Tuesday, August 31, 2004

How’s your bedside manners, doc?

The bedside manners of doctors is one of the elements that will be considered when assessing their competency.

The Deputy Director-General of Health, Datuk Dr Ismail Merican, said doctors must provide evidence that they had the knowledge and skills to be effective, competent, safe and reliable healthcare providers.

The competency assessment will cover all allied healthcare providers, including doctors.

Dr Ismail said what the Health Ministry hoped to implement with its involvement in the Continuing Professional Development (CPD) of healthcare providers was to link the assessment to what they did in their daily routine. "Doctors should not complain anymore about being assessed for competency based on something irrelevant." He said doctors were unhappy about the competency assessment as they felt that some portions of it were not relevant.

But with the new directive from Health Minister Datuk Dr Chua Soi Lek, he said, the ministry had come up with its own assessment for allied healthcare providers besides that of the Public Services Department (PSD).

"We cannot just promote people with any form of objective assessment. We will start with doctors first. Later, we will rope in the pharmacists, physicists, researchers and other allied health personnel." He said the competency assessment would also be based on credit points and logbook, meaning doctors would be assessed on how they performed in certain procedures and how they related to patients and others.

The ministry, he added, was working closely with the Section Concerning House Officers, Medical Officers and Specialists (SCHOMOS) and Malaysian Medical Association (MMA) to introduce the CPD activity in the assessment so that doctors would be evaluated on competency. "Doctors must provide evidence that they are armed with the necessary knowledge and skills to be effective, competent, safe and reliable healthcare providers." He said doctors were happy with this even though the requirements were quite stringent. "They are happy because they feel they would be evaluated based on something that is more relevant to what they do," he said, adding that they also needed to know some of the government procedures and policies as it was important to their core business.

"Doctors and allied healthcare personnel must be aware of the existing government policies so that they can work within the framework of policy decisions made by the Government." Dr Ismail said there were doctors and allied healthcare providers who did not know what was going on around them, including the policies within which they had to work. "They must know what they can and cannot do." He added that the Government was also introducing leadership and strategic planning skills for senior government officers who needed to be trained in the field.

"CPD is important because it will ensure that people are continuously updated and whatever they do is in keeping with the times so that they don't lose out on skills," he added.

He said that over the years a lot of things had changed and a lot of new skills and knowledge developed.

"There is also the changing global challenges and the expectation of the public is even greater," he said, adding that this was why they wanted doctors and those in healthcare to be equipped with the knowledge and skills which they may not have acquired as graduates.

At present, doctors have to undergo examinations and go for courses organised by the PSD.

Although they will still undergo one examination with the PSD, the ministry would conduct its own competency assessment for its staff. Dr Ismail also stressed that the CPD involved doctors in the public and private sectors as well.

He said it was a systematic process of life-long learning and professional development aimed at enabling healthcare providers to maintain and enhance their knowledge, skills and competence for effective clinical practice to meet the needs of the population.

Dr Ismail added that the CPD dealt with issues that were linked with professional competency, provision of quality care and improved health outcomes for doctors in both the public and private sectors.

Monday, August 30, 2004

Nation faces acute shortage of nurses

PETALING JAYA: Malaysia is facing an acute shortage of nurses with a nurse to patient ratio of 1:645 compared to 1:200 in developed countries.

Health Minister Datuk Dr Chua Soi Lek said that in order to meet the ratio of the developed countries, Malaysia has to train 8,000 nurses every year.

However, he said, the public and private colleges could only train 3,000 nurses yearly.

As of June this year, there are 39,232 nurses, of whom 75% were in government service.

"This is a big challenge for us, as we have to train at least 130,000 nurses over the next 16 years," he said before presenting diplomas to nursing students at the Assunta Hospital.
Putrajaya Hospital showcases latest eHealth service

PATIENTS registered with Putrajaya Health Clinic carry no appointment cards if they possess MyKad, the new chip-based national identity card.

The long queues that are a common feature in most government clinics and general hospitals in the country are unheard of in this futuristic healthcare facility in the nation's new administrative centre.

A patient with an appointment for the day merely swipes his MyKad at a terminal, which will then dispense a queue number for the doctor attending to his case.

