Have you quit yet?
Today, May 31 is
World No Tobacco Day.
In the aftermath of the underwhelming achievement of the "Quit clinics" (See
Chicken before the Egg due to poor publicity, USM's Poison Control Centre (how apt!) now has a
New Phone Service To Help Smokers Quit:
From Tuesday, smokers seeking help to quit can turn to a telephone-based advice programme that will coach them on a step-by step procedure with personal attention.
The National Poison Centre of Universiti Sains Malaysia started the novel programme for smokers in the country.
Called Quitline, the programme will be serviced by trained pharmacists of the centre five days a week from 10am to 4pm in conjunction with World No Tobacco Day that falls every May 31, said the centre in a statement, Monday.
Its director Professor Rahmat Awang said the programme would provide information to smokers who previously might not know where to seek help to kick their habit.
"Quitline will focus on advice and information dissemination. We hope to achieve some quitting rates from this manner rather than relying on medication alone," he said.
The number to call is 04-6572 924. |
It would have been better if the number had been toll-free - right now long distance call rates would deter most except for the most determined to stop smoking.
It's a start however and at least there is a phone contact rather than like the Public Health Deputy Director whining about lack of response to the Quit clinic when the press statement doesn't even have information on whom to call or where the clinics are located.
Priority treatment?
The PSD claims that
Pensioners’ medical claims get priority treatment.
I guess they now have come up with some PR spin since the NST highlighted the plight of Government retirees having to stop expensive medication for multiple sclerosis due to red tape (see
The Shame of It)
Well, what is the PSD thinking?
Commenting on Gomez’s case, Hasniah said the PSD received the first and only correspondence from her in a letter dated Nov 27, 2002.
A reply was given on Dec 17, 2002, to the effect that the matter was within the purview of the Perak Water Board.
A copy of the reply was extended to the board, which contacted the Health Ministry to determine the prescription for the drug issued by the hospital concerned.
Only after it was confirmed that the prescription was made did the board reimburse RM3,000 to Lopez in July 2004 |
The sequence of events seems quite clear to me. It seems like PSD first played "pass the buck" back to the Perak Water Board. This is a retiree for God's sake. More importantly a time lapse of
18 months from receipt of letter to reimbursement is disgraceful.
If this is the "priority treatment" pensioners can expect from the PSD, God help them.
Careful with that drink
Many still believe that moderate drinking is beneficial for the heart. The CDC is not so sure.
From
MedPageTodayCDC Study Skeptical on Moderate Drinking's Heart Benefit
A few drinks a day may not stave off the cardiologist after all, the federal government has warned.
Indeed, the benefits to cardiovascular health attributed to moderate consumption of alcohol may well be the result of other lifestyle or biological factors, said a study by the Centers for Disease Control and Prevention that was released today.
"If we compared this (alcohol) to a pharmaceutical drug, there's no way in hell the FDA would've approved it," said Tim Naimi, M.D., an internist and medical epidemiologist at the CDC's Chronic Disease Center, in an interview.
Moderate alcohol consumption should not be recommended to improve cardiovascular health, he added. "It should be viewed with extreme caution because there are no randomized studies on it."
Dr. Naimi and his team analyzed data from 250,000 American adults who participated in a 2003 telephone survey and found nondrinkers had a higher risk for heart disease because they had higher rates of hypertension, diabetes, inactivity, and obesity compared with moderate drinkers.
Participants were asked about socioeconomic status, smoking, medical conditions, lifestyle, marital status, race, even the number of teeth they had. Of the 30 factors assessed in the survey, 90% were significantly more common among nondrinkers than moderate drinkers.
"Moderate drinkers have lot of favorable lifestyle characteristics," Dr. Naimi said, including better socioeconomic status, more education, and overall better general health than nondrinkers, who tend to be poorer. |
Sceptics might also say that you can't form firm conclusions on a telephone survey. I personally think the jury is still out there. There still could be some cardiac benefits so I'm still going to enjoy that occasional glass of wine ;)
It's not only the doctors...
...who need appreciation that it is. Medical care in public hospitals also require well trained and dedicated nursing staff.
Misi wrote in the
MMR comments but I thought I'd highlight her comments here (since Haloscan comments disappear after a while):
Congratulations to all doctors with their new on call allowances. Are you all happy now? I was in Kapit Hospital some 8 years ago. I did my nursing job. I also do the doctor's work. Yes, more than 50 % of the time, I did doctor's work. And I am happy about it. Why? Because I was given to trust to do what my experience told me to do. I am grateful to these doctors who gave me the opportunities.
Don't worry. I did not do invasive procedures. But having said that, many of you out there would feel that it is not right. It is not right. Especially when you are paid for on call, overtime and what not, and the nurses "help" you out and all you have to do is to document. Worse still is you being ungrateful and you either scold the nurses or when you are called because of emergency, you refuse to come.
What I write here is the truth. Not slander. I write from my experience. I write because now I am still a nurse but a different category and I am being treated so unfairly by my own nursing professionals that writing is a way to ease the anguish in my heart. Yelling at each other in front of people in the office is not my style. I write this, hoping that one day, things will change for the good. If there is such a thing as good.
I believe in team work. I believe in doctors trusting the nurses. Nurses doing what they know. I believe in patients getting well and not getting worse. I believe both the doctors and the nurses can help the patients get well; each from their own angle with a desire to help the patients heal or make them comfortable. Doctors have more power. Sometimes, doctors must make the nurses think and act correctly because some nurses are like robots.
There was a mother about to deliver a breech. I looked for the doctor on call. He was playing sports and he was also the Director of the hospital. He popped in for a while and thought it was nothing and expected me and one jururawat masyarakat to deliver the baby. He was supposed to be around. He was supposed to take care of the mother and the baby. He did not.
The jururawat masyarakat and me struggled with the breech delivery and I prayed that nothing happenned. The baby came out well. The mother was well. God was with us.
But the doctor was no where to be seen. Who gave oxygen ? We. Who did suction ? We. Who monitored both baby and mom ? We.
Now, that is history. People only remember me for my weaknesses. They did not think that along the way, the jururawat masyarakat and me were more than just nurses.
Today, the government constructed a multi million ringgit modern clinic equipped with all the digital necessities. The politicians officiated the opening. The people from Kuala Lumpur came, most probably thinking that Kapit is so isolated. But back those days, only the hands of those responsible kept the patients then well. My hands were there. Unlike the Hollywood pavement of hands, I left an invisible mark. Nobody knew me. That breech baby or child now will never know me.
The one who knows is God. To Him, I place my hopes. In a world of lies, what is the truth ? People prefer listening to lies. People prefer the powerful on Earth. God closes the door but opens the window. God sometimes closes both and you have to be inside, along with your feelings, with your thoughts, with what you intend to do next. I think emotions are the hardest to overcome. I think overcoming emotions is one of the greatest winnings in life. |
I hear you Misi. That breech baby may never "know" you but you certainly touched the lives of the mother and child. All our actions do. And yes, eventually we are only answerable to God.
Don't think that every mundane thing we take as "routine" in hospital everyday is trivial. Checking that oxygen tank or suction device every morning may sound trivial but it's not. It means the world to the next baby you are resuscitating after delivery. It may mean the difference between life, death or cerebral damage from hypoxia.
I think Mitch Albom got it right - all of us, nurses and doctors are like Eddie Maintenance in
The Five People You Meet in Heaven. You touch more lives than you know.
PS I almost missed this long comment from Misi. If you would like to say your piece and its more than a comment, do send me
Feedback email
Train the kids!
Too many Malaysian patients I know just won't adopt a "healthy lifestyle". They look instead for magical supplements, vitamins, antioxidants and what-not as is being advertised. Eating healthily, exercise, avoiding cigarette smoke etc seems to be much harder for us.
