is much more rampant and where the West supports any steps by the government to curb piracy.
This is more akin to allowing a company to charge 10 cents/ for every litre of diesel or petrol sold at every petrol pump in Malaysia in return for doing nothing . Except in the labelling issue, it is even more punitive.
It punishes every Malaysian each time they fall sick particularly the elderly and the chronically- ill. It adds an extra cost layer to our increasingly costly healthcare system with no added benefit.
Unlike our ‘beloved’ tolled roads for which there are alternative routes, medicines have no substitute. Drugs are patented and cannot be copied easily, if at all. Even generic drugs (cheaper versions of original drugs whose patents have lapsed) will have to be labelled. No exceptions. Even syringes now have to be labelled.
Despite protests from the pharmaceutical industry, the US and EU, the Malaysians government has pushed through the hologram label proposal which scheduled to be implemented this month.
So much for developing a first class mentality to match our first class infrastructure, Pak Lah. We haven't progressed from the good old feudal days when the ‘ketua kampung’ would bestow special privileges upon his coterie of cronies.
Will this be the last straw that breaks the camel's back? Will the rakyat finally say ‘enough is enough’ and finally put their collective foot down?
Jun 7, 05 1:43pm
I was appalled to read the recent expose on the latest example of crony capitalism in Malaysia involving the award of an monopoly concession to label all medicines and drugs before they can be sold in Malaysia.
There was no open, competitive bidding for this concession, no terms of reference, nothing. The company that received the concession, Mediharta Sdn Bhd, is partly-owned by Dr Mahathir Mohamad's sister in law, Saleha Mohamed Ali.
The rationale for the concession? These hologram drug labels will allegedly prevent counterfeit medicines from reaching our shores. But the Western pharmaceutical companies that produce these medicines and who should be cheering such a move are actually criticising it because:
a. the incidence of fake medicine is small in Malaysia and limited to traditional herbal medicines, which is not their concern;
b. the holograms are easily copied anyway and
c. it adds an extra layer of costs with no benefits to the consumer
This issue is not the same as the pirated software (CDs, VCD and DVDs) problem in Malaysia which is much more rampant and where the West supports any steps by the government to curb piracy.
This is more akin to allowing a company to charge 10 cents/ for every litre of diesel or petrol sold at every petrol pump in Malaysia in return for doing nothing . Except in the labelling issue, it is even more punitive.
It punishes every Malaysian each time they fall sick particularly the elderly and the chronically- ill. It adds an extra cost layer to our increasingly costly healthcare system with no added benefit.
Unlike our ‘beloved’ tolled roads for which there are alternative routes, medicines have no substitute. Drugs are patented and cannot be copied easily, if at all. Even generic drugs (cheaper versions of original drugs whose patents have lapsed) will have to be labelled. No exceptions. Even syringes now have to be labelled.
Despite protests from the pharmaceutical industry, the US and EU, the Malaysians government has pushed through the hologram label proposal which scheduled to be implemented this month.
So much for developing a first class mentality to match our first class infrastructure, Pak Lah. We haven't progressed from the good old feudal days when the ‘ketua kampung’ would bestow special privileges upon his coterie of cronies.
Will this be the last straw that breaks the camel's back? Will the rakyat finally say ‘enough is enough’ and finally put their collective foot down?
Sunday, June 05, 2005
Ensuring healthcare delivery system works
The NST Sunday Interview
THE SUNDAY INTERVIEW: Ensuring healthcare delivery system works
By Annie Freeda Cruez
Datuk Dr Ismail Merican, the Director-General of Health, has been making his rounds, meeting the doctors, nurses and administrators of public hospitals around the country. Putting faces to names is just the first step of his mission to make public hospitals the first, rather than last, cho ice for Malaysians, he tells ANNIE FREEDA CRUEZ
Q: We heard you have been on rounds to check what is happening in hospitals?
A: I care just not for doctors but all levels of healthcare providers in the ministry. That is why I am going round the country meeting everyone ranging from state and hospital directors to specialists, doctors, nurses, attendants, medical assistants and allied health personnel.
Why? Because I want to send the message that each one of them is important in the whole structure of the healthcare system.
I find the time to do that. Some of them had never seen the face of their director-general before. Now they have, and I'm listening to what they say. They may have particular problems and may also give good suggestions to improve the service. The important thing is to make sure they know we care.
We may not be able to offer better remuneration, but at least we can improve the working environment and career structure and provide more opportunities for them to update themselves technically.
If they want to pursue further training overseas to improve themselves, I will be the first to support them. I have gone to the Penang, Seremban and Malacca hospitals and I hope to cover all the States this year. I want to make sure I know the people I am dealing with. Some of them are names I see on documents. Now I want to meet and put a face to the names.
Q: How are you planning to bring changes?
A: I (want to) remind doctors of their role. What they can do and what they cannot do, that is what I mean by good medical practice.
I would like doctors to go back to the original concept of being doctors. I want ministry doctors to be the best they can.
Now, we are giving them more opportunities for training, providing a good working environment and better on-call allowances. In essence, we take care of our healthcare providers, so they in turn should take care of the profession and their patients and clients.
Q: You are known as the no-nonsense Director- General...
A: I have a strong sense of urgency. When instructions are given, I expect those who have been entrusted with the task to carry it out quickly and not delegate it to someone who will take a couple of weeks or months to get it done.
I place a lot of emphasis on trust and responsibility. If, for some reason, the instruction is not carried out, they must come back to me with an explanation.
When I give it to them personally, I mean business, and it also means that it is urgent and needs to be done quickly, within a week or two.
Similarly, patients must be given due attention, care, importance and a sense of dignity. It is unprofessional to make people wait and wait for decisions to be made simply because no one wants to make a decision and keep on passing the buck.
Some decisions we have made to improve the healthcare system include the implementation of the fast-track lane, reducing patients' waiting time, making sure doctors wear their white coat and name tags, rotation of doctors to various disciplines, and branding the Ministry of Health.
I assess the staff at all times. People walk into my room and I assess them as to how much they know and how much they don't know. I want to make sure they know more than me and if I know more than them in their area of expertise, I get apprehensive with the officers concerned.
The state and hospital directors must inform us of anything unusual that happens in the State or hospitals so that we can take fast remedial action. Nothing is worse than getting the news from the newspapers.
Q: What about doctors' complaints?
A: Doctors are unhappy about the working environment and slow promotions. This is my priority and hopefully in the next few months, we will be able to get more good news from the authorities regarding this.
Doctors also welcome greater opportunities to specialise and improve their knowledge and skills.
Q: What other improvements do you have in mind?
A: If they can improve the healthcare delivery system, have a sense of belonging, have a sense of urgency and are imbued with the ministry's corporate culture, I will be more than happy.
Q: At what stage is the National Health Plan?
A: It is going according to plan. Under the Ninth Malaysia Plan we are gearing towards upgrading of healthcare facilities as well as improving human capital.
I don't want to depend too much on foreign expertise. We need to start the training right now. We need to identify people, send them overseas so that they can come back and train others. Building human capital is very important.
Right now there is an imbalance regarding the type of specialist services offered in this country. We want to address this problem.
We need to identify the people and train them so that after four to five years, we will have a good group of competent and highly skilled specialists and sub-specialists to cater to the needs of our country.
