Saturday, August 30, 2003

Daily Yomiuri On-Line: Ex-bureaucrat builds welfare facilities in Malaysia
: Shozo Sugimoto Yomiuri Light and Love Organization

In 1993, a Heath and Welfare Ministry bureaucrat quit his job working on behalf of the disabled and left for Malaysia.
'I wanted to search for the meaning of welfare service (in Malaysia) where my father died as a soldier,' said Ken Nakazawa, 62. Every summer, Nakazawa envisions his father's sorrow as he died shortly after the end of World War II.
'I thought Malaysia must have a different welfare system from that of Japan, which is heavily dependent on facilities,' he said, explaining why he left the ministry.
This month, Nakazawa opened a center and a home for the mentally disabled on Penang Island, west of the Malay Peninsula.
He did research for the program at a local university, and has opened a health care center for handicapped children, a job-training facility for adults and a mobile service to lend educational toys to infants.
The facility was built on a 2,000-square-meter plot of land, which was previously a palm forest.
Nakazawa has supporters in Japan, including Miyagi Gov. Shiro Asano, a former colleague.
Nakazawa said he had difficulties when he was raising funds for the facilities, but because of his Christian faith, inherited from his parents, he did not give up.
'I feel the greatest joy when I see the faces of handicapped children and adults brighten with joy,' he said.
Malaysia is a multiethnic nation of Malays, Chinese, Indians and others. Nakazawa is sympathetic to the concept of the 'caring society' advocated by Malaysian Prime Minister Mahathir Mohamad.
'This country's diversity and receptivity is a model for welfare systems in the rest of the world,' he said.
"The combination of self-help, mutual help and public help is important for welfare systems," he said. "In Japan, where the welfare system excessively relies on public assistance, welfare activities may be isolated from the public."

Friday, August 29, 2003

US award for public health advocate

PETALING JAYA: Malaysian public health advocate Mary Assunta has been conferred a prestigious award for outstanding individual leadership by the American Cancer Society for her contributions to the tobacco control movement.
Assunta, 46, is the first Malaysian to have been conferred the Luther L. Terry Award which is named after the former US surgeon-general who published the first scientific findings establishing the links between tobacco use, lung cancer and other illnesses in 1964.

Mary Assunta
She received the award in Helsinki, Finland, on Aug 4 during a special ceremony at the 12th World Conference on Tobacco or Health and shared the award with sociologist and University of Sydney professor of public health Simon Chapman.
An American Cancer Society press release said Assunta was recognised for her more than 25 years of work as a vocal opponent of the tobacco industry's rising influence in developing nations.
“Her tireless efforts on behalf of these countries was instrumental in putting their perspectives on the international tobacco control agenda,” the statement said.
Assunta worked with the Consumers Association of Penang for 20 years before joining the University of Sydney for her postgraduate studies.
She is now pursuing her PhD in Public Health at the University of Sydney, Australia.

Thursday, August 28, 2003

Utusan Malaysia Online - Home News:

Investigate death linked to okra - farmers federation
KUALA LUMPUR Aug 27 - The Federation of Malaysian Vegetable Farmers Associations Wednesday urged the Health Ministry to investigate the death of a Negeri Sembilan woman after she ate some okra (lady's fingers) Tuesday.
Association president Tan Su Chow said the Health Ministry must investigate the death as many people believed it was the result of food poisoning.
'We hope the Agriculture Ministry will consider the matter seriously to avoid a negative perception of vegetables farmed by locals and to assure everyone that local produce is safe for general consumption,' he said in a statement issued here.
He was commenting on the death of Mah Kiew @ Khiok, 60, Tuesday night at her home in Kampung Pasir Mas in Rantau, Seremban.
Three of her sons - Tan Sze Hock, 34; Tan See Leong, 33; and Tan See Choong, 31 - who also ate the okra were admitted to Seremban Hospital at 1 am and are reportedly in stable condition, he said.
The woman's youngest son, Tan Wee Lee, 21, said his mother vomitted and fainted a few times before she died at midnight. Her body was sent to the Seremban Hospital for a post mortem.
Her husband, Tan Chong Heng, 69, who also ate the okra, did not face any problem.
Tan said the death was inexplicable because food and agriculture experts have observed that the consumption of chemically-tainted vegetables does not result in death.
'This is a strange case and prior to a thorough investigation we cannot not make any presumption - that the death was caused by the consumption of the lady's fingers,' he said.
However, he reminded all farmers to follow the guidelines issued by the Agriculture Ministry, including the practices on using chemicals to ensure safety of locally farmed food.

"On behalf of the association, we feel sad and remain grieved by this death," Tan said.

Meanwhile, the State Health Director, Dr Rosnah Ismail, Wednesday confirmed that Mah Kiew @ Khiok, 60, died of food poisoning.

The Federation of Malaysian Vegetable Farmers Associations earlier said the woman had died in her home at midnight Tuesday while three of her sons were admitted to Seremban after consuming okra, or lady's fingers.

Dr Rosnah said the confirmation was based on a post mortem on Mah Kiew.

Nevertheless, it's not clear where the poison originated.

"Samples of the food, water and other materials were taken from the family's home and sent to the Chemical Department for analysis," she said at the Seremban Hospital here.

Also present were the State Woman's Affairs, Community Development and Social Action Committee Chairman Datuk Norhayati Omar and the Seremban Hospital Director, Datin Dr Zailan Adnan.
HIV/TB co-infections up: "KUALA LUMPUR: The number of people in Malaysia who are co-infected with both tuberculosis (TB) and HIV is on the increase, and they are mostly from prisons and drug rehabilitation centres, Health Minister Datuk Chua Jui Meng said.
He said the HIV/AIDS epidemic since the 1980s had had a significant impact on the incidence of TB because the immuno-deficiency status of HIV/AIDS patients made them more susceptible to TB and other infections.
“While in 1990 we had only six reported cases of TB/HIV co-infections, representing 0.06% of the total number of reported TB cases then, this number has increased to 933 cases or 6.5% of the total number of reported TB cases in 2002.
“Our TB/HIV problem lies mainly in the prisons and drug rehabilitation centres because of the captive population there,” Chua said yesterday, when opening the annual general meeting of the Malaysian Association for the Prevention of Tuberculosis here.
He said the ministry had been urging and collaborating with the National Drug Agency and the Prisons Department to screen inmates for TB, and was in the midst of preparing guidelines for the detection and treatment of TB patients to be used by personnel there.
“We must have a standard policy everywhere whereby those who have TB are also screened for HIV,” Chua said, adding that these guidelines in Bahasa Malaysia and English would be out soon.
The ministry in collaboration with the Academy of Medicine, Malaysia has already issued a second edition of the Practice Guidelines for the Control and Management of Tuberculosis for doctors, health care providers and non-governmental organisations.
He also said that almost 10% of the TB cases reported last year were foreign workers.
“Last year, out of 400,000 foreign workers screened"

Wednesday, August 27, 2003

Herbal drinks firm gets two weeks to back claims

IPOH: The company that produces the Orang Kampung brand Kacip Fatimah and Tongkat Ali herbal drinks has been given two weeks to respond to an allegation of misleading the public with false information about its products.