Anyway I was amused to see this Dilbert cartoon (did I not mention I'm a great fan of Dilbert?) which has a simple solution for those of you who continue to indulge in erroneous ways ;)
Site update: Recognised medical schools
The questions are coming in so I have put the
Recognised Medical Schools info as a permanent link on the right hand panel of the MMR front page (along with info for foreign doctors)
Electrostatic Scam
Yes folks, there is a new scam in town and folks are flocking to these centres offering "free treatment". Don't be gullible folks. There's always a catch and always some hidden agenda.
Our Cyberdoc has reported on this fad in his Cybermed article
Electrostatic Therapy - ElectropathyExcerpt:
Definition: Electropathy - The treatment of disease by electricity.
Why my sudden interest in electropathy? Recently there has been considerable interest by consumers in electro-static therapy or something similar using electricity. Free treatment signs for anyone and everyone from children to adults and the elderly are up at major department stores/outlets and consumers are shuttling great distances just to get this treatment at "less crowded" sites! Many branches have been opened and more are planned.
The pamphlet that I have claims, "Blood Cleansing, Improve Immune System, Regulate Involuntary Nervous System." Helps in Heart Disease, Diabetes, Asthma, Osteoporosis, High or Low Blood Pressure, Stroke, Constipation, Insomnia, Rheumatism, and to top it all Prevention of Chronic Diseases. My favourite is its ability to help autoregulate blood pressure. Give me a break!
A device that can do all that and has been around for many years in Japan! Wonder why only now we poor souls were considered to share in this great therapy! Not to mention names, but a lot of people who I know have been singing praises. You know you do this for 20 minutes a day and your urine will be clear and all aches and pains will disappear. The "man" or "lady" informs that you must also exercise and take your medication regularly and drink a lot of water. Wait! Isn't that what all we doctors have been saying all the while...exercise, take your medication regularly and drink water.
Lets look at it objectively, if one takes his/her medication regularly, exercise and is well hydrated will it not help manage whatever disease he or she is having. In addition when you are well hydrated, will not your urine be clear?
The catch is, if more and more people queue for this treatment, there will be a greater number wanting to buy this device. The cost? Around Rm 17,000! You may also get a discount! |
A Hallmark sign of a scam is any treatment that claims to be effective in a multitude of illnesses. It's sad that there are still so many gullible people out there!!
Here are some useful inks from
Quackwatch. Read these articles to arm yourself with knowledge to protect yourselves from these Quacks!
Distinguishing Science from PseudoscienceVulnerability to QuackeryTen Ways to Avoid Being QuackedSigns of a Quack device
Call allowance increase!!
irenelawek sends in this
tidbit from SinchewI can't read Chinese so I had to run it thru
Altavista Babelfish - the crude translation I gather is some announcement about an increase (? up to 400%) in Call allowance for Government doctors.
Can some kind Chinese-literate soul please confirm? If so this is good news for the hard-pressed over-worked underpaid MOs in Government service!!
Thanks irenelawek for the tip.
P.S. Dr wccheah was pointed out that the news last night has also appeared in Bernama:
Govt Doctors' On-Call Allowances Raised After 20 Years
Mediharta
Meditag guarantee of quality so we are told.
In that article, at least some enterprising persons asked pertinent questions which were unfortunately brushed off by the Minster of Health
Asked why only one company was given the right to distribute the security label, he said it was for security purposes.
On Mediharta Sdn Bhd’s selection, he said the contract was awarded before his tenure as Health Minister and "you have to ask the former Health Minister (Datuk Chua Jui Meng) on this". |
Well, curious as to who is behind Mediharta, I Googled and came out with some results:
From
Storm brews over little known company with monopoly to make drug labels:
In his September 2002 budget speech, Dr Mahathir announced that security labels would be affixed on all tobacco, alcohol and medical products in future to combat counterfeit and contraband material.
According to executives familiar with Mediharta, the award to the company was agreed to in late 2003 and signed 10 months later.
The plan was to have been implemented last June, but was deferred to May 1, 2005.
But medical practitioners contacted by BT mostly professed ignorance about the matter, the result of relatively muted press coverage.
Even The Sun, which gave the issue some space, confined its relatively indignant comments to three columns.
A check with Malaysia's Companies Commission showed that Mediharta is capitalised at RM1 million and has five shareholders, mostly unknown except for two.
They are Saleha Mohd Ali, the sister-in-law of Dr Mahathir with 9 per cent, and entrepreneur Sandra Wong with 25 per cent.
Ms Wong used to be a corporate adviser to Halim Saad in the early 1990s when the tycoon ran the Renong conglomerate but left to pursue her own business interests in 1996.
Both women hold no executive positions in Mediharta, however, which is run by Dr Andreas Teoh who holds another 25 per cent. |
and in
A fortune for making the pill bitterBut Health Minister Datuk Dr Chua Soi Lek's statement that the use of hologram labelling was proposed in 2002 and that it should have been launched last year, tells us a different story.
Simple arithmetic shows that it took three years of "secret" negotiations for the holograms. Everyone was kept in the dark on the matter, especially the consumers, who will have to fork out more for their lozenges and aspirins.
The industry, we have been told, was informed of this in June last year. But the question Chua has not answered is: Were open tenders called for the supply of holograms when it was proposed in 2002?
How and why did the ministry choose Mediharta Sdn Bhd to supply the holograms? The agreement between the company and the ministry was signed only in March last year, a month before Chua assumed the portfolio.
The present prime minister took office in October 2003 and immediately announced that open tenders should be called for all government contracts. By not calling for open tenders, the ministry defied the PM's directive. |
These are the "background" facts that I could dig up on the Internet. I make no conclusions - I leave that to you.
Aid for CML patients
Amit writes in about his Aunt who suffers from
Chronic Myeloid Leukemia and cannot afford the cost of the medication.
Well Amit, there is good news. The current medical treatment for CML is a drug called Imatinib Mesylate (Tradename is Glivec or Gleevec in the USA) which is indicated for older patients or in patients where bone marrow transplants are not possible or less preferable.
Unfortunately Glivec is expensive - in Malaysia it costs like RM 8000-12,000 per month. and this medication has to be taken life-long. Yet there is hope because there is financial assistance available in now 74 countries in the form of
GIPAP which is the Glivec® International Patient Assistance Program. What Amit should do is to get his Aunt to talk to her local doctor and get her on the GIPAP programme.
Site update: MS Society of Malaysia
Added the
Multiple Sclerosis Society of Malaysia's website to the MMR's
Public Societies and Associations listing.
The MS Society of Malaysia is on a
Mission to Track down Malaysian MS patientsThe society is holding an MS Link Meeting on June 25 at Crystal Crown Hotel in Petaling Jaya.Padma hoped that MS victims and their family members would attend the meeting so that they could obtain more information on how to live with the disease. Admission is free.
MS patients can contact the society by calling Padma at 03-78760568 or society secretary Wendy Lee Ming Li at 016-2268676. |
Should doctors wear white coats
The DG uttered something about doctors wearing white coats and suddenly Heads of Department are again reminding their staff to wear white coats.
Read in
PalmoAnest of his experience in his hospital.
In our hot and humid climate, white coats are impractical. They may even harbour
microbial flora. It's a vestige of old time medical practice. I think the DG and HODs should get real and move on with the times.
Links:
Keep smiling, MMA tells docsMore than meets the Eye (MMR post by Dr TE Cheah)
Anti-smoking : Shooting ourselves in the foot
From The Star,
Say no to tobacco fair, Government urged
KUALA LUMPUR: A tobacco control authority here is disappointed that the green light has been given for an international tobacco fair to be held here later this year despite the Tak Nak anti-smoking campaign.
