Beware - suffering ahead
So you want to be a doctor?
The Star Education today has two articles which might interest students thinking of doing medicine:
Beware, suffering ahead by Kevin Ooi, med student (now where's his blog? ;) )
Hard work makes a doctor an article by Dr. Khoo a.k.a vagus_n who Blogs
hereIt would be more interesting if there were pre-med courses here which have
Banana surgery and other "hands-on" experiences for prospective medical students...
Heatwave & Haze
Has it been hot! Temperatures reached a record 38 degrees in some places like Alor Setar this week. This is really sweltering heat. Coupled with the current haze blanketing the Klang Valley and other parts of the Peninsular (apparently due to local hotspots, and nothing to do with Indonesian forest fires), it's really been quite a miserable week, weather-wise.
Not suprisingly, it has been reported that
Patients With Heat-induced Ailments Soar As Temperatures RisePatients with heat-induced ailments have soared following weeks of hot and dry weather afflicting the country, according to a Health Ministry study in Port Klang.
Minister Datuk Dr Chua Soi Lek said the study found a dramatic increase in patients registering at the public hospital complaining about ailments relating to heat.
He said there were 1,412 cases in December last year but they increased more than three-fold to 4,297 cases in January.
Among the ailments were respiratory tract infections which rose from 419 cases in December to 1,322 in January, asthmatic cases from 32 to 124 and conjunctivitis cases from seven to 32, he told reporters at a briefing today on the health effects of the current hot spell that has triggered a rash of bush and forest fires and enveloped several states in thick haze.
The Department of Environment Saturday announced that the number of areas experiencing unhealth air quality had risen to 11 in Selangor and Negeri Sembilan from eight Friday.
Dr Chua said children below five and adults above 40 years of age, including people suffering from high blood pressure, diabetes, heart problems and lung infection, were more prone to health problems in the present condition of poor air quality.
"Hot weather can bring health problems especialy to the high risk groups -- farmers, manual workers and athletes," he added.
He said heat rashes due to sweat and heat fatigue were two common symptoms resulting from extensive exposure to heat.
If not treated, a person could suffer from heat "syncope", whose symptoms were giddiness and fainting, and this would be followed by heat cramp and finally heat stroke which could be fatal, he said.
He advised people to reduce outdoor activities, especially those in the high risk group, and extra-curricular activities for school children should be reduced if the air quality in the particular area was bad.
As precautionary measures, people should also drink more water and not wear tight clothes. |
Sensible advice indeed from the Health Minister - but thats to be expected since he
is really a doctor. I recall an ex-Health Minister when commenting on the Haze, advised the Malaysian Public "not to breathe in too deeply" !! Thankfully this person has long since retired.
In the meantime, its great to see that the top Adminstration is listening and not afraid to reveal the facts, as they have issued an order:
Inform API Level To Public, Ministries ToldDatuk Seri Abdullah Ahmad Badawi Saturday directed the relevant ministries to inform the public the Air Pollution Index (API) levels following deteriorating air quality to unhealthy stage, worsened by the current drought.
The prime minister, however, asked the media not to sensationalise the air quality situation.
"If the index exceeded the 100 mark, the people should be advised to take precautionary measures so as not to cause hardship to them," he said.
"This is particularly important to asthma sufferers. The poor air quality problem is not throughout the country, only in one or two places," he told a news conference after opening the RM1.8 billion Proton car manufacturing plant at Proton City here.
Abdullah said schools could also defer their sports activities if the air quality was unconducive to health.
He explained the current phenomenon was not due to haze but thick smoke from continuous peat soil and forest fires. |
We'll see if the
Dept of Environment will start reporting
APIs again in their website...
Air quality alert
The
Department of Environment has issued an
Air Quality AlertKUALA LUMPUR: The Department of Environment (DOE) is on high alert as air quality in eight locations - mainly in the Klang Valley - plunged to unhealthy levels, worsened by the current drought.
DOE air division director Che Asmah Ibrahim said the air quality in Port Klang, Petaling Jaya, Shah Alam, Kuala Selangor, Kuala Lumpur, Putrajaya, Nilai and Bukit Rambai was at an unhealthy level yesterday.