State Health Department director Datuk Dr Abd Razak Kechik said it would consider not taking court action against Syarikat Perniagaan Orang Kampung if it provided reasonable grounds for its claims that the two herbal drinks could, among others, kill cancer cells and cure hypertension, diabetes and malaria.

He said this included the company's readiness to change the health information printed on the labels of its canned drinks.

“It is all right for the company to make general claims on the nutritional value of the drinks but it should not mention specifically that its products could cure cancer and diabetes,” he added.

Dr Abd Razak said this when commenting on the company’s factory manager Wan Saiful Wan Haizan's denial that the labels were misleading and therefore violated Rule 18 (3) of the Food Act and Regulations 1985.

He also said the department would advise the company to recall all the Kacip Fatimah and Tongkat Ali canned drinks with the misleading labels.

Dr Abd Razak had led an operation to check food products on Monday, when three cartons of the herbal drinks produced by the company based in Merlimau, Malacca, were seized from several sundry shops in Kuala Kangsar.

eTaiwanNews.com/Using aromatherapy burners dangerous, agency says

I notice that Aromatherapy is becoming another "fad" (as usual with little evidence based backing) in Malaysia. This news snippet from Taiwan should hopefully throw some caution into those who practice aromatherapy.

===========================================================

Following a spate of reports on shoddy aromatherapy oil burners exploding while in use causing injury and death, the Cabinet-level Consumer Protection Commission yesterday warned the public of the potential danger of the so-called therapeutic products.

Recent incidents involve the same design of aromatherapy diffusers similar in shape to alcohol burners but filled with aromatic oil diluted with isopropanol, a highly flammable and poisonous liquid. The diffuser ignites the concoction and is different in principle to oil vaporizes that heat the essential oil to release the aroma.

The Cabinet has assigned the Department of Health to be responsible for oversight and supervision of aromatherapy-related goods.

At a press conference held yesterday afternoon, Huang Horng-chyuan, Consumer Protection Commission spokesman said the government did not plan to prohibit the use of aromatherapy burners, but did pledge to conduct further inspections to be carried out under the DOH and Ministry of Economic Affairs.

Huang said as many aromatherapy goods producers claim their products possess therapeutic qualities. The Consumer Protection Commission considers the DOH as more suitable than other departments to investigate aromatherapy related goods. According to the Consumer Protection Law the CPC has the authority to assign a relevant government department to supervise trading activity.

"If any product is claimed to have therapeutic qualities by the seller then the DOH should actively initiate the inspection of these products, and should also ask MOEA and other related department to analyze the veracity of the claim," said Huang.

"With regard to issues of safety of the aromatherapy burner and the quality of the aromatic oil, the Bureau of Standards, Metrology and Inspection under the MOEA will publish its findings in thirty days," added Huang.

If the product after analysis did possess therapeutic qualities then the DOH would assume responsibility for supervision, Huang told the Taiwan News. However, if the claim proves to be erroneous, the DOH and Fair Trade Commission ought to invoke the Pharmaceutics Affairs Law and Fair Trade Law to punish the seller or producer.

With reference to specific claims made by a local social welfare foundation that alleges the inferior aromatherapy products exploded in 10 separate incidents, Huang said the CPC responded appropriately and had coordinated the DOH, MOEA and Taipei City Government to inspect the two dealers accused by consumers.

To date the official said the inspectors had found the two dealer's product had violated the Pharmaceutic Affairs Law and Merchandise Label Law through inaccurately describing their merchandise and will mete out punishment, although he failed to provide details.

According to its spokesman the CPC has also ordered all local authorities to launch inspection of aromatherapy products sold in their jurisdiction. Violators of the Pharmaceutic Affairs Law and Consumer Protection Law will be given 30 days to rectify any breach.
Herbal drinks seized in Perak

KUALA KANGSAR: Two popular herbal drinks with the brand name of Orang Kampung have violated the Food Act and Regulations 1985 by having misleading claims on the labels.

State Health Department director Datuk Dr Abd Razak Kechik said the claims on the labels of Kacip Fatimah and Tongkat Ali that the drinks could kill cancer cells, cure hypertension, diabetes and malaria and increase female hormones were against Rule 18 (3) of the Act.

He said the department had seized several cans of the drinks from shops here.

Dr Abd Razak said producers were prohibited from stating that their food and drink products contained health, medicinal or stimulant values.


MISLEADING CLAIMS:Dr Abd Razak (centre)reading the labels of the Orang Kampung drinks sold at a sundry shop in Taman Bunga Raya in Kuala Kangsar yesterday.
“The claims by the manufacturers contravened the health principle as there is no drug that could kill cancer cells except radiation treatment while diabetes could only be controlled and not cured completely,” he said during the department’s operation to check on food products sold at sundry shops in Taman Bunga Raya here yesterday.

“We do not want people to believe and depend on the products for treatment of certain illnesses,” he said.

Dr Abd Razak said records at the Ipoh Hospital showed that many cancer patients, especially Malays, had only sought treatment at a late stage.

He said the department would take the producer Syarikat Perniagaan Orang Kampung, based in Merlimau, Malacca, to court for misleading the public.

Under the act, he said the company could face a jail sentence of up to two years and a maximum fine of RM5,000 upon conviction.

The department also seized bottled mineral water for not bearing the Health Ministry approval code.

“The approval code KKM (Kementerian Kesihatan Malaysia) is to ensure that the source of the mineral water is clean and is bottled according to the standard set by the ministry,” he said,

In Malacca, the producer of Kacip Fatimah and Tongkat Ali denied that information printed on the canned drinks was misleading.

Syarikat Perniagaan Orang Kampung factory manager Wan Saiful Wan Wan Haizan said the claims on the labels were vetted and approved by the relevant authorities after several amendments before the products entered the market more than a year ago.