Q: What about national healthcare financing?
A: I think enough has been said. The concepts and principles are very clear. The principle is, those who can afford must pay and those who cannot afford — the elderly, handicapped and the poor — will be taken care of by the Government. The concept is very simple.
We would like the public to get the same quality and scope of care or even better care from an integrated healthcare system.
Q: What about the target group?
A: It is being worked out. The Government and the ministry is very caring. We are not so heartless as to leave people in the lurch, as claimed by some NGOs or associations which keep on churning out statements and rhetoric as if they are the only ones who care about the people.
Please give us some credit. We have been toiling all these years to serve the people with high quality healthcare. Surely we are not about to abdicate our responsibility and leave sections of the population uncovered.
We always maintain that whatever we introduce is going to be better than what we have now. We are very caring and we will know what to do when the time comes.
Q: What plans (are there) to handle emerging are there and re-emerging diseases?
A: We have formed two committees. One is the National Pandemic Preparedness Plan, a special committee which will look into how we respond to a pandemic. It was set up in early May. I already had the first meeting to lay down the ground rules.
We must simulate an outbreak and see how far we are prepared. I intend to do this soon and enlist the co-operation of all stakeholders including the public and private sectors, the NGOs and the community.
We already have the SOP (standard operating procedures) and the guidelines about having these are not good enough. We need to simulate and test the system and see how prepared everyone is.
The second committee is the National Laboratory Biosafety committee which is important as well as it will make sure that all the labs in the country have the required standards to cater for the diagnosis of emerging diseases and identification of the aetiological agent.
We have in place a good surveillance system and early warning systems to detect unusual syndromes or atypical clinical presentations and take the necessary measures to contain and control as well as alert the community.
THE SUNDAY INTERVIEW: Ensuring healthcare delivery system works
By Annie Freeda Cruez
Datuk Dr Ismail Merican, the Director-General of Health, has been making his rounds, meeting the doctors, nurses and administrators of public hospitals around the country. Putting faces to names is just the first step of his mission to make public hospitals the first, rather than last, cho ice for Malaysians, he tells ANNIE FREEDA CRUEZ
Q: We heard you have been on rounds to check what is happening in hospitals?
A: I care just not for doctors but all levels of healthcare providers in the ministry. That is why I am going round the country meeting everyone ranging from state and hospital directors to specialists, doctors, nurses, attendants, medical assistants and allied health personnel.
Why? Because I want to send the message that each one of them is important in the whole structure of the healthcare system.
I find the time to do that. Some of them had never seen the face of their director-general before. Now they have, and I'm listening to what they say. They may have particular problems and may also give good suggestions to improve the service. The important thing is to make sure they know we care.
We may not be able to offer better remuneration, but at least we can improve the working environment and career structure and provide more opportunities for them to update themselves technically.
If they want to pursue further training overseas to improve themselves, I will be the first to support them. I have gone to the Penang, Seremban and Malacca hospitals and I hope to cover all the States this year. I want to make sure I know the people I am dealing with. Some of them are names I see on documents. Now I want to meet and put a face to the names.
Q: How are you planning to bring changes?
A: I (want to) remind doctors of their role. What they can do and what they cannot do, that is what I mean by good medical practice.
I would like doctors to go back to the original concept of being doctors. I want ministry doctors to be the best they can.
Now, we are giving them more opportunities for training, providing a good working environment and better on-call allowances. In essence, we take care of our healthcare providers, so they in turn should take care of the profession and their patients and clients.
Q: You are known as the no-nonsense Director- General...
A: I have a strong sense of urgency. When instructions are given, I expect those who have been entrusted with the task to carry it out quickly and not delegate it to someone who will take a couple of weeks or months to get it done.
I place a lot of emphasis on trust and responsibility. If, for some reason, the instruction is not carried out, they must come back to me with an explanation.
When I give it to them personally, I mean business, and it also means that it is urgent and needs to be done quickly, within a week or two.
Similarly, patients must be given due attention, care, importance and a sense of dignity. It is unprofessional to make people wait and wait for decisions to be made simply because no one wants to make a decision and keep on passing the buck.
Some decisions we have made to improve the healthcare system include the implementation of the fast-track lane, reducing patients' waiting time, making sure doctors wear their white coat and name tags, rotation of doctors to various disciplines, and branding the Ministry of Health.
I assess the staff at all times. People walk into my room and I assess them as to how much they know and how much they don't know. I want to make sure they know more than me and if I know more than them in their area of expertise, I get apprehensive with the officers concerned.
The state and hospital directors must inform us of anything unusual that happens in the State or hospitals so that we can take fast remedial action. Nothing is worse than getting the news from the newspapers.
Q: What about doctors' complaints?
A: Doctors are unhappy about the working environment and slow promotions. This is my priority and hopefully in the next few months, we will be able to get more good news from the authorities regarding this.
Doctors also welcome greater opportunities to specialise and improve their knowledge and skills.
Q: What other improvements do you have in mind?
A: If they can improve the healthcare delivery system, have a sense of belonging, have a sense of urgency and are imbued with the ministry's corporate culture, I will be more than happy.
Q: At what stage is the National Health Plan?
A: It is going according to plan. Under the Ninth Malaysia Plan we are gearing towards upgrading of healthcare facilities as well as improving human capital.
I don't want to depend too much on foreign expertise. We need to start the training right now. We need to identify people, send them overseas so that they can come back and train others. Building human capital is very important.
Right now there is an imbalance regarding the type of specialist services offered in this country. We want to address this problem.
We need to identify the people and train them so that after four to five years, we will have a good group of competent and highly skilled specialists and sub-specialists to cater to the needs of our country.
Q: What about national healthcare financing?
A: I think enough has been said. The concepts and principles are very clear. The principle is, those who can afford must pay and those who cannot afford — the elderly, handicapped and the poor — will be taken care of by the Government. The concept is very simple.
We would like the public to get the same quality and scope of care or even better care from an integrated healthcare system.
Q: What about the target group?
A: It is being worked out. The Government and the ministry is very caring. We are not so heartless as to leave people in the lurch, as claimed by some NGOs or associations which keep on churning out statements and rhetoric as if they are the only ones who care about the people.
Please give us some credit. We have been toiling all these years to serve the people with high quality healthcare. Surely we are not about to abdicate our responsibility and leave sections of the population uncovered.
We always maintain that whatever we introduce is going to be better than what we have now. We are very caring and we will know what to do when the time comes.
Q: What plans (are there) to handle emerging are there and re-emerging diseases?
A: We have formed two committees. One is the National Pandemic Preparedness Plan, a special committee which will look into how we respond to a pandemic. It was set up in early May. I already had the first meeting to lay down the ground rules.
We must simulate an outbreak and see how far we are prepared. I intend to do this soon and enlist the co-operation of all stakeholders including the public and private sectors, the NGOs and the community.
We already have the SOP (standard operating procedures) and the guidelines about having these are not good enough. We need to simulate and test the system and see how prepared everyone is.
The second committee is the National Laboratory Biosafety committee which is important as well as it will make sure that all the labs in the country have the required standards to cater for the diagnosis of emerging diseases and identification of the aetiological agent.