On Thursday, only Port Klang and Malacca had an unhealthy air quality level, she said.
The DOE measures the air quality in five levels - good, moderate, unhealthy, very unhealthy, and hazardous. The DOE has been issuing only the qualitative readings for air quality. |
The
DOE website used to give quantitative readings on air quality (back in the days of the terrible haze in the 1990s). Its a pity the powers-that-be see fit to discontinue this.
Anyway I am fishing out my N95 mask for outdoor use :(
Nursing the problem
First we hear the news that
More than half of trainee nurses fail the qualifying examLast year, only 44.4 per cent, less than half of the 2,000 trainee nurses passed the test, he said.
The ministry viewed the matter seriously as the country was still lagging behind in meeting the target set by the World Health Organisation by 2020, which requires a nurse for every 200 residents (1:200), he told reporters.
He said there were about 40,000 trained nurses working in government and private hospitals nationwide, with a ratio of one nurse to 645 people.
"To achieve the 1:200 ratio, we need to have about 170,000 nurses. From now until 2020, we've to train 130,000 nurses or about 8,000 a year.
"Now, we are only training 3,000 a year, either by the ministry or by private nursing colleges recognised by the ministry," he said.
He said the situation had been compounded by the high failure rate among trainee nurses.
Chua said a study by the Health Management Institute found most of the failed trainees did not have credits in English and Science at the Sijil Pelajaran Malaysia level.
He said the high failure rate problem did not exist in the Health Ministry-recognised private colleges where the passing rate was 98 per cent last year. |
I believe that if you want to improve the quality of candidates, then you have to improve the entrance requirements. I can't imagine how low the requiremenets are if "most of the failed trainees did not have credits in English and Science" - if you don't have a good knowledge of Science, then I can imagine the trainee Nurse will be struggling. On the other hand, if you want to increase the entrance requirements, then Nursing as a career in Malaysia has to be more attractive and I strongly feel the bottom line is a better career structure and better pay.
The Public Services Department is to blame as efforts by the Malaysian Nursing Association to address the issue aren't even attended to by the PSD so
claims the MNA President Dayang Annie Abang NarudinTo arrest this, the MNA wants a nursing division set up within the Health Ministry to look after matters related to the profession.
MNA president Dayang Annie Abang Narudin said yesterday that setting up a division in the Health Ministry was among several proposals they had made in 1996.
She said two years ago, the Public Service Department invited the association for discussions on the matter but nothing materialised.
“We are still fighting for it although we have been promised it would receive due attention over the years. Nothing has materialised so far,” she said. |
Such inaction is not atypical of Government machinery like the PSD.
The trend abroad is to have Nursing as a degree course rather than a diploma course. The quality of the candidates will certainly improve as more will be attracted to a career with better remuneration and better prospects.
An interesting point is the Health Minister just commented (but did not elaborate) that the high failure rate was mainly in the Public sector and not the Private sector Nursing Schools where the passing rate is 98%. All the trainee nurses sit for a common exam. So is the difference due to better selection by the Private Nursing schools or better teachers or both? Perhaps the better qualified trainees are attracted to the better working and pay prospects in the Private hospitals?
The pipes are calling..
While you turn on the tap to brush your teeth or wash your face, reflect on the fact that there's still a significant proportion of your fellow citizens who don't have tapped water, and are exposed to risks of water born infections like this tragic story reported in the
NST:
Contaminated well water is believed to have caused the death of a five-year-old boy.
Now the people who depend on the well are worried.
Five-year-old Mohd Norfitri Mohd Tahir, who had been suffering from high fever, vomiting and purging for the past few days, collapsed at home at 4.30pm yesterday and died upon admission to Sungai Petani Hospital.
His three-year-old sister, Siti Aishah, also started displaying the same symptoms and was warded early today.
Checks showed the well was located several metres from the common lavatory.
But families, who stay at the remote village, say they have little choice but to continue depending on their well for their daily needs. |
I recall during my medical student days, we had Rural health and District health postings and we had the opportunity to see the problems the rural folk have with water supply, sanitation and waste disposal. Looks like some things have not improved after more than 20 years.
Don't take water for granted. It is instances like this which drives home the fact that a clean water supply is essential for well-being. Indeed, the theme for
World Water Day 2005 is "Water for life" and how appropriate this is.