He added the company had yet to receive any official notification from the health department.

“The words on the cans do not claim that the drinks can cure cancer or other illnesses. We merely quoted research findings that said extract from Tongkat Ali is believed to have certain medicinal values.

“We will contact the Health Ministry as soon as possible to get clarification on the matter,” he said, adding he was shocked to learn about the seizure by Perak health department in the media.

Wan Saiful said the factory with 30 workers in Merlimau produced 48,000 canned drinks daily and the products were distributed nationwide, including Sabah and Sarawak.

He said the drinks, priced at RM2.80 each, were also exported to Singapore and Indonesia.

He added the company, established in 1994, also produced Pegaga and Noni drinks.

Tuesday, August 26, 2003

Treaty a way to seek redress

KUALA LUMPUR: Aggrieved Malaysians stricken with smoking-induced health problems can sue the tobacco industry after the Government ratifies the World Health Organisation's Framework Convention on Tobacco Control next year.

Health Minister Datuk Chua Jui Meng, who is scheduled to sign the treaty on behalf of the Government in New York next month, said the move was reflective of Malaysia’s commitment to combat the menace and the tragedies caused by tobacco products.

“Enough is enough,” Chua told a press conference at his ministry yesterday.


Health Minister Datuk Chua Jui Meng holding up cigarette packs with various messages.
“The tobacco industry must be prevented from causing so much damage, human misery and death.”

The treaty is an international legal instrument geared towards curbing the spread of tobacco and tobacco products worldwide.

A statement released revealed that between 10% and 12% of mortality in Malaysia was caused by diseases related to smoking over the past 20 years and that the overall adult smoking prevalence had increased from 21.5% to 28.8% from 1986 to 1996.

Chua said the Cabinet had decided recently that Malaysia would become a signatory to the treaty and that it would be ratified as soon as the necessary legislative requirements had been carried out.

In view of this, he said Malaysia would enact the Tobacco Control Act, which was being finalised by the Attorney-General’s Chambers, before ratifying the treaty that had already been signed by 47 countries.

However, only Norway has ratified the treaty, which required the endorsement of at least 40 nations before it could come into force.

“Once ratified by Malaysia, it would be applicable here and those affected by tobacco products could seek legal redress,” said Chua, adding that the treaty has a rider that holds the tobacco industry directly accountable for all the harm and damage caused as a result of using its products.

He said the Cabinet had also decided to create a secretariat and several national committees to oversee the way the treaty is carried out in Malaysia.

Chua said Malaysia has already taken some steps stipulated in the treaty such as making it compulsory for cigarette makers to carry rotating health warning messages with matching descriptors.

The cigarette packages would carry messages such as Cigarettes Are Heart Breakers, Cigarettes Hurt Babies and Cigarettes Leave You Breathless among others, which will be accompanied by matching pictures and illustrations.

When contacted National Cancer Council communications manager B. Raj Kumar, who heads the organisation’s anti-tobacco campaign, said Malaysia’s endorsement of the treaty and the impending legislation of the Tobacco Control Act were timely.

“Endorsing it will also protect the rights of passive smokers by allowing them to seek redress in the event they are afflicted by tobacco-induced diseases such as lung cancer because of their surroundings,” said Raj Kumar.

He said Malaysia currently lacked stringent measures and laws to protect non-smokers as well as children from tobacco smoke in public areas such as restaurants.


Monday, August 25, 2003

New Straits Times Online :Bill on use of traditional medicines


KUALA LUMPUR, Aug 22: The Health Ministry is drafting a Bill that will provide guidelines on the
use of Traditional and Complementary Medicine (TCM) in the country,
minister Datuk Chua Jui Meng said today.


He said the move was initiated following numerous public complaints against illegal traditional practitioners, both local and foreign, and the sale of unregistered medicines in the market.

He said the Bill would, among other things, provide for the formation of a TCM Council that will govern the practice of TCM in the coun-try, the registration of bona fide TCM practitioners, and the registration and use of quality TCM products.

"We have received thousands of complaints of unregistered traditional medicines being sold in the market and on the increasing number of illegal traditional practitioners treating people for various illnesses," he told reporters after officiating a two-day National Homeopathy Conference at Pan Pacific Hotel here.

Chua, who said there was currently no law to regulate the use of such medicine, however, declined to disclose when the draft would be ready for tabling in Parliament.

At present, there are 3,701 practitioners registered under five traditional umbrella bodies — Society of Traditional Indian Medicine, Feder-ation of Traditional Malay Medicine of Malaysia, Federation of Chinese Physicians and Medicine Dealers Association of Malaysia, Malaysian Council for Homeopathic Medicine and Malaysian Society for Complementary Therapies.

There are 2,221 Chinese traditional practitioners, Malays (300), Indians (84), homeopathy (687) and 409 various modalities under complementary medicines.

Chua said recent years had seen an explosion of products labelled as homeopathic or traditional.

Since 1992, the National Phar-maceutical Control Bureau had taken active steps to register and monitor all TCM products. This included analysing them for heavy metals, steroids, microbial content and adulteration with active pharmaceutical ingredients, to ensure the safety and quality of the products.

Only TCM products in pharmaceutical dosage forms are subjected to registration and to date, the bureau had registered 11,632 such products.

"We will do whatever is necessary to regulate the practice of TCM and not allow the lack of a legal instrument to be an excuse for apathy," said Chua, adding that the Ministry was guiding TCM practitioners, through their umbrella bodies.

The Ministry, he said, also planned to establish a new TCM Division which would be responsible for the structured development of TCM and the quality and standards of their services in the country and the proposal was being discussed with the Public Service Department.

Chua said the newly-formed National Committee for Research and Development on Herbal Medicine was also into the research and development of herbal medicine.

He also said the Cabinet had also allocated RM38 million to make Malaysia a global information hub on the integration of western and traditional medicine.

The National Committee, Chua said, had also directed the Malay traditional practitioners to document whatever they do for evidence, as presently the trade is passed down by word of mouth.

"We are also encouraging local universities to offer courses and training on TCM," he said, adding that some universities like Universiti Putra Malaysia, International Medical University, and Universiti Sains Malaysia had already introduced TCM awareness courses in their undergraduate and post-graduate medical programmes.

When told that some TCM practitioners call themselves "doctors", Chua said it was an offence under Section 33 (1) of the Medical Act 1971.