“It will diminish whatever anti-smoking efforts we have made,” said Malaysian Council for Tobacco Control president Prof Dr Syed Mohamed Aljunid.
“We have written to City Hall and the Prime Minister opposing their coming here.
“It would not be right for them to come or for the Government to give them permission to do so,” he said.
“This is especially in light of the Government's strong support for anti-smoking activities,” Dr Syed Mohamed said, adding that India and Bangladesh had refused to let the expo be held in those countries.
A private German firm has been given permission to hold the “Emerging Tobacco Markets 2005” expo here from Nov 14 to Nov 16.
Health Ministry director-general Datuk Dr Ismail Merican said the expo would affect tobacco production and use in Malaysia and Asean.
“It is regrettable that a conflict between short-term economic gains and public health interests often result in health taking on a lower rank in the priority list,” he said in his keynote address at the Malaysian Conference on Tobacco Control 2005 here recently.
Ministry parliamentary-secretary Lee Kah Choon, who opened the conference, said the Government was concerned about the situation.
However, he said, the issue must be looked at from a balanced perspective as the expo was a private venture.
“Even though the consequences are bad, they can come over here if they want to as Malaysia is a free trading nation,” he added. |
Allowing an international tobacco fair to be held in Malaysia, just when we are spending millions of ringgit on discouraging our citizens from smoking, is a embarassing flaw in judgement from our Government. Despite defending it as a private venture, the Government has failed to realise that the entire tobacco industry is indeed made up of private ventures! It appears that business has superseded the importance of a healthy population. It is shameful that even poorer countries like Bangladesh has displayed greater common sense and courage of not allowing such an unremorseful and defiant tobacco industry from thriving on its shores, despite its monetary attraction. The objections from the Ministry of Health DG and the president of the Malaysian Council for Tobacco Control has fallen on deaf ears. As for the "Tak Nak" campaign, I think it may be a more appropriate move to educate our politicians and top policy makers first on how to say " tak nak". Perhaps the taxpayers' money will be put to better use that way.
Feedback: looking for medical information
syaza writes:
actually i've got some question in my mind about medical problem but i don't know where should i get the info .
i want to know more about pre mature pregnancy/pregnancy.which website that i can log in that also include faq?
Well syaza, the WWW is a huge place isn't it? One needs to be cautious when searching for medical information since the information may or may not be reliable.
One of the best places to search for good medical information is the one run by the US National LIbrary of Medicine:
MedlinePlusJust put in the keywords you are looking for in the MedlinePlus search box at the top of the page and you will be taken to links with reliable and useful medical information.
For instance if you are interested in Premature Birth or Prematurity (I presume this is what you mean by "premature pregancy") just put those terms and hit the Search button!
Hope this helps.
The Shame of It II
I recently
highlighted the NST report on how civil servants and pensioners are being given a run around by the Government when it comes to expensive medicines like Beta Interferon for Multiple Sclerosis - to the extent that they have to give up on the treatment because they are expected to pay first and claim later ( a process which is not only inefficient but often delayed ).
I am glad the NST has followed up again with an
Editorial on this issue.
You may wonder why this should happen when the Governmetn hospitals are also funded in the end by the Government. The sad fact is that Government hospital drug budgets are woefully short. Hence the need for the hospitals to bill other Deparmtnets e.g. the PSD, Education Dept etc when it comes to expensive drugs. The latter include drugs like Growth factors, Rituximab, Alpha Interferon and Imatinib in cancer therapy.
What we really need is a smoother mechanism. In Beaurocracy-laden LaLaLand I doubt this will happen anytime soon.
Blogroll update: Gasman
Gasman has written in to inform that he has a blog. Updated in the MMR's Blogroll (on the right of this page). Welcome aboard!
Feedback: Industrial training
Princess writes:
please let me noe bout any private or government hospitals along wif d lab dats offer an industrial training for students?do sent me deir addresses along wif d person in harge of it(name + contact num).
I presume you mean Medical Laboratory Science Industrial training? I suppose it depends on where you are studying now. Your best bet would be to ask your course supervisor and seniors. Otherwise the MMR has lists of
Public and
Private hospitals.
If anyone knows of sepcifcs, please post comments or send feedback.
Chicken before the egg
From
The StarFew takers for Government's free ‘quit smoking’ programme
Poor response – that is the problem with a free government programme to help the country’s five million smokers quit the habit.
The programme, launched seven years ago, has only seen 20,000 smokers giving it a try.
The Health Ministry has been offering the three-month programme, which costs up to RM1,500, at more than 200 government clinics throughout the country, said its public health deputy director here Dr Sallehudin Abu Bakar.
He cited poor publicity and poor response from private general practitioners (GPs) as the reasons why the programme, launched in 1998, has not been as successful as hoped.
“Whenever the programme is publicised on radio or television, it is usually during non-peak hours, only when housewives are watching and listening. |
Don't blame the GPs. If there is poor publicity then of course there will be poor response. Duhhhhhhhhhhh.....
Of course if you have been a regular reader of the MMR, you would have realised I have mentioned the Quit smoking clinics several times:
here,
here and
hereNext time instead of relying on the Radio, perhaps the MOH should have relied on things GPs read like circulating the info in Berita MMA, print Media and the Internet. Yet, when you read of the "Press statement" in the papers like
Get all the help to quit smoking, at the end of it if you were Mr Joe Public, you would want to know where to go, who to call etc. Surely the "Press stamement" could have included a Phone contact ( 1-800 number), Website or something for Mr Joe Public to use to find out for instance where the nearest quit clinic is to his place of work or residence. Instead the publicity is useless if you give the public a run around and expect them to hunt the clinics down themselves. Couldn't the Public Health Deputy Director be more specific than say "quit clinics are localted in hospitals and various polyclinics"? Commonsense isn't it?
Baby Dumping : Worrying trend
From The NST,
Baby’s body found at hospital’s car park
IPOH, PERAK, Sat.
The decomposed body of a baby was found by a security guard making his rounds at the Ipoh Hospital car park today. |
A recent spate of baby abandonment should be a worry to us all. A probably culmination of teenage pregnancies, a plan to tackle this problem should be sought. Tackling the problem of teenage pregnancies should entail adequate and practical implementation of sex education in schools. Shying away or delaying the introduction of this topic in schools will only increase the gravity of the current situation. Sex education should not be biased towards religious beliefs but incorporate more realistic scenarios of teenagers today. This includes proper birth control measures and practices of safe sex. This is not abetting promiscuity but realising the complexities of teenagers of today.
I believe that a center for accepting babies conceived out of wedlock should also be set up in this country. Such anonymous depositing of these babies will hopefully prevent the deaths and exploitation of such innocent beings. It is time we remove prejudices and preconceived ideas that each of us may carry in order to effectively solve the situation of unwanted pregnancies.
The topic of abortion is probably more controversial. Perhaps opening up this topic to debate may spark an interest in a problem so often neglected by this society.
Feedback: Training Socso doctors
In response to
Socso Doctors must probe further where the Human Resources Minister feels there is under-reporting of occupational diseases and "wants Socso panel doctors to be trained in occupational health by the end of the year", an anonymous doctor has sent in feedback:
| I am not surprised with under reporting. Many doctors has been removed from SOCSO panel recently. I have tried to apply to be one of the panel but Socco informed me that they have adequate doctor under their panel. But i have enquired around my area none of the doctors are with the panel. When I reapply they told me that I must take a course under NIOSH. Well the course will cost me about RM4000 that means I have to see about 100 socso cases to break even ... which may take me a year a least so I didnt bother to apply again to SOCSO. |
Well I think the issue at stake here is training and accreditation. I don't believe all GPs would be well versed in Occupational Health and indeed periodic updates and CME are important in this area as with other areas in medicine.