Sheesh! II
Well, as if it's not enough that
smoking Sheesha is not seen as a big problem amongst youngsters, Malaysia is once again sending out the wrong signals about smoking. It is now hosting
ETM 2005 which is a big meeting on Emerging Tobacco Markets.
The
NST reportsCome November, intentionally or otherwise, Kuala Lumpur will be given the "dubious" honour to host the region’s largest tobacco trade conference and exposition (www.etm2005.com).
Called the "Emerging Tobacco Markets 2005", it claims to be a "unique" platform for all members of the Asian tobacco industry, including China, Indonesia, India, Malaysia, Thailand, Korea, Japan, Philippines, Pakistan and Sri Lanka.
Dubbed "the Asian tobacco connection", it firmly puts Malaysia at the heart of lucrative hub for the region’s tobacco industry.
Malaysia once again will be perceived as a keen supporter of the tobacco industry and, by extension, a promoter of the well-known killer product that the developed world is eager to dump.
And, as always, developing countries like Malaysia are poised for this role despite, of late, the strong and determined high-level statements and actions to stem out tobacco-related promotions.
What impact will this new tobacco industry offensive have on Malaysia’s recent initiatives like the Tak Nak! (Say No!) campaign? |
Precisely. What will happen to the Tak Nak campaign? Millions of ringgit of public funds spent in the ad campaign will go to waste I tell you. The only one benefiting seems to be the ad companies....
Query: MMC's e-mail address
TK Chong writes:
| Do you happen to know the e-mail address for Malaysian Medical Council (MMC). I could not reach them using the address in their website! |
Sorry I don't, TK. In my conversation with the MMC staff to try to get them to email the 42 page list of recognised universities, the staff said (just quoting her) that the electricity at their place was dodgy at the moment. As for email, the "server was always down". Get the picture? So much for e-Government and Putrajaya! But I guess (and hope) this is all teething problems which will be resolved in time to come.
Anyway if anyone knows an actual working email address for the MMC which the staff actually read and respond to, please post a comment or feedback here.
MMC list of recognised qualifications
I managed to track down the
MMC officer in charge.
The news is that the MMC has moved to Putrajaya and surprise,surprise, the telephone numbers have changed. This is of course
not reflected in the MMC website (surprise, surprise) but the MOH staff was kind enough to pass me the new number which is 03-88831415.
The staff informed me the list runs into 42 pages long (!) and asked me to fax in my request for the list - she promised to mail me this after I have done so.
Well I have done so.
If and when I get it, I am thinking of hosting the list here - anyone interested? Please leave a comment here if you are......
MMSAT II
student05 has sent in some feedback on the MMSAT from email she got from
MPM| For your information, the MMSAT test that is to be held on the 26 Feb 2005 is an admission test to enter Medical Schools in the local universities. But this exam (this year) will not be used for students who want to enter medical schools. It is just a pilot test (trial test) before decision is make to implement this test in future. This test is a 3 hour paper. All questions (130 questions) is objective type. You don't have to prepare anything cause the questions will be based on problems solving, critical reasoning and interpersonal understanding. |
Do you think an objective type aptitude test will be any better than say an interview to screen prospective medical students?
I don't believe anyone has the ideal screening system - be it academic grades, interviews and what-not.
I personally believe the screening is the tough undergaduate medical course itself. It must remain tough and competitive and should not turn into a spoon-feeding environment like much of the Malaysian education system today.
MMSAT
"student05" writes:
| i am waiting for my stp result for the moment. n currently i received a letter frm mpm about mmsat. can u tell me more about this test? wht does it base on? |
now there really must be smthng abt ths sms culture whch makes one frgt to use capitals and use shrtfrms ;)
Well, you are one of the lucky few who have been chosen for the
Pilot test for medic hopefulsI don't know much about it myself but from The Star:
A TOTAL of 3,200 Sijil Tinggi Persekolahan Malaysia (STPM) students will sit for the first ever Malaysian Medical Schools Admissions Test (MMSAT) on a trial basis this year.
Higher Education deputy director-general Prof Datuk Dr Hassan Said said the pilot test developed by the ministry's quality assurance agency would only be for STPM students and have no bearing on these students’ chances of securing a place in one of the country's six medical faculties.