We have in place a good surveillance system and early warning systems to detect unusual syndromes or atypical clinical presentations and take the necessary measures to contain and control as well as alert the community.
Wednesday, June 01, 2005
Big O: Redundant reflex?
The Darwinian logic behind the female orgasm has long remained elusive. Women can have sexual intercourse and even become pregnant, doing their part for the perpetuation of the species, without experiencing orgasm. So what is its purpose?
Over the last four decades, scientists have come up with a variety of theories, arguing, for example, that orgasm encourages women to have sex and reproduce or that it leads women to favour stronger and healthier men, maximising offspring's chances of survival.
But in a new book, Dr Elisabeth A Lloyd, a philosopher of science and professor of biology at Indiana University, takes on 20 leading theories and finds them wanting. The female orgasm, she argues in the book, The Case of the Female Orgasm: Bias in the Science of Evolution, has no evolutionary function at all. Rather, Dr Lloyd says the most convincing theory is one put forward in 1979 by Dr Donald Symons, an anthropologist.
That theory holds that female orgasms are simply artifacts - a byproduct of the parallel development of male and female embryos in the first eight or nine weeks of life.
In that early period, the nerve and tissue pathways are laid down for various reflexes, including the orgasm, Dr Lloyd said. As development progresses, male hormones saturate the embryo, and sexuality is defined.
In boys, the penis develops, along with the potential to have orgasms and ejaculate, while "females get the nerve pathways for orgasm by initially having the same body plan." Nipples in men are similarly vestigial, Dr Lloyd pointed out. The female orgasm, she said, "is for fun".
NYT News Service
Operation On Twins A Success, Says Doctor
ALOR STAR, June 1 (Bernama) -- A team of local medical experts successfully operated on a pair of twins to repair their deformed spines although the operation on one of them was stopped due to complications.
The operation on the 25 year-old twins, Norbarkhih and Norbarkhiyah Mohd Yusoff, which took 17 hours since yesterday until about 2am Wednesday, made history in the country's medical record.
Immediately after leaving the operating theatre at 1.50am, the Alor Star Hospital consultant orthopaedic and spine surgeon, Dr Zamyn Zuki, who led the team, went to meet the twins' father, Mohd Yusoff Shari, shook his hand and told him that the operation was a success.
Tears of happiness welled in Mohd Yusoff's eyes and his wife, Sharifah Esah Syed Osman, after hearing the news. Both thanked the medical team for giving hope of a normal life to their daughters.
The twins' parents dashed towards Norbarkhiyah, who was still in a semi-conscious state, and held her hands as she was wheeled out from the operating theatre.
Speaking to reporters, Dr Zamyn said the operation was considered a success although the surgery on Norbarkhih had to be stopped about 6pm yesterday because of excessive bleeding.
"In the situation facing Norbarkhih, we (team) decoded to stop the operation because of the high risks involved, including endangering her life, if we were to continue with the operation.
"But she can continue with the operation in a few weeks," he added.
Dr Zamyn said the operation on Norbarkhiyah went smoothly and took a longer time than expected, which was between 10 and 11 hours, because of the curve on her spine which was higher than estimated.
"The surgery (on Norbarkhiyah) was smooth and she had shown good response like moving her feet after the operation," he added.
Besides Dr Zamyn, others in the team were Universiti Malaya orthopaedic specialist Dr Omar Isa, Alor Star Hospital orthopaedic specialists Dr John Ooi and Dr Jasminder Singh, Sungai Petani Hospital orthopaedic specialists Dr Ajay Kumar Sharma, Taiping Hospital orthopaedic specialist Mr Chooi Wai Kit, two anaesthetists and 24 support staff.
Dr Zamyn said the twins were in stable condition and were placed in the Intensive Care Unit for observation.
He said the operation made a history because it was the first involving identical twins with the same problems of scoliosis (deformed spines) and the surgery on them were conducted at the same time.
"We will not have an occasion like this again - twins, same problems and their operation held simultaneously," he added.
As for Mohd Yusoff, 67, neither words nor expression could describe his feelings and appreciation to the medical team for the successful operation.
Mohd Yusof said he was restless throughout the operation and had feared the worst, especially after seeing Norbarkhih, being wheeled out of the operating room much earlier than expected.
He said he would ask Norbarkhih to continue with the operation to correct her spine some other time.
-- BERNAMA
In BolehLand where records are very important, another success has been claimed. History has been made :: The first time, identical twins with scoliosis has been operated on simultaneously in the same hospital in the same state and in the same country. As an aside note, the chief surgeon has declared the simultaneous operations a success although the surgery on Norbarkhih had to be stopped about 6pm yesterday because of excessive bleeding. He said also that she will be operated on again later. Here's wishing the two sisters an early and full recovery.
Monday, May 30, 2005
Prenatal Testing::Cervical swab may be enough
Cervical swab may be enough for prenatal testing
Fri May 27, 2:13 PM ET
Researchers in Australia have worked out a way to isolate single cells from a fetus in the cervical mucus of a pregnant woman, and to use these cells to test for genetic abnormalities.
According to Dr. Mandy G. Katz-Jaffe and colleagues at Monash University in Melbourne, current methods for detecting chromosomal abnormalities in fetuses have various limitations or drawbacks. For example, amniocentesis carries a risk of miscarriage. Some screening tests give a high number of high false-positive results, while others are labor-intensive.
In the medical publication BJOG: an International Journal of Obstetrics and Gynecology, the researchers describe their process for isolating fetal cells from the cervical mucus of women between 7 and 10 weeks into pregnancy.
Basically it involves using an enzyme to free up the cells, and fluorescent antibodies to tag the fetal cells.
Cells can then be checked for the number of copies of chromosome 21 -- two being normal, three indicating Down's syndrome.
Though further validation on larger sample sizes are required, the researchers say their results "are a proof of principle" that fetal cells isolated from cervical mucus can be used for genetic diagnosis.
The team has also developed other profiling systems to diagnose other chromosomal anomalies as well as single gene disorders.
A system like theirs, they write, could be used to test both high- and low-risk pregnancies during the first trimester, "resulting in earlier reassurance for the couple or the option of a first trimester termination."
---REUTERS
Fri May 27, 2:13 PM ET
Researchers in Australia have worked out a way to isolate single cells from a fetus in the cervical mucus of a pregnant woman, and to use these cells to test for genetic abnormalities.
According to Dr. Mandy G. Katz-Jaffe and colleagues at Monash University in Melbourne, current methods for detecting chromosomal abnormalities in fetuses have various limitations or drawbacks. For example, amniocentesis carries a risk of miscarriage. Some screening tests give a high number of high false-positive results, while others are labor-intensive.
In the medical publication BJOG: an International Journal of Obstetrics and Gynecology, the researchers describe their process for isolating fetal cells from the cervical mucus of women between 7 and 10 weeks into pregnancy.
Basically it involves using an enzyme to free up the cells, and fluorescent antibodies to tag the fetal cells.
Cells can then be checked for the number of copies of chromosome 21 -- two being normal, three indicating Down's syndrome.
Though further validation on larger sample sizes are required, the researchers say their results "are a proof of principle" that fetal cells isolated from cervical mucus can be used for genetic diagnosis.