I agree with what the Human Resources Minister and I hope that Socos sticks with its principles and recruits only qualified doctors in their panel. It appears there is a shortage so perhaps more incentives can be given to those interested in Occupational Health
Links
National Institute Of Occupational Safety And HealthDepartment of Occupational Safety and Health
HIV/AIDS : An unfinished war
From Medical News Today,
Chinese Govt Blocks Web Site Containing Information About HIV/AIDS for Men Who Have Sex With Men
19 May 2005
The Chinese government last month began blocking a popular Web site targeted at gay, lesbian, bisexual and transgender people that includes information about how to prevent the spread of HIV, |
HIV/AIDS remains a battle to be won. Despite having the artillery, they remain directed haplessly in different directions. Who would have thought that despite years of education, yet regressive decisions are made. Accepting Man's diversity in sexuality is a small step in battling the ravaging effects of HIV/AIDS. Unfortunately, the stigmatisation of a disease that often exemplifies social immorality has time and again stunted the effectiveness of our assault on this disease. When the people that governs one fifth of the population on our planet display their prejudices, it only signifies that much still remains to be done.
The shame of it
The trouble about working in the civil service is that hopes of your healthcare needs being provided by the Government may be dashed by bureaucracy.
Bureaucratic delay affecting MS trio :
Two teachers and the wife of an ex-serviceman are discontinuing treatment for multiple sclerosis. The reason: Bureaucratic delays in reimbursing medical expenses.
The teachers, from Penang and Sarawak, and the ex-serviceman's wife, from Penang, have resigned themselves to days of uncertainty.
They make up a handful of civil servants or family members of pensioners among the 100-odd Malaysians diagnosed with MS.
A doctor said: "The three cannot afford to spend a minimum of RM3,000 every month and keep their fingers crossed for swift reimbursement.
"After exhaustive appeals to the Education and Defence ministries, they only received their first claim some three months after submission."
Due to the delay, the trio had decided to stop treatment. |
This is simply dreadful, shameful and disgraceful. For civil servants to have to give up on medical care due to bureaucratic incompetence is simply unforgiveable.
Thanks NST for highlighting what has been happening to this unfortunate trio. But I can say it not only happens in the treatment of MS but in many other cases where the medication is expensive, especially in cancer treatment.
Medical Inventions
The Star has a feature on
Malaysian inventors on the rise and mentions some health realted inventions. A noteworthy one is Prof. Shamala Devi of UMMC's D.S. Quant Dengue kit - a three-in-one diagnostic kit for dengue fever. This invention won her a gold medal at the Geneva exhibition in April.
The kit allows one to detect, serotype and quantify the dengue virus in human samples in a single assay in two to three hours.
It will allow doctors to diagnose the virus within the first day of infection, a healthy improvement from the previous best diagnosis, which could only detect the virus on the fourth day.
Well done!
Locums - legitimise once and for all
The DG of Health has made a statement in the
press to the effect that Government doctors are not allowed to do locums in the private sector. If I am not mistaken, according to the General Orders, civil servants can partake other jobs outside office hours on their own time provided they obtain permission from the heads of department. After all Specialists from some teaching hospitals have private practices as well so why the discrimination against MOs trying to make ends meet?
This sort of statement is not going to help the plight of MOs. Already during my time (17+ years ago), MOs had to do locums to save up money as specialist examinations were held only overseas. It costs something like RM 15,000 in those days to fly to the UK and stay for a couple of months for the MRCP part (II). RM15,000 in those days was a lot of money especially when MOs earned something like RM1,500+ a month.
The issue of locums is now a hot topic in
Dobbs. One Dobber has pointed out that if CME were to become compulsory, private practitioners would find it difficult to attend CME sessions if there were no locums to cover for them when they are away.
It's not the case of the APC (Annual practicing certificate) being the issue of "legality" here - after all the APC only states the "main place of practice" and there is nothing to stop one from putting more places in the APC (how about "Peninsular Malaysia" or even "World"??!!??). It's not about being legal or illegal either - just whether or not the General Orders allows it and whether or not the powers-that-be will condone it officially.
So honorable DG of Health, perhaps you and the powers-that-be should take a hard look at reality. It would be far better to legitimise locums. That way
all sides benefit. The Government won't lose MOs who would be inclined to resign, the MOs get to earn more money to supplement their income, the private practitioners get their locum cover for them to attend CME meetings and even the Tax man will benefit since people won't report income if it were "illegal".
Just a reminder, the MMR runs a free
Online Locum Agency ;)
What about standards?
I don't get it. If you fail a qualifying examination and can't practice medicine in this country, what do you do? Sue the University? Seems like this is happening!!
From
The Star Filed last September, the group of doctors who graduated more than 10 years ago from non-accredited universities in India, Indonesia, Syria and Pakistan, sought a declaration that they have the right to be allowed to practise as doctors in accordance with Article 8 of the Federal Constitution.
They also sought an order that the decision to fail them in their final examinations by UM and the two other universities was unfair and discriminating. |
How about working towards passing the exam instead? Unbelievable.....
World Hypertension Day
World Hypertension Day will be celebrated for the first time today, May 14th 2005.
From
the Star A statement from the Malaysian Society of Hypertension (MSH) said the World Hypertension League (WHL) had designated May 14, as a day to emphasise the consequences of hypertension and to encourage people to monitor their blood pressure.
“Hypertension is highly prevalent in many countries in the world, including Malaysia. The WHL estimated that more than 1.5 billion people worldwide suffer from hypertension, with only a third of them being treated.
“In Malaysia, only 6% of hypertension patients have their conditions controlled,” said MSH president Datuk Dr Azhari Rosman. |
Well, perhaps the MSH president should take a look at the
Malaysian Society of Hypertension's website - absolutely no mention of World Hypertension Day. In fact this Pfizer sponsored website hasn't been updated for sometime, mentioning a Scientific Meeting which has come and gone and highlighting Hypertension Awareness Week for 2001!
We don't have to look far in Asean to see other websites like the
Phillipine Society of Hypertension mentioning this inaugural day.
Well, MSH, you can certainly buck up and wake up the webmaster of your website. Only 6% of Malaysian patients with hypertension have their condition controlled? Perhaps if you disseminate information better via the Internet it might help!
Links:
World Hypertension League
Nurses Day
I was reminded by the nursing staff in the ward that today is
Nurses Day.
This year's theme is:
Nurses for Patient Safety: Targeting Counterfeit and Substandard Medicines
How true. Fake medicines are rampant in this part of the world and how more unscrupulous can people be than to cheat and cause harm at the same time.
Nurses can help create awareness on this serious problem and the public too must play their part in being vigilant and not get medicines from suspect sources.
Anyway, here's wishing all Nurses a Happy Nurses Day!
Free health screening for Mothers!
The MMR wishes all Mothers a belated Happy Mothers' Day! There is a news report in the Star that there are
Free health screenings for all mums until the end of this week (Sunday)
Mothers nationwide – from first time mum to ‘senior’ parent – can receive a free screening package that includes breast examinations until the end of the week.
The health package also comes with free pap smear and blood tests, wellness screening and family planning services.
The programme, to mark Mother’s Day, started yesterday and would end on Sunday.
In a statement here, the Women, Family and Community Development Ministry said the free health-screening package is in recognition of women’s role in society.
It is available at any of the 50 National Population and Family Development Board (LPPKN) clinics and Nur Sejahtera clinics nationwide.