On the recruitment of foreign doctors, Chua said the Cabinet had directed the Chief Secretary to the Government to hold talks with the relevant agencies such as the Public Services Commission and the Malaysian Medical Council to study how they could shorten the process.


Utusan Malaysia Online - Health bits

Sarawak strives to achieve drug-free state status... In KUCHING, Assistant Minister of Housing Dr Abang Abdul Rauf Abang Zen said on Sunday that Sarawak wants to be the first state to be declared free of drug problems, ahead of the country's 2015 target.

"We want to achieve 100 percent success and aim towards achieving zero defect," he said at a seminar on drug prevention and education for the Kuching division Rukun Tetangga here.

"This may be a bold step forward but with commitment from the public and private sectors, God willing, we can achieve our target.

"Malaysians from all walks of life must pledge from today onwards to fight drug abuse at home, schools and other places commonly associated with drugs," he said.

Abang Abdul Rauf said there must be ongoing awareness campaigns by community leaders, church leaders, muslim religious teachers, non-governmental organisations and professionals to combat drug abuse.

He said there was an increase of 63 drug abuse cases or 25 percent last year from only 243 in 2001.

Although Sarawak registered the lowest statistics, the government and all levels of society must not rest on their laurels in efforts to fight drug problems, he said.

The anti-drug agencies had to constantly review the approaches used to stop drugs from making their way into the state through the Sarawak and Kalimantan border and parents must monitor their children's movements and ensure that they had the right kind of influences, he added.

KT outpatient treatment only at Health Clinic... In KUALA TERENGGANU, those seeking outpatient treatment in the city will no longer be entertained at the Kuala Terengganu Hospital (HKT) and should instead go to the District Health Clinic.

State Health director Datuk Zahari Che Dan said since April, HKT only catered for the needs of surgical patients.

All surgeries previously carried out in various departments at the hospital would be centralised in the new RM56 million centre, he told reporters after launching the "Keranamu Malaysia, Hidup Sihat Sejahtera" programme at state level here on Sunday.

Earlier in his speech, Zahari said the Terengganu people were fortunate as the government had provided them complete health facilities with six hospitals, 42 health clinics and 130 rural clinics.

"The number of health personnel has also been raised, and currently some 5,700 are serving in the state," he said.



Tuesday, August 19, 2003

Accept mental patients into society: Body

Langkawi: The Malaysian Psychiatric Association, the Health Ministry and a company, Janssen-Cilag, Saturday launched an awareness campaign called “Circle of Care” to eradicate the notion that mental patients are a danger to the public.

Association President Prof Dr Mohd Hussain Habil said the number of aggressive mental patients was low as most adjusted well back into society given the proper medical treatment.

“This programme intends to shift patient care from institutions to the home,” he told reporters after signing a memorandum of understanding in conjunction with the Malaysian Mental Health Convention here.

He said the programme was important - as one in every nine Malaysians suffered from depression to scizofrenia. And between seven to 10 per cent of mental patients committed suicide.

Janssen-Cilag, a company under Johson & Johnson, donated about RM60,000 towards the programme.

The programme kicked off in June when a support group from Hospital Sultan Aminah in Johor Bahru celebrated the return of Hospital Bahagia patients to their respective families.

Meanwhile, the Sultan of Kedah today urged the rakyat and related agencies to ensure the well-being of individuals who suffered from mental illnesses and not merely depend on mental health professionals.

The text of his speech was read out during the launch of the convention by the Raja Muda of Kedah.

The Sultan said efforts by the Health Ministry to promote psychiatric services to all people - in line with this year’s slogan “Mental Health for All” would be successful if there was good support from all concerned.

He urged all parties, including Government agencies and non-governmental organisations, to become a catalyst in actively promoting mental health services and care for patients within society.-Bernama

Open letter to Health Minister Chua Jui Meng

Dear Datuk Chua,

Citizens' Health Initiative (CHI) wishes to thank you for the reply from officers of the Health Ministry to our email of June 6, 2002 regarding the alleged dumping of HIV-contaminated Factor VIII in Malaysia in 1984/1985 by Cutter-Bayer.

Dr Abdul Rasid Kasri very kindly faxed me a copy of the letter by Dr Yasmin Ayob (dated July 25, 2003) in which she reported that:

Setelah mencari rekod-rekod lama Pusat Perkhidmatan Darah Hospital KL (PPDHKL), didapati memang PPDHKL membeli produk Factor VIII concentrate (Koate) dan Factor IX (Konyne) dari Sykt Cutter/Bayer sejak Julai 1984. Rekod-rekod sebelum ini belum dapat dikesan. Walau bagaimanapun, tidak ada rekod yang mencatitkan samada proses ‘heat treatment’ sebagai langkah mematikan virus dijalankan atau tidak ke atas produk ini, Koata (FVIII Concentrate) dibeli hingga Disember 1989 dan Konyne dibeli sehingga 1997...Melaui perbualan saya dengan Dr G Lopes dan Prof Datin G Duraisamy, FVIII Concentrate dari Cutter memang dibeli sejak 1982. Mengikut Dr Lopes, setelah ‘heat treated’ concentrate dibuat oleh syarikat ini, produk-produk yang telah dibeli ditukar dengan produk yang telah di ‘heat treated’. Memang ada pesakit hemophilia yang menggunakan Factor VIII dan Factor IX yang tidak di ‘heat treated’ sebelum ini.

If we juxtapose what Dr Yasmin reported in her letter to Dr Faisal Hj Ibrahim, against the New York Times article (May 22, 2003) by Walt Bogdanich and Eric Koli:

...At the November [1984] meeting [of Cutter officials], the minutes show, Cutter said it planned to "review international markets again to determine if more of this product [non-heat treated Factor VIII] can be sold."

And in the months that followed, it had some success, exporting more than 5 million units (a typical vial might contain 250 units) in the first three months of 1985, documents show. [heat-treated Factor VIII was being distributed by Cutter in N. American and European markets beginning February 1984].

"Argentina has been sold 300,000 units and will possibly order more, and the Far East has ordered 400,000 units," according to a March 1985 Cutter report. Two months later [ie May 1985], the company reported that "in Taiwan, Singapore, Malaysia and Indonesia, doctors are primarily dispensing non-heated ‘Cutter’ concentrate."

By then, while there were still a small number of buyers in the United States, nearly all of the unheated concentrate was being sold abroad, available records show.

All told, Cutter appears to have exported more than 100,000 vials of unheated concentrate, worth more than US$4 million (approximately RM15.2 million), after it began selling its safer product...