The team has also developed other profiling systems to diagnose other chromosomal anomalies as well as single gene disorders.
A system like theirs, they write, could be used to test both high- and low-risk pregnancies during the first trimester, "resulting in earlier reassurance for the couple or the option of a first trimester termination."
---REUTERS
Sunday, May 29, 2005
Girl Who Had 2nd Head Removed Goes Home
Associated Press
Sat May 28,10:05 PM ET
A baby girl who underwent surgery to remove a second head that was sharing a blood vessel with her brain has been released from the hospital, her doctors said Saturday.
Manar Maged was born March 30, 2004, with a rare birth defect, craniopagus parasiticus, that occurs when an embryo begins to split into identical twins but fails to complete the process, leaving an undeveloped conjoined twin in the womb. Manar also has a healthy twin sister.
"God has blessed us, this is a day of happiness for us, the girl is very well and she'll be going home today," said Dr. Naseif Hefnawi, director of Benha Neonatal Hospital.
There were 10 previous cases like Manar's throughout the world when she underwent surgery on Feb. 19, and Manar was the only one to have survived the procedure, Hefnawi said.
"The important thing is, the girl is improving day by day, her eyes are focussing more, anything she needs, day or night, will be available," Hefnawi said.
Manar slept in her mother's arms as the hospital's doctors applauded the news.
Hefnawi said the 14-hour surgery, carried out in the Nile Delta town of Benha, some 25 miles north of Cairo, was the first of its kind in the Middle East.
One can see pictures of Manar here prior to her surgery. And here is her after surgery ::
Friday, May 27, 2005
Ministry Acts To Overcome Dentists Shortage
KUALA LUMPUR, May 26 (Bernama) -- The Health Ministry is making efforts to train at least 375 dentists a year to alleviate the severe shortage of the professionals in the country, its minister Datuk Dr Chua Soi Lek said Thursday.
He said Malaysia now had 2,720 dentists, 3,780 short of the desired figure.
"At the ministry, only 890 vacancies or 57 per cent of positions available for dentists had been filled," he told a press conference after opening the 27th Asia Pacific Dental Congress at the Putra World Trade Centre (PWTC) here.
He said the shortage was due to declining interest in dentistry.
Chua said there were 1,873 dental clinics throughout the country, 20 mobile clinics and 276 teams on the move to provide dental services to the people, including in rural areas.
He said the mobile clincs had helped provide increased oral health coverage for Malaysians, especially schoolchildren, where for primary school it was 91 per cent and secondary schools 94 per cent.
Urban areas were well covered by the private sector, he added.
More than 1,500 dental professionals from over 28 countries are attending the five-day congress.
-- BERNAMA
He said Malaysia now had 2,720 dentists, 3,780 short of the desired figure.
"At the ministry, only 890 vacancies or 57 per cent of positions available for dentists had been filled," he told a press conference after opening the 27th Asia Pacific Dental Congress at the Putra World Trade Centre (PWTC) here.
He said the shortage was due to declining interest in dentistry.
Chua said there were 1,873 dental clinics throughout the country, 20 mobile clinics and 276 teams on the move to provide dental services to the people, including in rural areas.
He said the mobile clincs had helped provide increased oral health coverage for Malaysians, especially schoolchildren, where for primary school it was 91 per cent and secondary schools 94 per cent.
Urban areas were well covered by the private sector, he added.
More than 1,500 dental professionals from over 28 countries are attending the five-day congress.
-- BERNAMA
The country needs 6500 dentists but have only 2720, ie 41.8% of its requirements. The MOH has 1560 dental doctor positions on it sestablishment but only 890 are filled, ie there are 670 vacancies or 43% of iits establishment is unfilled. So what is our Higher Edu MINIster doing? Is he setting up more seats for dental undergraduates in our tertiary instituitions? The MOH, Datuk Dr Chua says the shortages are due to declining interest in dentistry. Of course, looking down smelly oral cavities is not a glamorous professional option but then again there are even worse places. There are so much new developments in dentistry and dental aesthetics, just look around there are so many with the pearly smiles and a show of braces! Knowing that each year there are overflowing demand made by those seeking doctoring seats in our IPTAs, the MOH and the MOE could work hand-in-hand and divert some of these students from medical doctoring to dental doctoring. So lets wait and see the MOOH will act to overcome this dentist shortage.
Govt Doctors' On-Call Allowances Raised After 20 Years
SERDANG, May 26 (Bernama) -- The government has agreed to raise on-call allowances of Health Ministry's doctors and medical specialists by 100 per cent in some cases.
The review, the first in 20 years, would take effect next month, said Health Minister Datuk Dr Chua Soi Lek, Thursday.
He said with the review, specialists' allowance for "active call" of over 16 hours continuously on a working day was raised from RM75 to RM150 while the allowance on a weekend and public holiday was raised from RM113 to RM170.
All categories of doctors on "passive call" and were recalled to come to work for over four hours on a working day would receive an allowance of RM90, instead of RM45 while the allowance on a weekend and public holiday would be RM100, instead of RM68, he said.
He said the allowance for "passive call" of less than four hours on a working day was raised from RM23 from RM50 while that on a weekend and public holiday was raised from RM34 to RM55.
Dr Chua said medical officers on graduate training would also receive higher overtime allowances.
Those on duty outside normal working hours of over 16 hours continuously on a working day would get RM100. The allowance on a weekend and public holiday would be RM110.
The overtime allowance previously was only RM25, he said.
He said the review was approved during a meeting of the Cabinet Committee on Salary chaired by Prime Minister Datuk Seri Abdullah Ahmad Badawi recently.
-- BERNAMA
The review, the first in 20 years, would take effect next month, said Health Minister Datuk Dr Chua Soi Lek, Thursday.
He said with the review, specialists' allowance for "active call" of over 16 hours continuously on a working day was raised from RM75 to RM150 while the allowance on a weekend and public holiday was raised from RM113 to RM170.
All categories of doctors on "passive call" and were recalled to come to work for over four hours on a working day would receive an allowance of RM90, instead of RM45 while the allowance on a weekend and public holiday would be RM100, instead of RM68, he said.
He said the allowance for "passive call" of less than four hours on a working day was raised from RM23 from RM50 while that on a weekend and public holiday was raised from RM34 to RM55.
Dr Chua said medical officers on graduate training would also receive higher overtime allowances.
Those on duty outside normal working hours of over 16 hours continuously on a working day would get RM100. The allowance on a weekend and public holiday would be RM110.
The overtime allowance previously was only RM25, he said.
He said the review was approved during a meeting of the Cabinet Committee on Salary chaired by Prime Minister Datuk Seri Abdullah Ahmad Badawi recently.
-- BERNAMA
The gomen continues to believe in adhoc, piecemeal, stop gap measures to deal with problems faced by its agencies. This is how it appears to many with the latest measure to deal with problems in its health delivery system. Will raising call allowances deal with the problems affecting gomen doctors? There will be some initial "elation" with the proposed increase, which for the 1,000 house officers amount to some 400%. But will it result in more doctors joining gomen service as was claimed by a house officer in this STAR report? The MMA, of course, welcomes the increase, but will this lead to a reduction in the number of gomen doctors leaving service? The answer is obviously NO to those questions. The MOH certainly does not believe that money is the root cause of doctors leaving service. There is more to it.