The screening is being offered to mothers in three categories:
·FOR young mothers (aged 20 to 29), the package covers family planning services, detection of breast abnormality and pap smear service for cervical cancer diagnostics check.
·FOR middle-aged mothers (aged 40 to 49) the package offers blood pressure test, body mass index, family planning services, breast examination, pap smear and blood tests for glucose and cholesterol.
·MOTHERS in the senior category (aged above 49), will get a package that offers blood pressure test, body mass index, breast examination, pap smear, blood tests for glucose and cholesterol, bone scan and menopause counselling. |
If you are also wondering what a Nur Sejahtera clinic is, I google searched the MMR and indeed there was a
news item about it last year. This is a brainchild of Datuk Seri Endon Mahmood and and are wellness clinics for women. The first Nur Sejahtera clinic was launched by the first lady of Malaysia and is located at the National Population And Family Planning Board (LPPKN), in Jalan Raja Laut, Kuala Lumpur.
Btw, Sejahtera means "peaceful" in Bahasa Malaysia.
Links:
Klinik Nur Sejahtera
End of Locums for Government Doctors?
From a report in
The NST,
The Director-General of Health mentioned,
| On locum work, he said government doctors were only allowed to do so in government hospitals and not in private clinics as most of them were now doing. |
As mentioned, it is common knowledge that Government Medical Officers and perhaps specialists, work as locums in many private clinics and hospitals in this country. The reasons are usually monetary in nature. Such locum positions are meant to supplement a mediocre income from the Government. Why else would they sacrifise precious rest time to toil in such clinics? When the desperation of trying to make ends meet becomes overwhelming, these medical officers are forced to work hard. Some of them do locums almost daily. I am pretty sure they would prefer otherwise.
Locum positions in government hospitals are severely restricted. How about medical officers from smaller district hospitals or clinics, where locum positions in the government sector is practically non-existent?
It is time the Government look at the realities of the issue. There is no point issuing a statement when it serves no purpose altogether. So how is the Director General going to solve the issues involved? How are these doctors to supplement their income in their spare time?
In an era where government doctors earn less than a secretary, who works 9 to 5 for five days a week, I feel that many doctors are not able to meet financial demands especially in areas like the Klang Valley where living expenses are rising exponentially. Even trivial expenses like stocking up an appropriate wardrobe can puncture a hole in one's pocket. A doctor that is dressed in appropriately will come across as unprofessional.
It is time someone looks into the welfare of doctors. Doctors are not superhumans and they are subjected to the stresses of life that other people have as well. I think doctors have had enough chastising especially those coming from the higher authorities and the media. It is time they recognise and take into account the mental stresses that doctors have to put up with. Come on, doctors can't even have a special day to celebrate and recognise their contributions unlike teachers and nurses.
To MMA, I think your voice is too mellow. There is no courage shown in vocalising real concerns involving doctors today. We need a proper organisation that represents government doctors and fill a void that the MMA has failed to fill time and again.
Site update: List of Recognised Medical Schools
The MMR has managed to obtain an updated list of Medical schools recognised by the Malaysian Medical Council. The list was kindly sent by Dr. Rosnah Yahya, Assistant Secretary of the MMC.
Dobbs kindly scanned in the 50 pages or so and I have converted the Word file to HTML. The formatting is somewhat off as I had to strip the Microsoft HTML clutter using the free
Microsoft Word 2000 HTML Mess Cleaner otherwise the pages were 400 Kb in size!
Anyway, the links have been added to the
Schools Section of the MMR, in the subsection:
Medical students intending to study overseas
A Reminder for to-be medical students
From the
NST,
Studying in unrecognised varsities
June Ramli
KUALA LUMPUR, Tues.
An increasing number of Malaysians are studying medicine in unrecognised universities abroad.
To date, some 300 students have enrolled in such universities, Health Ministry director-general Datuk Dr Ismail Merican said here today.
Dr Ismail, who is also the Malaysian Medical Council president, said some of these students had been misled by agents who claimed that these universities were in the midst of being recognised by the Government.
|
Once again, a reminder to prospective medical students, do double check if the university of your choice is fully recognised by the Malaysian Medical Council. Do not make the error of studying in an unrecognised university. Double check with the MMC and never trust the recruiting agents. A desperation to study medicine should not supercede basic common sense.
Misfits?
"Dr J Veight" wrote in to
Malaysiakini:
Foreign-trained doctors returning to practice in Malaysia are sometimes misfits, akin to Formula 1 drivers forced to drive Protons on estate roads. Many lack even basic medico-cultural fluency that locally trained medical graduates are competent with.
They have high expectations which local hospitals cannot fulfill and instead of exhibiting their gratitude (and staying power) for being trained at much public expense, often jump ship for private practice pretty early on in their careers. |
I don't agree with "Dr J Veight". I believe we should continue to send Malaysians overseas for exposure to training and skills which they can't obtain locally. At the post-graduate level, there is much to be learnt from abroad and there is absolutely nothing to lose by admitting it. If Dr J Veight thinks that Malaysians are only fit to be Proton drivers and not Formula 1 drivers, he sounds like he has a colonialist mentality.
While it is true that some return with unrealistic expectations, many do return to share their new skills and knowledge and overall will improve the standard of medicine in this country.
Will fast lanes work?
In an attempt to try to reduce waiting time at public hospitals, the strategy now is to instruct
Govt Hospitals To Have Fast Lane For Old People, PensionersPENANG, May 6 (Bernama) -- The Health Ministry Friday directed all government hospitals in the country to immediately establish a fast lane for outpatient treatment of old people, pensioners and those who require immediate medical attention.
Director General of Health Datuk Dr Ismail Merican said it was discourteous to make these people, especially the old, to wait too long for treatment. |
I am sorry to say so but this policy sounds like a political diversion. It won't work well if the bulk of your outpatient load comprises elderly patients and pensioners anyway.Those who require "immediate medical attention" should go to the A&E in the first place. I'll bet too there will be the ugly Malaysians who demand to be seen ASAP as in their eyes they require "immediate medical attention" for that urgent fever, aches and pains and what not which has been troubling them for 2 weeks now.
As I said before the long waiting time stems from over-crowded outpatient departments. You don't need to
hire a consultant (and wasting how much money may I ask?) just to find this out. The solution is to ultimately reduce overcrowding and this can be done only if patients are channeled from over-crowded large General Hospital OPCs to peripheral/district hospital OPCs or satellite clinics or even have arrangements with private GPs (meaning there should be cost reimbursement for pensioners or government servants).
Why do the public shun smaller district hospitals or satellite clinics for the larger general hospital OPCs? It may be a case that the perceive the GH OPCs to be better equipped and better staffed. Sometimes they are right as expensive medications may not be stocked in the peripheral OPCs or smaller hospitals. I recall once attending to an elderly patient who came from a town in Perak all the way to a teaching hospital's anticoagulation clinic. His accompanying relative made a ruckus complaining about the waiting time. I simply told him off by saying this elderly gentleman need not come all the way down to KL just for an INR and repeat prescription of warfarin and I proceeded to write a letter of referral to his nearest DH. The impolite person suddenly became very nice and insisted on this elderly person still coming back to the teaching hospital. The perception being his local health services not being as good.
Bottom line is that the "fast queue" system is IMO doomed to failure.
Not all gore!!
From The Star,
Exposing aspiring doctors to the gore
BY V.P. SUJATA
TANJUNG MALIM: Applicants for medical courses in local universities will be first taken around hospitals to allow them to look at the “gore” doctors have to see daily before their applications are approved.