The question that immediately arises is whether Cutter/Bayer withheld information on the availability of heat-treated Factor VIII from its buyers (or used various strategems to induce its buyers to continue purchasing old stocks of non-heated Factor VIII, which appears to have been the case in Hong Kong and Taiwan).

Was this also the case in Malaysia? CHI hopes Dr Yasmin's searches will uncover some documents which can throw light on this.

We appreciate that it may be difficult to establish whether the 11 reported HIV-infected hemophiliacs in Malaysia were infected through contaminated Factor VIII (before or after February 1984), or were infected via cryoprecipitates produced (locally?), or indeed through some other mode of transmission.

What is most important at this juncture, in the context of World Trade Organisation-mandated reductions in ‘trade barriers’, is that we retain adequate national discretion and jurisdiction over imports of potentially hazardous products - and manufacturing processes - as well as tightening up our own internal monitoring and surveillance of products and practices in the international marketplace.

May I also take this opportunity to raise a couple of concerns as a follow-up from last year’s Ministerial Dialogue with NGOs (June 2002):

1) At that dialogue, CHI and the Federation of Consumers’ Association of Malaysia (Fomca) enquired about the representation of organised labour on the Health Ministry sub-committee that was drawing up a fees reimbursement schedule for the National Health Security Fund.

Since salaried workers (and their employers) would be largely bearing the financial burden of national healthcare expenditures under this scheme via payroll deductions, you agreed that it was an oversight that labour was not represented, whilst the Malaysian Medical Association, Association of Private Hospitals of Malaysia, Malaysian Employers Federation, consumerists, and other stakeholders were represented.

It has been more than a year, and my recent enquiries with the Malaysia Trades Union Congress and Cuepacs lead me to understand that neither labour confederation has been invited to send representatives onto that sub-committee.

2) At a national conference on ‘Facing the Challenges of Globalisation and the New Trade Agenda’ (October 10-12, 2002, Penang) organised by the Health Ministry, a consultant from Ernst & Young reported on a survey of health tourism prospects for Malaysia, mentioning that cardiological and cardiothoracic services at that time constituted the largest clinical category (by value) of Malaysia's health tourism earnings. Institut Jantung Negara, according to this consultant, was a key player in this.

CHI believes that the Malaysian public is not against foreign nationals benefiting from our national healthcare capabilities, indeed we can take pride in this.

CHI however is much concerned when more and more of our local health resources are diverted to serving regional (and national) healthcare priorities as dictated by economic (market) demand, rather than on the basis of need.

Reportedly, the queuing time for a stress test at our public heart centres is currently in the region of three months.

At the 2003 Malaysian Health Conference ‘Partners in Health’ (June 23-24, 2003, Kuala Lumpur), organised by the Asian Strategy and Leadership Institute (Asli) I asked Health Ministry Director of Medical Practice Division Dr Ong Chee Leng for some statistics on health tourism services provided by our public hospitals. She said she would get back to me, and we look forward to her further communication.

May I end by thanking you again for your kind responses to our current concerns with the Malaysian healthcare system.

We deeply appreciate these dialogues and exchanges, and we sincerely believe that they can only enhance the performance of our healthcare system and its governance.

Chan Chee Khoon
Co-ordinator
Citizens’ Health Initiative

Monday, August 18, 2003

Increase work ethic in hospitals - Chua

KOTA BHARU Aug 17 - Health Minister Datuk Chua Jui Meng has urged the health sector, especially hospitals, to increase their work ethic in an effort to give the best service to the people of Malaysia.

He said the health sector was facing many new challenges due to high expectations and demands from the people who want a quality and ever-improving health service.

"The attitude of emphasising on service, quality and results should be prioritised. We must remember that quality is ever changing, following the needs of the customers," he said.

Chua's speech celebrating Kota Bharu Hospital (HKB) staff and management in conjunction with it winning the Prime Minister Quality Award (Public Sector) 2002 last year was read by Ministry secretary-general Datuk Alias Ali.

Chua said the health sector needed to be sensitive to technological innovations and its management should be able to change according to the customers' needs by being proactive, creative and thinking positively.

Chua also praised HKB for the various awards which it had won, including the Prime Minister's Award, which was the highest recognition to government agencies and departments for excellent quality management.

HKB was the second hospital to be conferred the award, after the Tengku Ampuan Afzan Hospital in Kuantan received it in 1999, he said.

HKB, which received ISO 9002 certification in 1994, was also accredited by the Malaysia Society for Quality in Health three times since 2000.
Health: Dangerous minds

Dr Yen Teck Hoe

According to the Malaysian Psychiatric Association, between 10 and 15 per cent of Malaysia’s population suffer from some form of mental illness. These range from depression to anxiety disorders and substance addiction. While the percentage may not seem alarming, consider this: 15 per cent of Malaysia’s population (24 million) would amount to 3.6 million people.

Compare this to the World Health Organisation’s Global Burden Study projection for year 2020 which revealed that depression, a form of mental illness, would be the second largest cause of disability after cardiovascular diseases. These facts and figures only elevate the need to address mental health and its importance.

However, addressing the issue is an uphill task with the most obvious obstacle being our mindset. The stigma attached to mental illness is so strong that if we know of anyone who is suffering from some form of mental illness – be it a phobia, depression or anxiety disorders, we are quick to label them as crazy. What’s worse is that if that person is seeking medical treatment for his condition, then the uninformed will see it as an endorsement of his so-called craziness.

This vicious cycle repeats itself, so much so that there is a high tendency for sufferers to not seek treatment rather than face discrimination and be ostracised. This will only worsen his/her problem and in serious cases, lead to suicide. A classic example is the late Hong Kong singer Leslie Cheung and local HVD actor Chin Chew Kiong.

Another obstacle is that people themselves don’t even know that they are suffering from mental illness leading to under-diagnosing of the problem. For example, a patient may suffer from dizziness, difficulty in breathing, shakiness, palpitations, chest pain or pressure, numbness, nausea or diarrhoea. To the patient, it may be a physical problem and refrains from telling the attending doctor the levels and patterns of these occurrences. But they are actually panic disorder symptoms.

Therefore, it is important that we equip ourselves with information on mental health. According to the World Health Organisation, mental health is a state of well-being in which the individual realises his or her abilities. They should be able to cope with the normal stresses of life and work productively.

The above definition is an ideal scenario for optimal mental health. However, it is difficult to block out and escape the many additional stresses that life brings us. Even tragic events may have an effect.