Only a Royal Commission can effectively deal with the problems the MOH and its employees are facing now and in the near future. There has been no major revamp of the health services for years. Its policies on staff recruitment and retention have to be look into. Better conditions of service have to be formulated. It has to look into balancing the ethnic composition of its staff and ensuring that there is merit promotions. Just raising allowances will keep some of the doctors happy for an initial short period but the larger problems prevail.
Only a Royal Commission can effectively deal with the problems the MOH and its employees are facing now and in the near future. There has been no major revamp of the health services for years. Its policies on staff recruitment and retention have to be look into. Better conditions of service have to be formulated. It has to look into balancing the ethnic composition of its staff and ensuring that there is merit promotions. Just raising allowances will keep some of the doctors happy for an initial short period but the larger problems prevail.
Serdang Hospital Begins Operations In July
KUALA LUMPUR, May 26 (Bernama) -- The Serdang Hospital near here which has been completed at a cost of RM690 million, will begin operations in July, Health Minister Datuk Dr Chua Soi Lek said.
He said the 620-bed hospital would be capable of catering to the needs of about 300,000 people from Bangi, Kajang, Puchong and Putrajaya and right up to parts of Negeri Sembilan.
The hospital, one of five planned to reduce congestion at the Kuala Lumpur Hospital(HKL), would begin its operations in stages, he said during a ceremony to mark the handing over of the hospital to his ministry by the Works Ministry at the hospital site, Thursday.
The other four are the Selayang and Putrajaya hospitals, which are already operating and the ones in Ampang and Sungai Buloh which are in the final stages of being handed over to the ministry.
Chua said his ministry had agreed to make the Serdang Hospital a referral centre for kidney ailments before specialising in cardiovascular and cardiothoracic diseases when it was fully operational later.
He said the other hospitals would also have their own areas of specialisation with the Putrajaya Hospital focussing on endocrinology and thyroid diseases, the Selayang Hospital for liver ailments, the Sungai Buloh Hospital for accident induced infections and the Ampang Hospital in immunology.
He did not expect the increase in the number of hospitals to result in a shortage of doctors or specialists.
Chua added that the new Serdang Hospital would not affect operations at the nearby Kajang Hospital which would continue to operate as normal.
-- BERNAMA
He said the 620-bed hospital would be capable of catering to the needs of about 300,000 people from Bangi, Kajang, Puchong and Putrajaya and right up to parts of Negeri Sembilan.
The hospital, one of five planned to reduce congestion at the Kuala Lumpur Hospital(HKL), would begin its operations in stages, he said during a ceremony to mark the handing over of the hospital to his ministry by the Works Ministry at the hospital site, Thursday.
The other four are the Selayang and Putrajaya hospitals, which are already operating and the ones in Ampang and Sungai Buloh which are in the final stages of being handed over to the ministry.
Chua said his ministry had agreed to make the Serdang Hospital a referral centre for kidney ailments before specialising in cardiovascular and cardiothoracic diseases when it was fully operational later.
He said the other hospitals would also have their own areas of specialisation with the Putrajaya Hospital focussing on endocrinology and thyroid diseases, the Selayang Hospital for liver ailments, the Sungai Buloh Hospital for accident induced infections and the Ampang Hospital in immunology.
He did not expect the increase in the number of hospitals to result in a shortage of doctors or specialists.
Chua added that the new Serdang Hospital would not affect operations at the nearby Kajang Hospital which would continue to operate as normal.
-- BERNAMA
Four More Hospitals To Be Completed, Says Samy
SERDANG, May 26 (Bernama) -- Four more hospitals are expected to be completed and handed over to the Health Ministry before the end of the year, Works Minister Datuk Seri S. Samy Vellu said Thursday.
They are Ampang Hospital, Sungai Buloh Hospital, Sungai Petani Hospital and Alor Star Hospital.
The hospitals are expected to be handed over on July 15, July 31, Oct 31 and Dec 31 respectively, he said.
Samy Vellu added that the Ampang Hospital would be equipped with 562 beds, Sungai Buloh Hospital (620), Sungai Petani Hospital (498) and Alor Setar Hospital (660).
The Ampang and Sungai Buloh hospitals have been completed while the Sungai Petani and Alor Setar hospitals were in the final stages of completion, he said.
The contractors for the projects are Ahmad Zaki Sdn Bhd, Tunas Selatan Konsortium Sdn Bhd, THUB-BDB JV (joint-venture consortium between TH Universal Builders and Bina Darulaman Bhd) and MH Projects Sdn Bhd respectively, he said.
Samy Vellu said all the hospitals except Ampang were built complete with staff quarters, training colleges and nurses quarters.
On Serdang Hospital, he said that work on the RM687 project in October 2000 and was completed last year.
It was constructed on a 129,000 square-metre site and has 670 beds in 19 wards, Samy Vellu said.
He said it provides services up to "tertiary care" level including for cardiology, cardiotorasic and neurology.
It is equipped, among others with the MRI machine (Magnetic Resonance Imaging), TV scanner, mammography, hydrotherapy unit and 29 haemodialysis machines.
It has eight "gardens" on the "roof" for patients to stroll in.
He said the hospital uses the "Thermal Ice Storing system" for air-conditioning. The system is considered one of the cheapest and most effective available.
-- BERNAMA
They are Ampang Hospital, Sungai Buloh Hospital, Sungai Petani Hospital and Alor Star Hospital.
The hospitals are expected to be handed over on July 15, July 31, Oct 31 and Dec 31 respectively, he said.
Samy Vellu added that the Ampang Hospital would be equipped with 562 beds, Sungai Buloh Hospital (620), Sungai Petani Hospital (498) and Alor Setar Hospital (660).
The Ampang and Sungai Buloh hospitals have been completed while the Sungai Petani and Alor Setar hospitals were in the final stages of completion, he said.
The contractors for the projects are Ahmad Zaki Sdn Bhd, Tunas Selatan Konsortium Sdn Bhd, THUB-BDB JV (joint-venture consortium between TH Universal Builders and Bina Darulaman Bhd) and MH Projects Sdn Bhd respectively, he said.
Samy Vellu said all the hospitals except Ampang were built complete with staff quarters, training colleges and nurses quarters.
On Serdang Hospital, he said that work on the RM687 project in October 2000 and was completed last year.
It was constructed on a 129,000 square-metre site and has 670 beds in 19 wards, Samy Vellu said.
He said it provides services up to "tertiary care" level including for cardiology, cardiotorasic and neurology.
It is equipped, among others with the MRI machine (Magnetic Resonance Imaging), TV scanner, mammography, hydrotherapy unit and 29 haemodialysis machines.
It has eight "gardens" on the "roof" for patients to stroll in.
He said the hospital uses the "Thermal Ice Storing system" for air-conditioning. The system is considered one of the cheapest and most effective available.
-- BERNAMA
Wednesday, May 25, 2005
Bagaimana nak melahirkan lebih ramai jururawat
LAPORAN PARLIMEN KESEBELAS
26 April 2005
Dr. Rozaidah binti Talib [Ampang] minta Menteri Pengajian Tinggi menyatakan bagaimanakah pihak kementerian dapat membantu hasrat melahirkan lebih ramai jururawat terlatih di negara ini memandangkan hanya sebahagian kecil daripada kursus kejururawatan di IPTS mendapat pengiktirafan Lembaga Akreditasi Negara.