Higher Education Minister Datuk Dr Shafie Mohd Salleh said the move was to ensure that applicants would know what they were in for and not drop out halfway. cont.... |
Although it is important to enlighten to-be-medical students surrounding the realities of medical practice, highlighting gory scenarios alone may not do the profession any justice. The challenges in medicine are definitely not the "gory" patients but rather the commitments and arduous work involved from the day he/she becomes a medical student.
Exposing one to the realities of medicine is not to deter them from joining this exciting field but rather to confirm their interest in it. Excitement about medicine should not be stifled by displaying the gory nature that doctors have to inevitably face. It is about giving the students a balanced view so that they can make more informed choices.
Another area to improve on is the admissions criteria. Academic performances should not be the sole defining entry requirement as stipulated in most entry requirements of medical colleges/universities. It may be important to look into other aspects in the assessment of a student's suitability to enter medicine. Perhaps emulating North America by making medicine a post-graduate programme may breed more mature and serious medical practitioners. Requiring a basic degree or exposure in relevant fields, may help sieve those genuine contenders from the pretenders.
Ultimately, medicine is a wonderful field to explre despite all the laments that one may read (especially from MMR ) ;)
MMR invitation: Interested in blogging ?
The MMR is inviting interested persons from the Malaysian Medical Profession (doctors, dentists, nurses) who are keen to blog and express/share their viewpoints with readers of the MMR.
If you are keen, please
email me and I'll send you the blogger invitation. Blogging is very easy and all you need to know is how to use a browser and have an Internet connection.
Meritocracy? What meritocracy?
From The Star,
Meritocracy system for varsity entry to continue
PETALING JAYA: The meritocracy policy for entry into public universities will continue.
Higher Education Minister Datuk Dr Shafie Mohd Salleh said the policy was new and should be given time to work.
“We have just started the policy for meritocracy. We must give it time to work before we can do an impact analysis,” he said after opening Universiti Malaya’s international conference on health science.
(Previously, the student intake was on a race-based quota system. Bumiputras were allocated 55% of places offered, Chinese 35% and Indians 10%.)
On Wednesday, it was reported that deputy Umno Youth chief Khairy Jamaluddin had said the movement wanted the Government to change its meritocracy policy for entry into public universities if it was found that bumiputra students make up a minority in critical courses.
The modified merit-based entry system started in 2002. cont... |
It is again an attempt to pull wool over our eyes. Perhaps the highlighted words spells it all. "Modified Merit-Based System". Modified? As far as I am concerned, the word merit is quite clear and requires no modification. Any attempt to covertly redefine the word only points to the fact that meritocracy has never really taken off in the first place.
Medicine is a perfect example of such intentional manipulation of the word "meritocracy". When entry to local institutions are based on two separate examination formats, with clearly different standards, claiming meritocray is ludicrous. Unfortunately, such manipulations even extend into post-graduate programmes.
It is a shame that a young leader like Khairy, still believes that protectionist policies are the way to go. The lack of meritocracy in his political career path does not justify abolishing it altogether. If I remember correctly, the percentage of bumiputras in public universities was about 70% and this is excluding exclusively bumiputra universities like University Teknology MARA. Perhaps Khairy would like to furnish more details to justify his statement. It sends shudders up my spine to envision a possible future leader having such short sightedness.
Ultimately, it appears that Malaysia is not ready for meritocracy. Sadly, it possibly never will be.
Reducing waiting time - blaming doctors?
From the NST:
Tardy doctors and delays in opening registration counters are two reasons for long waits at hospitals. Health Minister Datuk Dr Chua Soi Lek said today that patients who turned up late for appointments or on the wrong dates also contributed to the problem.
This was compounded by the unsystematic filing of patients' medical records and delays in preparing laboratory test results.
"These are among the reasons why hospitals, particularly those in major towns, are unable to achieve the hospital's client charter of 90 minutes' waiting time." Registration counters in the morning should open half-an-hour before the doctors start treating patients, he added. |
I would like to take the NST to task for putting in bold in their article
‘Reduce long waiting hours at hospitals' at the very first line that "Tardy doctors" are a reason for this perennial problem in government hospitals. It gives readers the impression this is the major reason for the long waiting time. If there are tardy doctors in public service these are indeed the minute minority from my experience. Registrations counters too do not open late as far as my observation goes.
What the problem is is that the clinics are simply overcrowded. Waiting times can be easily reduced by cutting down the numbers in the clinics to manageable numbers but no, the administrators do not see this as a politically acceptable solution, so the overcrowding continues. The doctors and staff continue to be hard pressed.
And the rub salt to the wound, they now are labelled as "tardy".
There are inefficiencies in the system which can be improved for sure, like missing hospital records, files not coming in on time and late lab results.Patients too need to be educated on the meaning of the word "appointment". Administrators need to take the brave stand and say this is it - this is the quota for the day - beyond which it is simply NOT meaningful to run a clinic.
To tell or not to tell
Noh Suggests Allowing Doctors To Disclose HIV Patients' Illness To Spouse
BALING, May 5 (Bernama) -- Internal Security Deputy Minister Datuk Noh Omar, Thursday suggested that the Health Ministry looked into the medical ethics relating to HIV/AIDS to allow doctors to disclose a patient's illness to his or her spouse.
He said doctors, for example, should be allowed to tell the wife of a HIV patient about his infection so that she could take preventive measures to avoid contracting the disease herself.
At the moment, he said, doctors were bound by their ethics not to disclose their patients' illness without their consent, but he feared that HIV patients would keep their condition secret from their spouses. |
Now this is a touchy issue. Isn't it also unethical for the doctor not to tell if it means the spouse will be endangered?
In actual practice I think the vast majority of hiv patients after counseling will also allow the spouse to be counseled, since the spouse also needs to be tested etc.
However what does one do in the exceptional case where the consent to counsel the spouse is refused?
Will the law protect the doctor? Is the doctor party to endangering the spouse if he does not tell?
Link
HIV infection: the dilemma of patient confidentiality - editorial
The fact is...
From the letter section Malaysiakini,
Doctors must put patients first, allowances second
Dr Chong
May 5, 05 1:44pm
It is interesting to note that the current woes of Dr Lin are still very much the same as what I and my colleagues complained about when we were junior officers.
However our conditions were comparatively much worse. Nevertheless, we enjoyed ourselves as junior officers in the medical service knowing well that is the best period to develop a good foundation to be a good doctor in the future.
It was just in 1991 when I started as a houseman. Knowing very well that the Kuching Hospital was short of doctors (you could say the most understaffed in Malaysia at that time), I opted to go there for my first training.
We also knew they were good consultants there to guide and train us. As a houseman, being on call for 15 days a month is not uncommon. Even being continuously on call is a norm. And imagine that back then, there wasn’t even on call allowance!
But we relished performing our duty to our patients, knowing very well that it will also benefit us.
At that time they were only three compulsory postings (to the medical departments) but we clamoured for two more compulsory postings (which are in place now) as we felt inadequate when serving our patients without rotating through the five major postings.
In the US, junior medical officers start their rounds as early as 5.30am before being joined by the more senior officers for even more rounds. Their normal day routine does not end until 7 or 8pm.
Medicine is unlike any other profession. The wards are both a place for us to learn and acquire skills and also a place to serve our patients.
The Health Ministry (MOH) may realise that complaints from its doctors are always the same but ultimately, to me, service to the people is of the utmost importance.
I am not siding with the MOH as I am already in private practice after serving my dues for more than 10 years. But now, even after the government providing on call allowances and others, there there are still complaints.
Dr Lin will realise that what he faces now is lights years ahead of what we faced. And that was only as recent as 10 years ago. The MOH has done a lot to improve our working conditions and salary.