Mental illness in itself takes many forms. Some of the more common conditions can be categorised as mood disorders and anxiety disorders.

We’ve all felt sad and down at some point in our lives. But when that feeling of hopelessness and melancholy becomes too much to bear and insufferable, it takes a toll on your life. This persistent sad mood is the first sign of a mood disorder. There are several types of mood disorders with the more common ones being depression, post-partum depression and pre-menstrual stress (PMS).

Feeling anxious is a part of normal human experience. But when your feelings get out of control and its not just an isolated case of sweaty palms and nervousness, but a constant occurence that disrupts your everyday schedule, it could be that you are suffering from some form of illness – an illness of the nervous system which is medically recognised as anxiety disorder.

There are many types of anxiety disorders such as anxiety disorders with anxious mood, generalised anxiety disorder, panic disorder with or without agoraphobia, obsessive compulsive disorder, simple phobia and social phobia.

The above are just a cross section of the many types of disorders and like any other physical medical conditions, mental illness CAN be treated. One need not suffer in silence as there are trained psychiatrists and medication available to overcome this problem. All it takes is more understanding and an informed public.

* Dr Yen Teck Hoe, MD, MPM, is a psychiatrist and a member of the Malaysia Psychiatric Association.

Pool facilities, doctors told

KUCHING: Health practitioners in the state should pool their facilities and expertise in view of the rising cost of medical equipment and personnel, Deputy Chief Minister Tan Sri Dr George Chan said.

This would ensure that the latest medical facilities and know-how would be affordable to all, he said.

“Medicine is now becoming more expensive and Sarawak will not be able to afford the latest equipment and tools if we are divided into different sectors – government, private or teaching institution. So sharing facilities is a step in the right direction,” he said.

Speaking at the two-day joint Universiti Malaysia Sarawak-Sarawak Health Department medical colloquium here yesterday, Dr Chan said medical practitioners should also share their expertise.

Saturday, August 16, 2003

Daily Express, Sabah, Malaysia --Unqualified students

Kuala Lumpur: Education Minister Tan Sri Musa Mohamad came out with a shocking expose Thursday - that those who failed science subjects and others from the arts stream are among Malaysian students taking up medical courses in Ukraine.

He said this was discovered after the Ministry conducted a study on 100 out of the 650 Malaysian students there.

“We made a survey on 100 students and found that half of them are not qualified for the medical course. This is something serious.

“Some of them failed in the science subjects and some are from the arts stream,” he told reporters after attending the 21st national-level King’s Cup oratory competition here.

Musa said this in response to queries on why the Ministry had tightened the minimum qualifications needed for admission to local and foreign universities.

Musa said the Ministry also discovered the same scenario at one university in Russia.

“This happened and fortunately we know about it early. I think the people in Ukraine or Russia did not do this on purpose, I think they are either confused or made to be confused,” he said.

Asked on how the confusion could have arisen, Musa said it could be due to the different grading systems practised by Malaysia and Ukraine.

“In Ukraine, to them the digit “ 9 “ (which denotes fail in Malaysia) is the highest grade but for us it is the lowest.

“Hence, there is confusion and I believe their recruitment agents here allowed this to slip through,” he said.

Musa said to prevent a recurrence of the situation, Malaysian students who wished to study abroad were advised to use the services of agents registered with the Ministry.

“Otherwise, we will not be responsible if they happen to be cheated,” he said.

News reports Thursday said the Education Ministry had tightened the minimum qualifications needed for first-degree courses.

The move was in the wake of certain foreign universities which admitted students with inferior qualifications, according to the reports. - Bernama

Wednesday, August 13, 2003

All ethnic groups donate blood, says Chua

KUALA LUMPUR: Statistics show that all ethnic groups in Malaysia were donating blood, dispelling the perception that there were communities which were not willing to be blood donors, Health Minister Datuk Chua Jui Meng said.

He said in the Klang Valley last year, 45% of donors to the National Blood Bank were Malays, while 43% were Chinese and 8% Indians.

Until July this year, the breakdown was 51% for Malays, 37% Chinese, 8% Indians and the rest made up of other ethnic groups and fo-reigners.

Speaking to reporters after launching the National Association of Malaysian Life Insurance and Financial Advisors’ (Namlifa) Nationwide Blood Donation campaign at his ministry yesterday, Chua said it was clear that the taboos and superstitions linked to blood donation were disappearing.

Chua said that an annual increase of 8% in the blood bank supply would be enough to meet demand.

He said last year, the amount of blood donated increased by 8.7%, with 418,118 units donated, compared to 387,711 units in 2001.

Namlifa president Phang Siang Yang said its nationwide blood donation campaign would be held between Aug 11 and Aug 17.

Stop new tactics, tobacco firms told

KUALA LUMPUR: The Health Ministry will meet players of the tobacco industry and ask them to stop some of the new tactics that they have adopted to promote cigarettes after the ban on such activities, its minister Datuk Chua Jui Meng said.

The ministry was “very aware” of the ingenious tactics used by the tobacco companies to promote their products since the Jan 1 ban on all forms of cigarette promotions, he told a press conference after launching the National Association of Malaysian Life Insurance and Financial Advisers’ nationwide blood donation campaign at the ministry yesterday.

He refused to reveal the new tactics, but hinted that they could involve “going to certain places, getting free cigarettes and seeing lovely girls.”

Asked whether such new tactics included sending attractively-dressed promotion girls to public areas to push cigarettes, he said: “This has been already been going on, but they are now even more ingenious than that.”

All forms of tobacco advertising and sponsorship, including that on brand names, travel and non-tobacco products, had been banned since Jan 1. However, the Cabinet exempted certain sports and sporting events from this ban.

Direct cigarette advertising had been banned much earlier.

On Malaysia’s signing of the World Health Organisation’s Framework Convention on Tobacco Control, Chua said he would be presenting a memorandum on the matter to the Cabinet within the next two weeks.

He said it would be up to the Cabinet to decided when Malaysia would sign the convention.

“We have been given one year until next June to sign the convention,” he said.

Chua also said around 10,000 people in Malaysia died from tobacco-related diseases yearly.

New Straits Times Online - MTUC: ‘Very, very slow’ PSC needs change of attitude

KUALA LUMPUR, Aug 11: The Public Services Commission’s inefficiency in processing work applications involved not only foreign doctors but local workers as well, according to the Malaysian Trades Union Congress (MTUC).