Setiausaha Parlimen Pengajian Tinggi [Datuk Dr. Adham bin Baba]: Tuan Yang di-Pertua, berdasarkan rekod sehingga 2005 Mac, pihak kementerian telah meluluskan 20 buah permohonan kursus kejururawatan dalam pelbagai peringkat pengajian daripada 16 buah IPTS manakala 7 permohonan masih dalam proses penilaian dan pertimbangan.
Berdasarkan ketetapan semasa, satu Kursus Pengajian Kejururawatan yang telah diluluskan hanya perlu memenuhi ketetapan Akta IPTS 1996 berkait dengan pencapaian standard minimum sebelum graduan boleh diberi penganugerahan kelayakan dan keluar bekerja. Bagaimana pun, sekiranya IPTS menyasarkan graduan boleh menyertai awam adalah dinasihatkan agar IPTS untuk memohon dan mencapai perakuan Akreditasi (LAN).
Tuan Yang di-Pertua, pihak kementerian sentiasa menyokong sepenuhnya usaha kerajaan menambah bilangan jururawat terlatih dalam perkhidmatan kesihatan. Oleh itu, pihak kementerian amat mengalu-alukan mana-mana pihak swasta yang berhasrat menubuhkan kolej yang menawarkan kursus latihan kejururawatan ke peringkat tinggi.
Pihak swasta yang berminat boleh mengemukakan permohonan untuk mendaftar sebagai IPTS dan memohon mengendalikan kursus sebagaimana termaktub di bawah Akta IPTS 1996.
Dr. Rozaidah binti Talib: Terima kasih Tuan Yang di-Pertua, terima kasih Yang Berhormat Setiausaha Parlimen. Tuan Yang di-Pertua, untuk mencapai nisbah yang ideal antara seorang jururawat kepada penduduk iaitu dari .... [Gangguan sistem rakaman] kepada 200. Negara kita memerlukan untuk mengeluarkan lapan ribu jururawat setahun sedangkan sekarang kita mengeluarkan pada kadar tiga ribu
setahun.
Oleh itu apabila terkeluar berita bahawa ada 1,200 jururawat yang telah tamat kursus daripada IPTS tetapi mereka ini tidak diiktiraf oleh LAN, maka ini kita rasakan satu kerugian. Oleh itu, saya ingin mendapat sedikit penjelasan daripada Yang Berhormat Setiausaha Parlimen tentang dakwaan kolej-kolej swasta bahawa walaupun keperluan kursus, tenaga pengajar dan kelengkapan yang lain diiktiraf oleh Lembaga Jururawat Malaysia, mengapakah ianya masih tidak diiktiraf oleh LAN kerana Lembaga Jururawat Malaysia ini merupakan badan profesional yang lebih arif tentang keperluan kursus kejururawatan.
Terima kasih.
Datuk Dr. Adham bin Baba: Terima kasih Yang Berhormat. Memang betul pada waktu ini kita mempunyai nisbah 1:436 penduduk. Setakat ini sehingga Disember 2004 Jururawat Terlatih sekarang hanya ada 56,703 orang dan sekiranya sasaran 1:200 penduduk memang kita perlukan 8,000 pelatih setahun tetapi pada waktu ini hanya ada 3,000 dan di peringkat IPTA yang melatih ada 1,162 orang, di peringkat IPTS sekarang ada 2,861 dan daripadanya 1,200 adalah calon dari Kementerian Kesihatan Malaysia di IPTS.
Kita memang mempunyai kapasiti yang terhad kerana setiap permohonan untuk menubuhkan IPTS perlulah mendaftar di Kementerian Pengajian Tinggi melalui JPS dan LAN. Secara prinsipnya kita harus melihat bagaimana IPTS–IPTS yang mendaftar itu mahu dan mempunyai potensi untuk mendapatkan perakuan LAN dipilih untuk meneruskan program dan yang kedua haruslah mewujudkan mekanisme penilaian dan pemantauan secara naziran yang berkesan dalam memilih dan mengesan prestasi pelajar-pelajar. Sebenarnya pihak badan-badan profesional seperti Lembaga Jururawat dan juga Kementerian Pengajian Tinggi harus ada penyelarasan yang dianggotai oleh JPA, LAN dan agensi-agensi lain yang berkaitan dan kita juga memohon supaya Majlis Akreditasi Lembaga Jururawat sendiri ditubuhkan supaya kita boleh bekerjasama dalam hal menambahkan bilangan pelajar-pelajar kejururawatan.
Dr. Junaidy bin Abdul Wahab [Batu Pahat]: Terima kasih Tuan Yang di-Pertua. Kita dapati bahawa untuk mendapat kelulusan daripada LAN nampaknya payah. Soalan saya ialah apakah kriteria yang diguna pakai oleh LAN supaya pengiktirafan kepada IPTS dalam segi kursus kejururawatan ini akan dapat diperolehi ataupun diakui dan dipercepatkan?
Terima kasih.
Datuk Dr. Adham bin Baba: Terima kasih Yang Berhormat. Pihak LAN sentiasa mengalu-alukan pihak-pihak yang ingin mengendalikan kursus ataupun membuka IPTS tetapi sebelum membentuk amalan terbaik, kita perlu ada jaminan kualiti dan ia dilaksanakan melalui tiga peringkat proses penilaian.
Yang pertama, pihak IPTS perlulah memohon penilaian kelulusan penilaian kursus pengajian dahulu yang memfokus kepada kesediaan IPTS menawarkan sesuatu kursus pengajian dipohon. Contohnya seperti kalau kita hendak melatih di peringkat Diploma, tenaga pengajarnya mestilah di peringkat Sarjana Muda. Kalau kita hendak melatih jururawat di peringkat Ijazah, mestilah tenaga pengajarnya satu tahap yang lebih tinggi daripada Program Sarjana Muda.
Yang kedua, mereka juga harus memohon untuk mencapai standard minimum yang diperlukan untuk menilai tahap pematuhan standard bagi kursus pengajian yang sedang dikendalikan.
Yang ketiga barulah untuk mencapai kecemerlangan dalam penilaian sesuatu kursus pengajian, mereka memohon pengendalian perakuan akreditasi. Peringkat-peringkat inilah yang kita lakukan untuk memastikan setiap jururawat yang merawat kita ada jaminannya supaya mereka tidaklah dikatakan tidak bermutu dalam perkhidmatan.
---From Malaysia Today
26 April 2005
Dr. Rozaidah binti Talib [Ampang] minta Menteri Pengajian Tinggi menyatakan bagaimanakah pihak kementerian dapat membantu hasrat melahirkan lebih ramai jururawat terlatih di negara ini memandangkan hanya sebahagian kecil daripada kursus kejururawatan di IPTS mendapat pengiktirafan Lembaga Akreditasi Negara.
Setiausaha Parlimen Pengajian Tinggi [Datuk Dr. Adham bin Baba]: Tuan Yang di-Pertua, berdasarkan rekod sehingga 2005 Mac, pihak kementerian telah meluluskan 20 buah permohonan kursus kejururawatan dalam pelbagai peringkat pengajian daripada 16 buah IPTS manakala 7 permohonan masih dalam proses penilaian dan pertimbangan.