“This is for the consumption of our researchers only,” Higher Education deputy director-general Prof Datuk Dr Hassan Said told reporters last week.
Asked what the ministry was doing to avoid last year's fiasco where 128 top scorers were initially denied entry into public medical schools, Prof Hassan said universities were opening up more spaces this year.
“But if the number of students who score a CGPA (cumulative grade point average) of 4.0 increases, then we will not be able to cope. We may have to bring in the private sector,” he said after opening the Malaysian Association of Private Colleges and Universities (Mapcu) Education Exhibition 2005. |
Do share you experiences on the MMSAT test when you do sit for it. Good luck!
Medical students and foreign doctors
I am still getting lots of queries on recognition of foreign medical degrees and also tons of requests from foreign doctors seeking jobs in Malaysia.
I'll make this post as a permanent link in the MMR to clarify matters once and for all and further requests will link to this post.
1) Please direct all queries on recognition of foreign medical degrees to the
Malaysian Medical Council. The MMC is now in Putrajaya and the general phone line is 03-88831415. The MMR has managed to get an updated
List of Recognised Medical Schools but the information is current only as of March 2005. The MMR does not vouch for the accuracy of this list so please check directly with the MMC.
2) The MMR is not a recruiting agency for foreign doctors. The
Public Services Department is the Government agency which recruits employees into the Government service so please enquire over there. They have an
online Job application section but it appears to be in Bahasa Malaysia (the National Language of Malaysia) only.
AddendumDr Viveg adds this comment:
It is the Public Services Commission, an independent body appointed by The Agong,which recruits employees into Govt services on receiving requests from the various govt agencies. NOT the PSD .
The online job application address is:
http://www.spa.gov.my
Special for Doctors you can apply and fix any tuesday morning for the interview,If you fulfill the requirements and pass the interview your appointment letter will be given to you on the same day
Please click the English version for english |
3) The MMA has an informative page on
Guidelines for Full Registration with the Malaysian Medical Council for Foreign Medical OfficersOther related information from the MMA:
How to Apply for MMC Registration
Guidelines For Full Registration With The Malaysia Medical Council For Malaysia CitizensRegarding the matter of the
Unscheduled Universities Examination, Dr. Wan Mazlan Bin Md. Woojdy, Secretary,Malaysian Medical Council has kindly provided some answers to frequent questions:
a) Is the Unscheduled Examination open to graduates from ANY unrecognised medical school or is there a list of Unrecognised medical schools graduates of which are eligible to sit for the examination?
Ans - the unscheduled examination is open to graduates from any unscheduled universities provided:
a. he is a Malaysian citizen or related to Malaysian either by blood (either parents or both a PR) or marriage or a PR;
b. comes from a university that provides training for modern medicine;
b) What is the application process and prcedure for the Unrecognised medical school graduates who wish to sit for this examination?
Ans - firstly, the examination dates will be published in major newspaper to inform and invite aspiring candidates. Usually it's done twice a year (i.e in August/Sept and November). Application should be submitted within the stipulated time using specified forms available from us. Aspiring candidates should check with us from time to time as well as ensuring that their degree comes from colleges/universities that provide training for modern medicine.
For further clarification, you can contact Dr. Wan Mazlan (03 88831400) or Dr Rusnah (03 8883 1401)
4)The MMR maintains a free
Online Locum Agency but the emphasis is on jobs wanted and jobs available in Malaysia. For a foreign doctor, unless you have Permanent resident status, then you can only work in the Public (Government) sector so requests for Locum posts wanted from Foreign doctors will not be posted unless you are a Permanent resident of Malaysia.
Feedback: Nursing school intake
Haryani writes:
| i need to know when is the 2nd intakes for nursing diploma program for university of malaya medical centre. ithank you for your help. |
Thanks for writing in. I have no idea, Haryani.
The MMR has some links to Nursing schools in the
Schools section. These are just those I could find with websites. The UMMC's website is unfortunately down (all too often!!) but there is an Unofficial website for the School of Nursing, and from this
page, there is this contact:
PERTANYAAN?