If he has a mobile phone he would have had an SMS reminder the day before, plus pertinent information – such as having to fast for eight hours prior to his visit – if he were scheduled to undergo any laboratory tests.

Dr Wong Kien Seng is particularly proud that the applications are Buatan Malaysia – developed locally by programmers, all of whom are Malaysian citizens.
This is information technology communications at work, realising the nation's eHealth programme, a flagship application of the Multimedia Super Corridor. The clinic and the 272-bedded Putrajaya Hospital, which provides secondary level care, have become the nation's showcase of its healthcare services of the future.

And patients could expect further enhancements and refinements, promised Dr Wong Kien Seng, chief executive officer of Kompakar eHealth Tech Sdn Bhd (KeHT), who has been involved in the project from day one. KeHT is a subsidiary of the Kompakar Group.

The Clinic Information System (CIS) has run live in Putrajaya Clinic since November 1999, and the Total Hospital Information System (eTHIS) since November 2000, according to Wong, who is particularly proud that the applications are Buatan Malaysia – developed locally by programmers, all of whom are Malaysian citizens.

The two systems are currently Windows-based. But the hospital is keen on migrating to a Java-powered, open source version that Kompakar is near to wrapping up. An open source system will help the hospital cut costs in that no royalty payments are involved.

Although the open source version is aimed primarily at the China market, Kompakar's stand is “flavours” – it provides applications that meet the client's operating platform, whether Windows-based, Unix, or open source.

Wong, with over 10 years of healthcare industry experience, said CIS and eTHIS allowed doctors from the clinic to refer patients to the hospital electronically. Patients need not carry a hard copy of referral with them when visiting the hospital.

The hospital staff are able to preview patients' initial record – the clinical clerking, investigations' test and results – and proactively plan for patients' care prior to their consultation.

More importantly, eTHIS contains a comprehensive medical folders module that enables doctors to access patients' medical records online, even on wireless networks when required.

In the pipeline is a picture archiving and communications system intended to be used for long-term archiving of medical images. This, coupled with other data culled from the hospital's records, will enable a decision support system that will help doctors in diagnosis and treatment.

Besides, KeHT is working on a shrink-wrapped version of its CIS application that will be offered as a stand-alone system for the smaller healthcare providers.

Wong said in addition to Putrajaya Hospital and Clinic, eTHIS had also been customised for the Pantai group hospitals in Bangsar (Kuala Lumpur) and Pandan Indah (Selangor).

KeHT is also looking at working with other hospitals within the Bursa Malaysia-listed Pantai group.

Besides Malaysia, KeHT is currently targeting eTHIS at hospitals in China, Australia, Indonesia, Thailand and, eventually, Vietnam. The Kompakar group has overseas subsidiaries in Singapore, Hong Kong, Thailand, Australia and China.

Saturday, August 28, 2004

Survey: Many M’sians are financially ill-prepared for illnesses, accidents

Kuala Lumpur: One among almost every five Malaysians stands to face serious financial difficulties within just three months if he or she is forced to stop work through illness or accident, a survey has found.

The survey, AIA Life Matters, which tested Asians’ attitude towards insurance and risk, showed that in Malaysia, without any form of critical illness, medical or accident insurance cover, 18 percent of those interviewed admitted they would face financial difficulties in just 12 weeks or less.

They would be almost totally reliant on family support or personal savings, the survey said.

The good news, however, was that Malaysia’s 18 percent was the lowest among the countries covered in the survey which was commissioned by American International Assurance Company Limited (AIA).

In Thailand the figure was 24 percent, while Hong Kong and Singapore both registered 20 percent each.

The survey also found that half of all Malaysian respondents admitted they would be struggling to survive financially in more than 12 months and would face acute financial difficulties in the event of an accident or illness.

The figures were similar to Hong Kong, but less than Singapore at 54 percent and Thailand at 55 percent.

Over 70 percent of the respondents in Malaysia said they would either rely on their family for support, or their personal savings, while around 12 percent hoped for charity and social welfare.