Berdasarkan ketetapan semasa, satu Kursus Pengajian Kejururawatan yang telah diluluskan hanya perlu memenuhi ketetapan Akta IPTS 1996 berkait dengan pencapaian standard minimum sebelum graduan boleh diberi penganugerahan kelayakan dan keluar bekerja. Bagaimana pun, sekiranya IPTS menyasarkan graduan boleh menyertai awam adalah dinasihatkan agar IPTS untuk memohon dan mencapai perakuan Akreditasi (LAN).
Tuan Yang di-Pertua, pihak kementerian sentiasa menyokong sepenuhnya usaha kerajaan menambah bilangan jururawat terlatih dalam perkhidmatan kesihatan. Oleh itu, pihak kementerian amat mengalu-alukan mana-mana pihak swasta yang berhasrat menubuhkan kolej yang menawarkan kursus latihan kejururawatan ke peringkat tinggi.
Pihak swasta yang berminat boleh mengemukakan permohonan untuk mendaftar sebagai IPTS dan memohon mengendalikan kursus sebagaimana termaktub di bawah Akta IPTS 1996.
Dr. Rozaidah binti Talib: Terima kasih Tuan Yang di-Pertua, terima kasih Yang Berhormat Setiausaha Parlimen. Tuan Yang di-Pertua, untuk mencapai nisbah yang ideal antara seorang jururawat kepada penduduk iaitu dari .... [Gangguan sistem rakaman] kepada 200. Negara kita memerlukan untuk mengeluarkan lapan ribu jururawat setahun sedangkan sekarang kita mengeluarkan pada kadar tiga ribu
setahun.
Oleh itu apabila terkeluar berita bahawa ada 1,200 jururawat yang telah tamat kursus daripada IPTS tetapi mereka ini tidak diiktiraf oleh LAN, maka ini kita rasakan satu kerugian. Oleh itu, saya ingin mendapat sedikit penjelasan daripada Yang Berhormat Setiausaha Parlimen tentang dakwaan kolej-kolej swasta bahawa walaupun keperluan kursus, tenaga pengajar dan kelengkapan yang lain diiktiraf oleh Lembaga Jururawat Malaysia, mengapakah ianya masih tidak diiktiraf oleh LAN kerana Lembaga Jururawat Malaysia ini merupakan badan profesional yang lebih arif tentang keperluan kursus kejururawatan.
Terima kasih.
Datuk Dr. Adham bin Baba: Terima kasih Yang Berhormat. Memang betul pada waktu ini kita mempunyai nisbah 1:436 penduduk. Setakat ini sehingga Disember 2004 Jururawat Terlatih sekarang hanya ada 56,703 orang dan sekiranya sasaran 1:200 penduduk memang kita perlukan 8,000 pelatih setahun tetapi pada waktu ini hanya ada 3,000 dan di peringkat IPTA yang melatih ada 1,162 orang, di peringkat IPTS sekarang ada 2,861 dan daripadanya 1,200 adalah calon dari Kementerian Kesihatan Malaysia di IPTS.
Kita memang mempunyai kapasiti yang terhad kerana setiap permohonan untuk menubuhkan IPTS perlulah mendaftar di Kementerian Pengajian Tinggi melalui JPS dan LAN. Secara prinsipnya kita harus melihat bagaimana IPTS–IPTS yang mendaftar itu mahu dan mempunyai potensi untuk mendapatkan perakuan LAN dipilih untuk meneruskan program dan yang kedua haruslah mewujudkan mekanisme penilaian dan pemantauan secara naziran yang berkesan dalam memilih dan mengesan prestasi pelajar-pelajar. Sebenarnya pihak badan-badan profesional seperti Lembaga Jururawat dan juga Kementerian Pengajian Tinggi harus ada penyelarasan yang dianggotai oleh JPA, LAN dan agensi-agensi lain yang berkaitan dan kita juga memohon supaya Majlis Akreditasi Lembaga Jururawat sendiri ditubuhkan supaya kita boleh bekerjasama dalam hal menambahkan bilangan pelajar-pelajar kejururawatan.
Dr. Junaidy bin Abdul Wahab [Batu Pahat]: Terima kasih Tuan Yang di-Pertua. Kita dapati bahawa untuk mendapat kelulusan daripada LAN nampaknya payah. Soalan saya ialah apakah kriteria yang diguna pakai oleh LAN supaya pengiktirafan kepada IPTS dalam segi kursus kejururawatan ini akan dapat diperolehi ataupun diakui dan dipercepatkan?
Terima kasih.
Datuk Dr. Adham bin Baba: Terima kasih Yang Berhormat. Pihak LAN sentiasa mengalu-alukan pihak-pihak yang ingin mengendalikan kursus ataupun membuka IPTS tetapi sebelum membentuk amalan terbaik, kita perlu ada jaminan kualiti dan ia dilaksanakan melalui tiga peringkat proses penilaian.
Yang pertama, pihak IPTS perlulah memohon penilaian kelulusan penilaian kursus pengajian dahulu yang memfokus kepada kesediaan IPTS menawarkan sesuatu kursus pengajian dipohon. Contohnya seperti kalau kita hendak melatih di peringkat Diploma, tenaga pengajarnya mestilah di peringkat Sarjana Muda. Kalau kita hendak melatih jururawat di peringkat Ijazah, mestilah tenaga pengajarnya satu tahap yang lebih tinggi daripada Program Sarjana Muda.
Yang kedua, mereka juga harus memohon untuk mencapai standard minimum yang diperlukan untuk menilai tahap pematuhan standard bagi kursus pengajian yang sedang dikendalikan.
Yang ketiga barulah untuk mencapai kecemerlangan dalam penilaian sesuatu kursus pengajian, mereka memohon pengendalian perakuan akreditasi. Peringkat-peringkat inilah yang kita lakukan untuk memastikan setiap jururawat yang merawat kita ada jaminannya supaya mereka tidaklah dikatakan tidak bermutu dalam perkhidmatan.
---From Malaysia Today
It looks like there are many problems between the Nursing Board and LAN. There are just too many steps to certification. hey, can we just go back to SRN (State Registered Nurse) for the present instead of Degreed Nureses.
The other bigger problem the hospitals and health facilities are facing is the absence of a good ethnic mix in its nurses. This is as in the polis force. As pointed out by the Royal Commission, such a senario causes problems. Too often one hears in the kopitiams that it is so hard to communicate when one is ill and in gomen health facilities. Will the MOH or whoever is responsible make attempts to ensure a healthy ethnic mix. Again from kopitiam talk, it appears that this is not due to the lack of applications by the Non-Bumis but rather that they are faced with some unspoken quota when it comes to applicant selection. A virtual mono-ethnic nursing staff leads to many problems :: communication difficulties, cultural misunderstandings, shortage of staff during festival seasons and so on. These cannot but lead to unhealthy circumstances/environment when attempting to nurse the sick back to health.