Hubungi:
Pengetua, Sekolah Kejururawatan,
Pusat Perubatan Universiti Malaya,
59100 Kuala Lumpur,
MALAYSIA
tel: (03) 7950-2251 / 2252
fax: (603) 7954-7701
e-mel:
CheAn@uhkl.edu.my I suggest you try the phone as I am not sure if the email address is still valid.
KL - disabled friendly?
The NST
reports:
His zest to see the world keeps Denis Metail ticking, regardless of his wheelchair.
The 50-year-old Canadian, who flew here from Bangkok, has been a common sight in the streets of Kuala Lumpur for the past several weeks in shopping centres, restaurants and bookshops.
"Kuala Lumpur is a disabled-friendly city," Metail said, adding that he first heard of the city after reading that his countryman, Jacques Villeneuve, the F1 driver, drives for Petronas.
"I was surprised to find it so easy to get around town here with the amenities for the disabled," said Metail, who now travels around the world seeing how disabled-friendly each country is. |
Maybe parts of KL but I can tell you there's much of KL and PJ which is not wheelchair friendly. Our pavements do not have ramps for wheelchair access as do many buildings and shopping complexes. All you see are steps steps and more steps.
Even some newly designed condominiums do not have the disabled in mind. Just check the next time you are at a property fair and ask the salesperson "Is the condo/house disabled friendly?" and chances he/she will give a sheepish smile and tell you he doesn't know or is not sure.
Mandatory pre-marital HIV testing
The Star
reports that Perlis is joining Johor in becoming another state where pre-marital HIV testing for Muslims will become compulsory.
This is a somewhat controversial issue and some questions to be raised are:
- cost effectiveness of such a programme
- should it be confined only to Muslims?
- source of funding - who pays?
- will the couple still be allowed to marry if one is found to be HIV +?
- will it prevent HIV infection
after marriage?
The issue of test sensitivity and specificity may be less problematic with the new generation of HIV tests.
What do you think?
Links
Should pre-marital HIV testing be made compulsory? - a DebateProposed compulsory HIV testing for couples who are getting married (Singapore, e-Consultation)
Malaysian Aids Foundation
Dengue : Learning from Cuba?
From NST,
Cuban expertise sought in control of dengue
A.Hafiz Yatim and June Ramli
KUALA LUMPUR, Feb 10:
Malaysia is seeking Cuban expertise to effectively control dengue, Health Minister Datuk Dr Chua Soi Lek said.
Cuba is the only country in the world to have had success in controlling dengue and hepatitis-B, he added.
"Malaysia can learn from the Cuban experience.
"Clearly, Cuba has the advantage in handling the two contagious diseases and Malaysia should benefit from this. Even Singapore, better known for its strict enforcement, is not as successful as Cuba," he told reporters at the MCA Chinese New Year open house at Wisma MCA here yesterday. Continued |
There is no magic nor mystery in the control of dengue. As summarised in the last sentence of the article regarding the Cuban epidemic of dengue in 1997.
"The 1997 Cuban dengue outbreak demonstrated once again that dengue reappears where Ae. aegypti control is relaxed. Taking into account these facts, Cuba maintains its policy of vector eradication and recommends an exerted effort in the American region to prevent a recurrence of dengue similar to the one in Southeast Asia, where DHF/DSS is the leading cause of hospitalization and death among children"
It is mainly about vector control i.e. the control of the Aedes Aegypti mosquito which carries the dengue virus. When hospitals and clinics are themselves breeding grounds for these mosquitoes, what more do we expect from the general public. Despite having dengue on our shores for ages, it is amazing why we are still not competent enough in combatting dengue. The Government machinery is rusty and not fully utilised. We are not mobilising our own public health specialists to control the population of Aedes mosquitoes. We lack innovation and creativity in combatting this menace. Instead we depend on current measures which may be obsolete and proven ineffective. What are we to learn from CUBA?
From the Cuban experience,
"The campaign to control the vector started before the beginning of the 1997 dengue outbreak and is well established. Although the campaign required the mobilization of scarce financial resources and experts from all over the country, early intervention prevented spread of the outbreak to other potentially vulnerable municipalities."The vector control requires long term and sustained measures. More financial aid needs to be disbursed in these critical areas. Our public health officials also need to be more vigilant and must be able to recognise early signs of a possible dengue outbreak. We cannot take chances.