"They are very, very slow even with today's information technology," its president Senator Datuk Zainal Rampak said today.

Zainal was responding to a statement by Health Minister Datuk Chua Jui Meng that the shortage of foreign doctors in Malaysia stemmed from the inefficiency of PSC's recruitment process. On the recommended time needed to process applications, Zainal said it should take about one month.

"There should be guidelines and procedures to speed up the decisionmaking process. A change of attitude is needed," he said.

Meanwhile, PSC, in a Press release, refuted allegations that its recruitment process was inefficient.

Chairman Datuk Abdul Wahab Adam said the process involved the Foreign Ministry, Health Ministry and PSC.

He said it took about two to four months for the application forms to reach PSC from the two ministries and about a month for the commission to process the applications.

"We have conducted the interviews first and made conditional offers a day after. The offer is made before applicants registered with the Malaysian Medical Council, which is a requirement.

"This shows we speed things up," he said. Deputy Prime Minister Datuk Seri Abdullah Ahmad Badawi recently said benefits offered to foreign doctors working in Malaysia would have to be reviewed to alleviate the shortage of doctors.


Tuesday, August 12, 2003

Utusan Malaysia Online - PSC: qualified foreign docs to be hired immediately

KUALA LUMPUR Aug 11 - The Public Services Commission has offered to hire immediately qualified foreign doctors who have been interviewed although they have yet to register with the Malaysian Medical Council (MMC), the authorising body for doctors to practice in the country.

Commission Chairman Datuk Abdul Wahab Adam said the offer would be made by the commission either immediately or one day after the candidate, who had been interviewed, is found to be suitable for the job.

"However, the offer is conditional - the candidate must register with the MMC after accepting the offer. This means the commission has relaxed the procedures to speed up recruitment," he said in a statement on Monday.

He said the easing of the rules was only for the post of doctors due to the critical nature of the problem.

Utusan Malaysia on Monday published a report, quoting the Health Ministry as saying that the shortage of foreign doctors in the country was due to the commission's delay in recruiting them.

The daily quoted Health Ministry Parliamentary Secretary S. Sothinathan as saying on Sunday that the recruitment process took months from the date of advertisement of vacancies, call for interviews till the offer letters are issued.

Health Minister Datuk Chua Jui Meng said on Monday that he had asked the ministry's secretary-general to ask the commission to revert to the old format which enables the ministry to conduct interviews and offer temporary contracts to foreign doctors.

Abdul Wahab said the blanket approval by the Chief Secretary to the Government Tan Sri Samsudin Osman was also a move to expedite recruitment of foreign doctors.

He said the Foreign Ministry and foreign missions were also involved in the hiring of foreign doctors.

He said the Health Ministry was involved in vetting the applications to determine the applicants' eligibility, experience and registration with the MMC while the commission issued the interview and offer letters.

Abdul Wahab said the Health Ministry needed 1,149 foreign contract doctors and to fill up the vacancies, the commission contacted the Foreign Ministry to advertise the vacancies in countries like Bangladesh, Indonesia, India and Pakistan.

In Indonesia, letters calling for interviews were issued quickly as the commission received assistance from the country's health department, he said.

In other countries, the interview letters would take about a month to be sent to the applicants and another 14 to 20 days to decide on the interviews, he added.

Sunday, August 10, 2003

Utusan Malaysia Online - Work more closely on healthcare, private and public sectors told

PUTRAJAYA Aug 9 - The private and public sectors need to work more closely to safeguard the national healthcare system by managing the exponentially increasing demand on healthcare without sacrificing accessibility and affordability of services, Datuk Seri Abdullah Ahmad Badawi said on Saturday.

The deputy prime minister said that this urgent demand for healthcare was one main challenge faced by the country amid increasingly-stretched resources because of the societal and environmental changes and personnel shortages.

"One way to move ahead is by enhancing partnership (between private and public sector) in this area," he said when opening the Kumpulan Perubatan Johor (KPJ) Medical Conference 2003 here.

Abdullah said that he was aware of the many discussions between the private and public sectors on restructuring the financing and delivery of health services in Malaysia.

Different models pursued by other countries had been studied with the aim that a structure suited to Malaysia's condition would be formulated.

"Whatever the precise structure may be, the private sector will have the clear role in bolstering and complementing public services," he said.

Abdullah said that the focus clearly was on value for money care.

He said that the private sector had played its role in offering a comprehensive system which included health promotion and preventive and rehabilitative care for both the urban and rural population.

He said that greater private sector involvement was encouraging which led to the near-doubling of private hospitals and speacial-care homes from 119 in 1983 to 211 last year.

Indeed, selected urban centres are now very well served by private healthcare facilities resulting in doctor to patient ratio that is better than the national averages of Singapore, Britain and Japan.

However, Abdullah reminded medical practitioners against a backdrop of changing disease pattern while there was still an acute shortage of health professionals.

This included doctors, pharmacists and nurses, he said.

The deputy prime minister said that a vast improvement from before must be made because the current doctor to population ratio stands at only 1:1465.

He said that it was still far from Malaysia's target of 1:600 by 2020.

On training, he said that six public universities and three private medical colleges at present had expanded their capacities from producing 5,900 graduates trained in the 1996-2000 period compared to 3,250 in the previous five-year period.

He said that as of March this year, the Health Ministry had filled 77 percent of the near 13,000 ministry vacancies for medical doctors.

The Cabinet, he said, had approved the creation of 1,149 posts for foreign contract doctors.

"Despite these advances, much more needed to be done to mitigate the shortage of personnel," he said.

For instance, he said, out of the total allocation for foreign doctors, offers had been made to 404 doctors but only 135 had reported for duty.

Speaking to reporters later, Abdullah called on the Health Minitsry to look into this matter by expediting the recruitment process.

The ministry also needs to review the competitiveness of the package offered, he said.

"We must also draw up and implement effective incentives to attract even more Malaysian doctors working abroad to return home," he added.

Friday, August 08, 2003

Prevent pregnant women from standing, factories told

BERITA Harian reported an appeal by midwives specialist and gynaecologist Dr Harlina Halizah Siraj of the Universiti Kebangsaan Malaysia Hospital for factories to give exemptions to pregnant women in jobs which require workers to stand.

She said this was to avoid the risk of premature births, adding that standing for too long could lead to fainting, swollen feet and affect blood flow to the foetus.

Dr Harlina was commenting on the daily’s earlier report that the MTUC had received complaints from workers of Japanese-owned factories requiring them to stand the entire working hours.