Some of this was made possible through our constant discussions with the MOH through the Schomos (Section Concerning HOs and MOs) section of Malaysian Medical Association. |
It is my belief that doctors have always been putting patients as their highest priority. Their dedication to their patients should never be questioned. Seeking better working conditions is neither synonymous with uncaring attitudes nor greed. As we venture into this new century, improvements should be an inevitable event. Comparing with and maintaining archaic standards is both foolish and unwise.
The system should not strive just to keep doctors for the initial stages of their careers but to create a conducive environment where they can advance their careers in public services. Leaving after 10 years of public service for greener pastures is no grounds to claim that the current system is fair and just.
In a time when healthcare standards are improving by leaps and bounds, more are expected of doctors. Medical errors are no longer as acceptable as that of yesteryears. This era of evidence based care has certainly made medicine an ever evolving dicipline. It is no longer acceptable when a doctor appears aloof about major breakthroughs in medicine, more so in this period of information technology. Keeping up with such developments can sometimes be laborious, as it is interesting. The point is that medicine has become more challenging now than it has ever been before. Expecting housemans to perform at a high standard for 37 or 38 hours straight without sleep, equates to torture and ridiculously unreal.
Doctors are often confused with Mother Theresa. With bills to pay, a family to upkeep and ever increasing post-graduate examination fees, current salary schemes are doing great injustices to a profession requiring so many years of sacrifice. Spiralling living standards do not help either. Demanding a fairer salary scheme, in my opinion, is justifiable and expected. With uncertain working hours that usually extends beyond the official times, the current salary if broken down to that paid per hour, is shamefully paltry.
Ultimately, the Ministry of Health is not doing enough to secure a better deal for doctors. Despite recent small advances, Schomos or the MMA has been relatively passive bystanders and on many occasions, ignoring pertinent issues involving doctors of today.
Just as we have phased out bullock carts as a mode of transportation, so should the working conditions of doctors be improved. Making comparisons with that of years gone by, displays an inherent nature of Malaysians, which is resistance to change and positive developments.
Being bullied or is it part of learning?
From Medical News Today,
One in three medical students has been bullied, BMA survey shows
04 May 2005
Over a third of medical students have been bullied, a survey by the British Medical Association shows today (Wednesday 4 May, 2005).
Thirty-five per cent of medical students who responded to the BMA Medical Students Committee welfare survey had experienced some form of bullying while at university or on a hospital placement.
Around one in four had been bullied by a doctor, while one in six had been bullied by a nurse. Forms of bullying ranged from racial or sexual discrimination to humiliation by teachers in front of patients. One respondent had been victimised for not having come from a medical family and another had been put under pressure to carry out a procedure without supervision.
Commenting on the survey results, Leigh Bissett, chairman of the BMA's Medical Students Committee, says "These figures are unacceptable. The idea that students learn best when they're terrified is outdated, bad for students and bad for patients. There should be no place for bullying in the NHS and it's time we adopted a policy of zero tolerance."cont.... |
Every doctor will have his/her fair share of unpleasant experiences in the ward. The above scenarios are certainly not too far-fetched and unfortunately, can still be seen in Malaysian hospitals today. There is certainly a lack of professionalism and displays an utter disrespect to a colleague in medicine.
I have always admired what a professor in medicine once said on our graduation night, " We are all equal now". Medicine in Malaysia is so riddled with hieriachy that we lose sight of the importance of working as a team. Many seniors have purported earned their stripes and are no longer subjected to the rigors of daily ward chores that other more junior team members have to contend with.
I agree that terrifying students or even junior doctors with bullying tactics is outdated. It is time we accord to them the necessary recognition and compassion. In the same vein, we should only overwork our young doctors if the more senior ones are equally prepared to be overworked themselves. Extremely long working hours is part of bullying and in some cases bordering on torture. We can no longer justify this act, as medical negligence issues become increasingly prominent. Gone are the days when mismanaging a patient is gone unnoticed.
The MOH and University Hospitals should adopt a similar zero tolerance to bullying and should make an avenue available for young doctors to voice their concerns.
Polio : Every reason to be concerned
"Malaysia has nothing to fear". These words spells ignorance. As reported in The Star,
Malaysia polio-free since 2000
PETALING JAYA: Malaysia has nothing to fear from the discovery of two polio cases in the west Java province of Indonesia, National Health Services Department’s Disease Control Division director Dr Ramlee Rahmat said.
“Malaysia has been polio-free since the year 2000 and we actively monitor the situation on the ground,” he said.
Dr Ramlee said the department looked for symptoms of polio, such as acute flaccid paralysis, and immediately addressed it.
“We also have very good immunisation coverage (about 95%) and follow World Health Organisation (WHO) guidelines.”
Dr Ramlee said Indonesia was in the South-East Asian region, which was still not completely polio-free, whereas Malaysia was part of the Western Pacific region that had been polio-free for some time now. cont.... |
It has now been discovered that these strains of polio originated from the epicenter of the epidemic in Africa.
From the International Herald tribune,
Polio strain from Africa is confirmed in Indonesia
By Donald G. McNeil Jr. The New York Times
WEDNESDAY, MAY 4, 2005
NEW YORK A case of polio has been detected in an Indonesian baby, according to World Health Organization officials, indicating that an outbreak spreading from northern Nigeria since 2003 has crossed an ocean and reached the fourth most populous country.
The virus, found in a village on the island of Java, is most closely related to a strain that was found in Saudi Arabia in December, the officials said. The virus was probably carried there either by an Indonesian who had worked in Saudi Arabia or by a pilgrim who had gone to Mecca in January.
Indonesia's last polio case was in 1995, and it is now the 16th country to be reinfected by a strain of the virus that broke out in northern Nigeria when vaccinations stopped there and then crossed Africa and the Red Sea.cont.... |
With such a large proportion of immigrant population, especially from Indonesia, and the yearly haj to Mecca, Malaysia could be at the brink of rediscovering polio on its shores. The continuing polio vaccination programme in Malaysia is commendable and the work of many rural nurses and midwives are much appreciated.
Nigeria is a perfect example of how ignorance breeds disaster. Many parents believed that the polio vaccine would make the children barren and even spread the HIV/AIDS virus. It is unfortunate that many such refusals have religious connotations.
From the BBC News,
Nigerian state thwarts polio push
A national polio immunisation campaign is due to resume in Nigeria, but one northern state is refusing to join in.
Kano opted out of a drive last year, when some Islamic leaders said it was part of a western plot to render Muslim women infertile. cont.... |
Stringent standards involving our immunisation programmes should be upheld. At the same time, monitoring the health threat from immigrant population should be stepped up not only for polio but for other transmissible disease like tuberculosis, which is also on the rise. This is a wakeup call to our health authorities. It is only hoped that it is met with positive and concrete actions.
More Concern About Vitamin E Supplementation
Source:
Journal WatchRef:
Bairati I et al. A randomized trial of antioxidant vitamins to prevent second primary cancers in head and neck cancer patients. J Natl Cancer Inst 2005 Apr 6; 97:481-8.
This randomized, placebo-controlled Canadian trial was designed to assess whether antioxidants could reduce the incidence of second primary tumors or recurrence of first tumors among 540 patients who underwent radiation therapy for head and neck cancer. For the first 156 patients, active treatment included both daily vitamin E (400 IU) and ß-carotene (30 mg). However, midway through the trial, other studies revealed potential harm from ß-carotene; thus, active treatment included only vitamin E for the remaining 384 enrollees. Median follow-up was 52 months.
During the first 3.5 years of follow-up, while patients were taking supplements, the incidence of second primary cancers (mostly lung or trachea) or recurrence of first tumors was significantly higher in the vitamin group than in the placebo group (141 vs. 85 events per 1000 person-years). After 3.5 years, cancer incidence was lower with vitamin supplementation than with placebo, but 8-year estimated cancer-free survival still favored placebo. Notably, the early increase in cancer was seen even in the subgroup of patients who received only vitamin E.