The risk factors are well stated in the epicenter of the epidemic in Cuba, Santiago de Cuba province.
"The municipality is located in Santiago de Cuba province, in the eastern part of the country, and has several risk factors for the reemergence of dengue: limited water supply, inadequate eradication efforts, high vector infestation, and increasing migration of people from Latin American and Caribbean disease-endemic countries to the municipality."These are factors that we have known for ages. What are we to learn from CUBA then? Perhaps better management of finance and human resource. I find it shameful that despite having many institutions of higher learning, we are unable to come up with an answer ourselves for a problem for which the solution is so clearly evident and simple.
Reemergence of Dengue in Cuba: A 1997 Epidemic in Santiago de Cuba
Feedback: Anfrage aus Deutschland
David Capelle writes:
I would like to tell you how I have come to appreciate the informations offered at your web site since I recently found it through Google. I think there are few other sites online to compete. Therefore I would appreciate if you could maybe help me with the following question of mine.
I am currently a third year medical student in Germany. Having married a Malaysian two years ago I am now planning to move to Malaysia once I finish my studies God willing. So far, however, I could not find any useful information as to what might be the conditions in order for foreign medical officers to practice in Malaysia. I would appreciate it very much if you could provide me with any information on whether and how basic medical degrees from Germany can eventually be recognised in Malaysia. |
Thank you for your kind words, David.
There are a few issues foreign medical graduates need to contend with:
1) Whether or not the basic medical degree is recognised in Malaysia. This is determined by the
Malaysian Medical Council and enquiries have to be made there. German medical schools are not listed in
their website link of recognised Universities but this MMC web page is likely out of date and you have to enquire directly from the MMC.
2) Whether or not there is a job available. This would depend on the Government bodies (
Public Services Department for the Ministry of Health hospitals, or the
various major local Universities under the Ministry of Education). One can apply to either the PSD (JPA) or the individual Universities directly. Interestingly the PSD has an
online Job application form but typical of many Government websites, this link does not work! (well at least when I tried it just now)
3) Work permit from the
Immigration Department.
It is easier if you have certain skills or are trained in a specialty in demand. I personally know of a German expat who joined a local teaching hospital for a while (he was trained in Psychiatry). The route might be easier this way but still the bureaucratic obstacles are daunting and I am afraid there doesn't seem to be any easy way. There have been instances of foreign spouses of Malaysians who are doctors and yet have been unable to obtain work in Malaysia for many years. Personally I feel this is a waste of valuable resources but the the amount of red tape the bureaucrats put in place is really daunting.
Good luck!
Thalassemia tragedy
The NST reports that a
Settler seeks help to treat children  With two sick children to care for, a Felda settler is facing the strain on his RM400 a month income.
Che Soh Putih's fifth child, Siti Aminah, 13, and the seventh and youngest, Suriati, 7, are both thalassaemic.
"Both of them need monthly blood transfusions," he said at his home in Felda Ciku Satu here recently.
Che Soh, 62, said Siti Aminah had had her spleen removed when she was nine, but her condition had not changed much.
The two girls have to be hospitalised two to three days each time they go forblood transfusion, and the expenses come up to between RM200 and RM300. With his meagre monthly income, the costs have taken a toll on the family.
The girls' mother, Che Nah Mat, 49, said there were many times the hospital trips had to be scrapped because there was not enough money.
She said she had applied to the Welfare Department for assistance about two years ago, but had not received any reply. |
This is a sad story from many angles. It shows the sorry state of our health care system where many poor people with chronic illnesses are struggling with their daily lives. The Government continues to fall short in health care delivery in this area. The Welfare Department? No reply after 2 years? I'll bet any assistance given eventually will not even cover the monthly hospital trips.
Children with thalassemia severe enough to require monthly transfusions also require a costly drug to remove excess iron - this can easily run into something like RM800-1000 per month in drug costs. Iron overload eventually leads to heart failure and other organ damage which results in death of the child by the time he or she is in her teens. This is all preventable but at a cost.
We are still waiting for the National Health Financing Scheme.