The daily also quoted National Institute of Workers Safety and Health chairman Tan Sri Lee Lam Thye as saying that such a working system would not help to increase productivity as workers would be exhausted.

Thursday, August 07, 2003

Forbes.com:Radiology NightHawks

With the rise of telemedicine, I think certain medical practices will change. Radiologists' jobs may be threatened. Those less skilfull may see their services overwhekmed by reports from others.

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"Radiology is becoming totally electronic," says Trefelner at the end of one of his all-night, 12-hour shifts. "And people no longer want to take the call because they're burned out. At one time radiologists got one or two calls a night, but now they're getting six, ten, 12 studies a night." For liability purposes, a "nighthawk," which is what people such as Trefelner have been dubbed, reads a study (such as a CT scan, MRI or ultrasound) that has been performed elsewhere and the radiologist who hired the nighthawk generally must read the same study the next day.

There are only about five nighthawk companies in the U.S. so far, but many more are opening up overseas, especially in countries with a good number of English speakers, such as Australia, Malaysia, India, Israel and South Africa. Trefelner's outfit is unusual in that he and his employees are all based in the U.S.; other companies send American radiologists overseas to work hours when U.S. clients are sleeping.
Ministry to tap into data to fight cancer

JOHOR BARU: The Health Ministry will tap into the data of cancer cases registered with the National Cancer Registry to draw up plans and provide medical facilities to fight the illness.

Health Ministry’s director-general Tan Sri Dr Mohammad Taha Arif said the registry had so far registered 26,089 cancer cases but the ministry believed the figure only represented two-third of those affected.

“There are many who are not registered yet but this is not the responsibility of the affected person,” he said, adding that it was the duty of service providers such as the practitioners, laboratories and x-ray centres to help register such patients.

“We hope to create an awareness among the service providers to submit the vital information to us so that we can gauge the actual number and plan for sufficient facilities in future,” he said.

Information collected by the registry could also be useful in drawing up educational and promotional programmes for public awareness, he said yesterday after opening the 4th Johor Scientific Meeting themed “Cancer – Challenges Ahead.”

With sufficient data, the ministry could concentrate on the target group, list out the risk factors, draw up preventive measures, request for more medical staff and larger budget, he added.

Dr Taha said according to the registry, most of the 11,825 males who were diagnosed with cancer were suffering from lung cancer while majority of the 14,274 cases involving females had breast cancer.

Variations according to age and ethnicity were also observed, he said, adding that men developed cancer at an average age of 59 years old while it was 52 for women and 82% of cancer occurred among those aged 40 and above.

Dr Taha pointed out that while cancer was once akin to receiving a “death sentence,” there were now many ways to detect the illness and various drugs had been found to fight the disease.

“What is important is that one goes for early screening. In many cases, cancer can now be totally cured or there are sufficient medication to prolong one’s life span even after being diagnosed with cancer,” he said.

He added that a healthy lifestyle and a proper diet could lower the risk of cancer.

Monday, August 04, 2003

Business News: Sesco group nets Sarawak hospital job

A CONSORTIUM comprising Sesco Engineering Sdn Bhd and Vamed Engineering GmbH & Co KG of Austria has been awarded the RM350mil first phase of the Sarawak International Medical Centre (SIMC) in Samarahan near Kuching.

Sesco Engineering is a subsidiary of Sarawak Electricity Supply Corp (Sesco).

The consortium will design, build, equip, commission and maintain SIMC, developed by state-owned Sarawak Specialist Hospital and Medical Centre Sdn Bhd.

The Mayo Foundation of US is the project’s consultant. The project’s feasibility study was carried out by the Mayo Clinic eight years ago.

Sarawak Chief Minister Tan Sri Abdul Taib Mahmud laid the foundation stone for the project on 40ha on Thursday.

Phase one of the project, expected to be ready in three years, will have a three-storey hospital podium complex and an eight-storey in-patient accommodation building, according to Sarawak Specialist Hospital and Medical Centre chairman Tan Sri Dr George Chan Hong Nam.

Dr Chan, also Deputy Chief Minister and Minister for Finance and Industrial Development, said SIMC would have facilities that met the demand for a highly specialised modern health care system.

When operational, SIMC will have three specialist outpatient clinics, an accident and emergency department, kidney and stone centre, wellness and heart centre and a cancer centre.

There will be six operating theatres, an imaging department, a laboratory/pathology department, a cardiac catheterisation laboratory and a physiotherapy department.

Also to be provided are teaching/training and educational facilities as well as medical and non-medical support services.

Dr Chan said SIMC would have 166 beds, including 12 VIP suites.

“SIMC, when completed, will also serve as a major supplementary clinical teaching facility for Universiti Malaysia Sarawak.''

Sunday, August 03, 2003

Medical workers from China get holiday in Malaysia

"PENANG: Some 250 medical workers from China, who fought relentlessly against the Severe Acute Respiratory Syndrome (SARS), are in Malaysia for a holiday treat as a reward. "

Great. So what about Malaysia's brave health care workers? Small monetary thank you and that's it.

Saturday, August 02, 2003

RM5.5m for SARS fighters

KEPALA BATAS: A total of RM5.5mil will be given within the next two weeks to 9,368 public health employees involved in containing the Severe Acute Respiratory Syndrome (SARS) outbreak, said Health Minister Datuk Chua Jui Meng.

He said Prime Minister Datuk Seri Dr Mahathir Mohamad had agreed to his proposal to have the special allowance increased to RM500 a month for support staff and RM1,000 a month for professional staff in recognition and appreciation of their contributions during the crisis.

The special SARS hardship allowance included in the economic stimulus package was initially fixed at RM200 a month for support staff and RM400 for professionals.

“The amount to be paid will be proportionate to the number of days served from March 16 to June 30,” Chua said after visiting the new RM83mil Kepala Batas Hospital here.

“The allowance is not only for the 5,619 personnel involved directly in the SARS treatment but also for the 3,749 staff who were assigned to monitor (the situation) at international entry checkpoints, to investigate SARS cases at homes and hospitals, to monitor contacts who were quarantined, and to conduct prevention and control activities,” he said.

The Cabinet had also directed the ministry to “institutionalise” efforts made at the local, national and international levels to contain the disease, he said, adding that Malaysia was successful in containing the outbreak that had caused 812 deaths in 30 countries.

A model would be formulated based on input from the national committee set up to contain SARS, and it would be used to fight future outbreaks and handle other national crises, he added.