The other bigger problem the hospitals and health facilities are facing is the absence of a good ethnic mix in its nurses. This is as in the polis force. As pointed out by the Royal Commission, such a senario causes problems. Too often one hears in the kopitiams that it is so hard to communicate when one is ill and in gomen health facilities. Will the MOH or whoever is responsible make attempts to ensure a healthy ethnic mix. Again from kopitiam talk, it appears that this is not due to the lack of applications by the Non-Bumis but rather that they are faced with some unspoken quota when it comes to applicant selection. A virtual mono-ethnic nursing staff leads to many problems :: communication difficulties, cultural misunderstandings, shortage of staff during festival seasons and so on. These cannot but lead to unhealthy circumstances/environment when attempting to nurse the sick back to health.
Tuesday, May 24, 2005
Security Hologram Labels
Health Ministry Will Review Security Label Usage If Ineffective
KUALA LUMPUR, May 24 (Bernama) -- The Health Ministry will not hesitate to review the usage of security labels for products registered under the Drug Control Authority (DCA) if it is proven to be ineffective, Minister Dr Chua Soi Lek said Tuesday.
However, any change must be supported by valid claims, he told reporters after launching the Meditag Label Awareness campaign here.
Effective May 1, all registered pharmaceutical and health products must have the Meditag security hologram label to specify that the products have been approved for sale in a move to combat the increasing number of registered health products.
Mediharta Sdn Bhd, the producer of the Meditag security labels, has been given the task to distribute the labels to all manufacturers and importers of health products registered with the ministry.
However, manufacturers of health products were reported to be unhappy with the move, arguing that it was needless to implement the system as the quantum of counterfeit health and drug products in the country was minimal.
Dr Chua said the number of counterfeit products might be small but the availability of unregistered products was a major issue.
He said that in 2003, the Pharmaceutical Enforcement Division of the ministry seized RM6.5 million worth of unregistered health and drug products but the figure escalated to RM26 million last year.
"The industry should view this exercise as a social responsibility to ensure that only authentic products which have been approved by the DCA are on sale in the country," he said.
Asked why only one company was given the exclusive right to distribute the security label, he said : "If it was given to many companies, we wouldn't know which one (security label) is fake and which is not."
Queried on Mediharta Sdn Bhd's selection, he said the contract was given during the tenure of his predecessor and "you have to ask the former health minister."
-- BERNAMA
KUALA LUMPUR, May 24 (Bernama) -- The Health Ministry will not hesitate to review the usage of security labels for products registered under the Drug Control Authority (DCA) if it is proven to be ineffective, Minister Dr Chua Soi Lek said Tuesday.
However, any change must be supported by valid claims, he told reporters after launching the Meditag Label Awareness campaign here.
Effective May 1, all registered pharmaceutical and health products must have the Meditag security hologram label to specify that the products have been approved for sale in a move to combat the increasing number of registered health products.
Mediharta Sdn Bhd, the producer of the Meditag security labels, has been given the task to distribute the labels to all manufacturers and importers of health products registered with the ministry.
However, manufacturers of health products were reported to be unhappy with the move, arguing that it was needless to implement the system as the quantum of counterfeit health and drug products in the country was minimal.
Dr Chua said the number of counterfeit products might be small but the availability of unregistered products was a major issue.
He said that in 2003, the Pharmaceutical Enforcement Division of the ministry seized RM6.5 million worth of unregistered health and drug products but the figure escalated to RM26 million last year.
"The industry should view this exercise as a social responsibility to ensure that only authentic products which have been approved by the DCA are on sale in the country," he said.
Asked why only one company was given the exclusive right to distribute the security label, he said : "If it was given to many companies, we wouldn't know which one (security label) is fake and which is not."
Queried on Mediharta Sdn Bhd's selection, he said the contract was given during the tenure of his predecessor and "you have to ask the former health minister."
-- BERNAMA
Looks like another brilliant idea going down the drain. But then someone has been given the monopoly of producing and selling the said labels. So it is very unlikely that they will be withdrawn. Obviously this is going to cause a hike in the prices of medicine. More confusion to the consumers. Consumers will have to be trained to recognise the genuine hologram labels. And of couse it's gonna give more business to the "hologram pirates" and make those fake medicine makers more innovative. Believe me, those into this business can be very innovative and very quick on he turn. After all unregistered health and drug products were said to be worth more than RM26 million last year.
Sunday, May 22, 2005
Doctors can now advertise but not oversell
Doctors can now advertise but not oversell
By Annie Freeda Cruz
Doctors and hospitals can now advertise their services. However, they cannot exaggerate their abilities and facilities or oversell themselves. The Malaysian Medical Association has decided to allow this to enable the public and the world to know what Malaysia has to offer in the field of medicine.
MMA president Datuk Dr N. Arumugam (picture) said hospitals could advertise their facilities but they were not allowed to make claims that their machines were the best or that they could cure this or that disease.
Similarly, he added, doctors could advertise their speciality, with photographs, but were not allowed to state their place of work.
Dr Arumugam warned that disciplinary action could be taken against doctors who advertised their place of work or made claims about their achievements and successes.
Talking to the New Straits Times, he said, the relaxation of the guidelines was in line with changes in the medical field and the Government’s aggressive promotion of medical tourism.
"When we go onto the Internet or read medical journals and other publications, we get a lot of information about what hospitals and specialists in other countries offer, with some even making open claims as to their achievements and successes. But, unfortunately not Malaysia."
He said many people thought other nations, including Singapore and Thailand, had better medical facilities than Malaysia.
"Now, we want the public and the world to know that we too have hospitals with similar or better facilities and services, including the latest medical equipment and machines and also specialists in various fields."
Dr Arumugam observed that those practising alternative medicine openly advertised and made claims that their products could cure illnesses.
Furthermore, Dr Arumugam said, some hospitals, including certain government hospitals, were already using various techniques to advertise their facilities and services, especially in the form of news items or product launches.
---NST
By Annie Freeda Cruz
Doctors and hospitals can now advertise their services. However, they cannot exaggerate their abilities and facilities or oversell themselves. The Malaysian Medical Association has decided to allow this to enable the public and the world to know what Malaysia has to offer in the field of medicine.
MMA president Datuk Dr N. Arumugam (picture) said hospitals could advertise their facilities but they were not allowed to make claims that their machines were the best or that they could cure this or that disease.
Similarly, he added, doctors could advertise their speciality, with photographs, but were not allowed to state their place of work.
Dr Arumugam warned that disciplinary action could be taken against doctors who advertised their place of work or made claims about their achievements and successes.
Talking to the New Straits Times, he said, the relaxation of the guidelines was in line with changes in the medical field and the Government’s aggressive promotion of medical tourism.
"When we go onto the Internet or read medical journals and other publications, we get a lot of information about what hospitals and specialists in other countries offer, with some even making open claims as to their achievements and successes. But, unfortunately not Malaysia."
He said many people thought other nations, including Singapore and Thailand, had better medical facilities than Malaysia.
"Now, we want the public and the world to know that we too have hospitals with similar or better facilities and services, including the latest medical equipment and machines and also specialists in various fields."
Dr Arumugam observed that those practising alternative medicine openly advertised and made claims that their products could cure illnesses.
Furthermore, Dr Arumugam said, some hospitals, including certain government hospitals, were already using various techniques to advertise their facilities and services, especially in the form of news items or product launches.
---NST
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