The
MMR's public societies and associations section has links to several Malaysian Thalassaemia organisations like the
Thalassaemia Association of Malaysia. If I have missed out any, please let me know.
The Year of the Rooster
The MMR wishes all readers celebrating Chinese New Year A Gong Xi Fa Cai!!
While the astrologers are
speculating all sorts of things in store for the Year of the Rooster, I am surprised no one has stated the obvious.
The Year of the Rooster is going to be make or break time for the containment of Bird Flu.
Yes I truly think unless we really get on top of this, there is a serious chance that the virus may mutate and may result in a disastrous pandemic, something the WHO is very concerned about.
Dr. Cheah already mentioned, we must keep a vigilant
Eye on Bird Flu and even more so in this year of the Rooster we must continue to watch the birds carefully.
Links:
WHO Avian Flu homepageCDC Avian Flu homepageVad's corner - H5N1
Sheesh!
Apparently smoking shisha is a fad catching on amongst youngsters here. The Health Minister is quoted as saying "
there is no law against shisha"
The Health Ministry's tough anti-tobacco stance does not include the shisha which was banned by Thailand two years ago for containing toxic substances.
Health Minister Datuk Dr Chua Soi Lek said the tobacco used in shisha was not classified as regular tobacco.
He said shisha had not been categorised as smoking and there was no law against teenagers smoking it. |
Shisha smoking has its origins in the Middle East and people there smoke it with a Hookah (
Wikipedia info). Apparently it (the Hookah) can also be used for smoking hashish, marijuana, or other smokable substance, operating on the principle of a water pipe.
Shisha apparently is tobacco mixed with fruit flavours. We won't argue about the health dangers here even if shisha smoke contains less carcinogens than regular smoke. It still is tobacco and it still does contain nicotine (albeit in lesser concentration) which is the addictive drug which keeps one smoking.
The same article quotes that "Then Thai Health Minister Sudarat Keyuraphan had stated that the habit was harmful and would make it easier for the young to graduate to cigarettes."
I think the Thais got it right and our Health Minister is wrong. Shisha smoking should be banned along with cigarette smoking.
It is an offence for anyone under 18 to buy cigarettes or indulge in smoking under the Control of Tobacco Products Regulations 1993 (Amendment 1997).
Those found smoking or chewing tobacco or in possession of cigarettes in a public or private place can face fines of not more than RM1,000.
I think as long as shisha contains tobacco then youngsters or any underaged persons found indulging in shisha smoking is breaking the law.
I suggested in
Holy Smoke that the Tak Nak campaign whereby millions of ringgit were spent is likely to end up as a failure. How true if the Health Minister were to send the wrong message that shishah smoking is "ok". I sure hope he was misquoted!
Years ago, the "knowledgeable authorities" here banned a harmless children's song called "
Puff the Magic Dragon" claiming it could induce kids to take up drugs. What about shisha smoking? Sheeeeeesh!!
Trial by Fire?
Housemanship! A dreaded word among young doctors. The joy of graduation soon dissipates into thin air and seems a distant past. A year of no respite is ahead. Much is expected of these young souls and little attention is paid to the fragility of their minds. Many are uprooted from their comfort zones and thrown into faraway places. Lost and alone. All else are at a standstill as they are grinded on a daily basis. Ward chores are the only agenda of the day. It is usually at this occasion that many regretted the decision to study medicine.
Indeed, many senior doctors often applaud the "trial by fire" notion of housemanship. With absurdly long working hours and little appreciation in return, many housemen wonder how fickle-minded these senior doctors can be. The joy of doing medicine may be temporarily lost under such strenous working conditions.
The question is, should we put a cap on the working hours of these junior doctors? How do we expect them to learn and perform when there is little gas left in the tank? Should the lives of patients be entrusted to the tired minds and bodies of these doctors?
I think these issues have been debated long enough. Many countries have now put a limit on the number of continuous working hours a doctor is allowed to do. I think there are existing labour laws which stipulates that. Unfortunately, doctors are not under the jurisdiction of such laws. It has become of paramount importance that we stress on the working conditions of government doctors. It remains an important element in the worsening brain drain situation. The paltry salary just rubs salt into these wounds.