The survey covered 500 people comprising the general public aged 25 and above. In Singapore, the respondents were aged 20 and above. The telephone interviews, which were conducted in the second quarter of this year, was surpervised by Taylor Nelson Sofres.

AIA Malaysia vice president and general manager, Richard Bender, said the survey which would be an annual affair, was aimed at helping AIA design and price its insurance products.

The survey clearly indicates the big risks that people unwittingly take by not having adequate insurance coverage, he said at a media briefing here today.

“People ignore the financial impact on individuals and their families from the potentially high costs of expensive medical treatment, the longer-term implications of respite after-care and the consequences of permanent disability,” he added.

Meanwhile, AIA Malaysia vice president, accident & health department, Chuah Chin Seong said the company would be introducing two new insurance products over the next two months, High Networth Personal Assurance (PA) and Scholar PA. - Bernama

Thursday, August 26, 2004

Specialist register next year to check competency

KUALA LUMPUR: A specialist register will be set up to ensure these professionals are fully competent, said Health Minister Datuk Dr Chua Soi Lek.

He said the Health Ministry had been working with the Academy of Medicine Malaysia (AMM) to develop the registry.

"The registry will also facilitate interactions, referrals and patient management among fellow specialists in various disciplines, and help members of the public identify the specialists that they want," he said at the 5th MOH-AMM Scientific Meeting at the Sunway Lagoon Resort Hotel here Thursday.

He said the registry would also ensure only competent foreign specialists were credentialed to practise in the country after the implementation of the Asian Free Trade Area.
Tips on preventing medical errors

KUALA LUMPUR: Local healthcare personnel will have the opportunity to learn from overseas experts on ways to prevent medical errors during an international conference on health risk management next month.

Medico-Legal Consultant Dr M. Ponnusamy said the conference, organised by the Malaysian Medical Association, would touch on topics such as clinical risk management in various fields including haematology, pharmacy, radiology and nursing.

The conference will be held on Sept 4 and 5 at the Putrajaya Marriott. Those interested can log on to www.mma.org.my or www. adventcgs.com.

Wednesday, August 25, 2004

Himalaya Herbal Healthcare picks M’sia as regional hub

BANGALORE-BASED Himalaya Herbal Healthcare will make Malaysia its regional hub as it continues expanding worldwide in the fast growing herbal healthcare industry.

Himalaya Herbal Healthcare, the biggest herbal healthcare company in India, will finally set foot in Malaysia after extending its presence to over 50 countries in the world.

“Malaysia is the first country in South-East Asia we are entering and we plan to make it our regional hub.

“This is because it has a very good consumer base with discerning consumers who are exposed to the best healthcare products in the world,” chief executive officer and president Ravi Prasad said in an interview in Kuala Lumpur yesterday.

Prasad, who is here for the local launch of Himalaya Herbal Healthcare products, said many people still had doubts and myths about herbal products.

“Herbal products are safe and do not have any side effects on consumers. We have combined our herbal products with contemporary science and we spend a huge amount of money on research and development.

“In fact, it usually takes us 8 to 10 years of research and testing before a product is launched.

“We do not believe in using chemicals and all our products are chemical-free,” he added.

Himalaya Herbal Healthcare, one of the top 10 companies in the pharmaceutical industry in India in terms of unit sales, is expecting a 25% growth in revenue from its current US$80mil.

“We expect revenue to exceed US$100mil this year. There is huge potential in the herbal healthcare industry. The global herbal healthcare industry is worth US$63bil and growing at 20% -25% a year,” said Prasad.
Doc: Herbal drugs may not be safe

KUALA LUMPUR: Natural herbal products are not necessarily safe and effective in treating diseases as they have not undergone tests, said a pharmacologist from University of Strathclyde in Britain.

Dr Brian L Furman said interest in such products was increasing as people were losing faith in conventional medicine.

“Some people in the Britain turn to natural products because they believe it is safe.

“They think that because it is called natural products it is naturally safe. That's purely a false perception,” he said after delivering a talk “Biomedical Sciences at Strathclyde - Drug Discovery from Natural Products” at Technology Park Malaysia yesterday.

“My conception of herbal (or natural) products is that it is another route to getting a new medicine,” he said, adding that the problem with natural products was that many had yet to go through systematic scientific procedures.