Comment: These results are consistent with a theory that antioxidant vitamins can accelerate cancer progression, leading to earlier appearance of latent tumors. Although one should be cautious in extrapolating to other cancers, these findings suggest that cancer patients should avoid antioxidant supplements.
— Allan S. Brett, MD
|
I think this is a warning to all cancer patients and their advocates who ingest or promte the consumption of "supplements", particularly antioxidants.
There is too much pseudo-science being marketed by various people including pharmacists - all in the name of selling vitamins and supplements. All that hype about Vitamin E in secondary prevention of cardiovascular disease has come to naught. Now there's more evidence that it's not only useless in cancer, it may even be detrimental.
Further reading:
Vitamin E Supplementation: What to Do?
Scientific Miracles : An act of God ?
From CNN,
Injured firefighter speaks after 10 years
Wednesday, May 4, 2005 Posted: 1359 GMT (2159 HKT)
 ORCHARD PARK, New York (AP) -- Ten years after a firefighter was left brain-damaged and mostly mute during a 1995 roof collapse, he did something that shocked his family and doctors: He perked up.
"I want to talk to my wife," Donald Herbert said out of the blue Saturday. Staff members of the nursing home where he has lived for more than seven years raced to get Linda Herbert on the telephone.
It was the first of many conversations the 44-year-old patient had with his wife, four sons and other family and friends during a 14-hour stretch, Herbert's uncle, Simon Manka said.
"How long have I been away?" Herbert asked.
"We told him almost 10 years," the uncle said. "He thought it was only three months."...cont.... |
Miracles do happen. And when it happens, it baffles the most brilliant of doctors and scientists alike. It defies logic. Imagine a person with severe hypoxic brain damage, recovering functions that were lost for 10 years as highlighted in this article. Perhaps we are missing some vital clues here as to the complexity of the human body. As we attempt to decipher this invention of God, we can only marvel at the meticulously efficient functions down to its molecular level.
Perhaps there was indeed some sort of devine intervention here. Gazing at the enormity of the universe only instills humility in Mankind and the acceptance that a Higher Being exists, even to sceptics.
Or maybe, the scientific world is being confronted with a jigsaw piece that has been the missing link all this while. The human brain after all remains the final frontier of the human body. It is probably the least understood organ to date.
Ultimately, not everything may be explained logically with science. There may be an angel on our shoulder after all!!
NHFS: Hungry for more Information
The debate continues. For a scheme that is going to revolutionise the way healthcare is financed, there appears to be a paucity of information. Bits and pieces are being revealed from time to time and the public is expected to piece together a giant puzzle.
From the Editorial NST (3rd May 2005),
| As it is, none of the numerous reports commissioned by the Government has been made available to the medical professionals, let alone laymen. This is perhaps why the "debate" on the scheme that the Health Minister apparently hoped for in December has not materialised. If he wants the issue to be "discussed openly in a mature way", then more information should be released for public scrutiny about what the Government intends to do. There is also a need to engage in more meaningful dialogue with professional associations such as the MMA and civil society organisations. |
It is paramount that input from different organisations be heard and pertinent questions answered. Even purported consultants, that are contracted to study this scheme, may not be able to fully comprehend the gravity of this scheme and how it will affect the lives of many Malaysians.
It is strongly recommended that the Government openly discuss this issue with greater transparency and sincerity. Areas from its implementation to its future management requires greater scrutiny by the relevant organisations. Utilising the media and online chat forums may be a step in the right direction. Involving relevant bodies like the MMA and consumer associations in its infancy is wise so as to avoid unnecessary discord when the eventual launch is made.
The Government should not assume that they know what Malaysians desire. Such autocratic mentality will only nurture failure and sow seeds of distrust with this current administration.
Do not let our guard down
From The Star,
Polio detected in Indonesia for first time in 10 years
JAKARTA, Indonesia (AP) - Indonesia has detected its first case of polio in a decade, prompting the government to launch a massive vaccination campaign that is expected to reach more than 5 million children, the World Health Organization said Tuesday.
A 20-month-old girl was diagnosed with polio on April 21 and authorities believe she came in contact with a migrant worker or tourist who had contracted the disease while outside the country.
The case - the first since 1995 - prompted government health workers to do house-to-house vaccinations in four neighbouring villages, intensify surveillance and eventually vaccinate 5.2 million children under 5 by July.
"A case of polio has been detected in Indonesia,'' said Dr. Bardan Rana, a WHO medical officer investigating the case.
"This is an imported case. Somebody must have brought it in, spread around and then the person came in contact with the child.''
Indonesia is the latest polio-free country to find a new case.
Since 2003, 15 other previously polio-free countries have reported new cases, after a vaccine boycott in Nigeria was blamed for causing an outbreak that spread the disease to other countries. - AP |
The polio case in Indonesia should be a lesson to Malaysia, a polio-free nation, to be continually vigilant in its vaccination campaign against polio. The target of 100% coverage for polio vaccination should be always strived for.
At the same time, immigrants to this country, especially from polio endemic countries, should be carefully screened and should undergo stringent medical investigations before being allowed into the country. The current medical examination for immigrants is lax and incomprehensive, leaving gaping loopholes that are exploited daily by foreign nationals.
This eradicable disease should not be allowed to step foot in Malaysia again after the last reported case in 1992.
Polio EradicationWHO Polio Information
NHFS: Should there be discussion?
Even the MMA is in the dark....
MMA Seeks To Discuss Health Scheme Issues With Government
KUALA LUMPUR, May 1 (Bernama) -- The Malaysian Medical Association (MMA) will discuss with the government the issues and concerns of the public and medical practitioners regarding the proposed National Health Financing Scheme.
Its president Datuk Dr N. Arumugam said patients and doctors felt they were being "kept in the dark" about the scheme.
He said many people were worried because free healthcare would be withdrawn.
"It is going to change a culture of 50 years -- from total free care to partial payment. The people need a lot of information (about the new scheme)," he told reporters after a meeting of the MMA Private Practitioners Section Sunday.
The new scheme, expected to be introduced next year, would remove free healthcare benefits for most people, except the poor, government servants, handicapped citizens and the underprivileged who would continue to be subsidised by the government.
The scheme will be based on a "community-rated" financing mechanism under which the cost and risk-sharing will be spread across the population, with the rich subsidising the poor, the young the elderly, the healthy the sick and the employed the unemployed.
According to Health Ministry reports last month, the scheme was in the final stages of preparation and consultants were working out a mechanism on the quanta hospitals should charge patients. |
It is going to be a major change to the system of healthcare financing in this country. We have only an inkling of what it is going to be about. Surely there could be greater transparency?
This NHFS is going to impact on all of us in a big way and we need to know more before it is implemented (shoved down our throats?).
Emergency Evacuation
Today after rounds at the hospital, we smelt something burning at one of the hospital lifts. Shortly after, the "Code red" warning sounded (fire alert). I don't think it was a real fire, more like an electrical short.
However this incident has reminded me to blog my support for the Malaysian Blogger campaign for assisted building Evacuation protocols for mobility-challenged people.
| Peter Tan, a fellow blogger faced this problem recently. During the height of the quake, this blogger was posting entries. Through our conversations, he revealed that he was fearful yet felt helpless. It prompted him to write to the building manager, and request that an orderly evacuation plan be created, of course, taking into account the safe removal of the disabled. He was branded a troublemaker. That's caring Malaysians for you. |
Links:
Building Manager from HellEvacuation Prepardeness Guide (contributed by
Dobbs)