Site update: more blogs and schools
Dr YY Yap writes in to tell of two other web pages he maintains:
Otolaryngology - a site with news and updates for ENT surgeons
ENT Quiz - a quiz site for ENT students/trainees and anyone else interested.
Thanks for the heads-up YY.
I have included these links in the
Doctors Personal webpages section of the MMR.
heekheen also wrote in to inform that the
Universiti Sabah Malaysia website has been updated and how has a new URL. The link in the
Medical Schools section of the MMR has now been updated accordingly. Thanks heekheen.
Dirty hospital canteen
The shame of it all. The canteen at the Tengku Ampuan Rahimah Hospital in Klang has been closed by officers from the Selangor Health Department after it was found to be unhygienic so reports
The Star.
I recall during my teaching days in Klang that the canteen was a "double storeyed" one and the hospital staff ate at the upper level. Hygiene was perhaps a little dodgy but it was like your average Malaysian hawker type food court serving predominantly Malay fare.
Anyway if standards have deteriorated, then kudos to the State Health Department for showing no fear or favour when it comes to public safety. I wonder if the Hospital Pengarah is even a little embarassed by this incident? Hopefully
Jel & Co have not been eating there. Then again the student's hostel canteen might be a little cleaner ;)
World Cancer Day
Tomorrow, February 4th is World Cancer Day.
Every year 10 million people around the world will be diagnosed with cancer – and this number is expected to reach 15 million by 2020. Cancer causes six million deaths each year, that is around 12 per cent of deaths worldwide.
Lung, colorectal and stomach cancer are among the five most common cancers in the world for both men and women.
Those of you who have been following Ivan Noble's brave and inspiring online journal detailing his battle with brain cancer would have been saddened to read his
final entry.
Ivan's final words in his diary were:
I will end with a plea. I still have no idea why I ended up with a cancer, but plenty of other cancer patients know what made them ill.
If two or three people stop smoking as a result of anything I have ever written then the one of them who would have got cancer will live and all my scribblings will have been worthwhile. |
There you have it. One of the major causes of cancer today is cigarette smoking. Give it up, NOW!
Links:
National Cancer Institute (USA)
National Cancer Society of Malaysia
Regaining brains II
Deja vu.
Bernama reports that the Ministry of Health is trying to
Woo M'sian Specialists Abroad.
The Health Ministry will shorten the three-year compulsory service in government hospitals in a move to attract Malaysian specialists to return to serve in the country.
Health Minister Datuk Dr Chua Soi Lek said the relaxation offered to specialists with degrees and qualifications recognised by the Malaysian Medical Council was among steps taken to overcome shortage of specialists in certain disciplines. |
I really can't understand the thinking behind this move. The critical shortage of key specialists lie in the major MOH hospitals due to a "brain drain" to the private sector and indeed abroad. Now if you want to attract back these specialists, surely shortening the compulsory service is not going to attract them for very long. Some might come back just to serve the shortened compulsory service and then they are free to go into private practice and elsewhere.
The Bernama report also mistakenly states that the "ministry would also cut short the compulsory housemanship period at government hospitals to Malaysian specialists with advanced medical degrees from the United Kingdom from 18 months to six-and-a-half months". I suspect they are referring to the "specialist gazettement period" for post-MRCP/FRCS holders from abroad and not "housemanship".
They also mention "Malaysian specialists aged 45 and above who returned to serve in the country would be exempted from the three-year compulsory service with government hospitals."
So it is not only shortened but done away with altogether for some - it appears now that you could even go straight into private practice from abroad without even serving with government hospitals if you are aged 45 and above. So much for fairplay. This will only benefit the private sector. So much for thinking about your own backyard! I think this will prompt an even larger exodus from Universities and Government hospitals whereby middle and senior ranking speciliasts will be thinking they might as well leave now before the private sector becomes saturated (it will not be for a long long time given the expanding population and health needs - just that you can't be too fussy about location).
I already suggested in
Regaining brains how policies favoring only specialists from abroad are unfair to the skilled specialists serving in our own Universities and MOH hospitals.
We should be thinking of how to RETAIN our brains and not only ways to REGAIN them.
No point regaining brains only to lose them again. Obviously the MOH administration and policy makers are the ones who need to regain brains if they think strategies like this will work.