Dr Furham said for some natural products, the amount of active ingredients could change enormously under different conditions, “which means we can't predict what the dose is going to be.”

He cautioned those using natural products to find out about the amount of active ingredients they could produce, whether they were safe and effective.

He also pointed out the dangers in mixing natural products with conventional medicine which could lead to harmful interactions.

On the prospect of natural products, he said, the pharmaceutical industry was interested in using pure compounds from natural products that could control diseases more effectively.

Dr Furman is currently involved in research of potential anti-obesity agents.

Tuesday, August 24, 2004

WHO Commends Malaysia On Swift Action On Bird Flu

Asian nations need not panic over the recent outbreak of the Highly Pathogenic Avian Influenza (HPAI), but instead take concerted long-term measures to contain it, said WHO Western Pacific regional director Dr Shigeru Omi.

He said the countries should further strengthen their surveillance systems on the outbreak to prevent the strain from re-emerging later. "The virus is still circulating among poultry farms and there is always a chance for the virus to gain the ability to transmit on a human-to-human basis."

"So, people should strengthen their surveillance, but at this point of time, we do not need to panic," he told reporters.

He was here for the opening of the two-day ASEAN Consultation on the Impact of AFTA on Tobacco Trade and Health forum at Hotel Equatorial Penang Monday. Dr Omi congratulated the Malaysian Health authorities for taking prompt and decisive action to contain the avian flu outbreak.

"Malaysia has done a good job to cull the chickens and has taken immediate action to go to the ground to address the issue. The country has also dealt with the Severe Acute Respiratory Syndrome (SARS) very well, and has learnt from its past experience, the Nipah virus outbreak," he said.

He added that the WHO was not recommending vaccination for animals as a major cure for the virus because it may give a false sense of security. Health Minister Datuk Dr Chua Soi Lek said the tests on the veterinarian and the three children at the Kota Baru Hospital confirmed that they were free from avian flu.

"They will be discharged soon. And, with this, there are no other suspected avian flu cases in Kota Bharu so far," he said.
Government plans to lower amount of tar and nicotine in cigarettes

PENANG: The Government will study a proposal to reduce the contents of tar and nicotine in cigarettes by 25% and 13% respectively, Health Minister Datuk Dr Chua Soi Lek said.

He said the move was among several proposed amendments to the Control of Tobacco Product Regulation 1993, under the Food Act 1983, which allows the maximum of 20mg of tar and 1.5mg of nicotine in each cigarette.

“We hope to reduce the level of tar to 15mg and nicotine to 1.3mg in each cigarette when amendments to the regulations are made,” he said after opening the two-day Asean Consultation on the Impact of Afta on Tobacco Trade and Health forum in Penang yesterday.

Dr Chua said the Government would soon extend no-smoking zones to cover places of worship, hotel lobbies and toilets as well as public toilets.

“I have also asked the Energy, Water and Communications Ministry to work with the Health Ministry to control all forms of direct and indirect advertisements by tobacco companies,” he said.

Dr Chua said the Government was keen to establish a Health Promotion Foundation, which would be sustained by “sin taxes” from tobacco and alcohol firms to fund sports, cultural and health promotions and activities.

He also said Malaysia, which had signed the World Health Organisation Framework Convention on Tobacco Control last September, was in the process of ratifying it.

Monday, August 23, 2004

BIRD FLU: Clean bill of health for three

Kelantan State Medical Health director Datuk Dr Ahmad Razin Datuk Ahmad Mahir said the three people were discharged yesterday after tests showed they did not have the bird flu virus.

Speaking to newsmen after launching a State-level hepatitis awareness campaign, today Dr Ahmad Razin said samples taken from a 16-year-old girl, her mother and a veterinary officer were sent to the Institute of Medical Research (IMR) and came back yesterday, positively clearing all three.

Student Siti Munirah Ismail and her mother Fatimah Che Haron, 40, are from Kampung Baru, Pasir Pekan in Tumpat, where the virus was detected in the carcasses of two kampung chickens, while veterinary officer Rosnani Awang was involved in the culling of birds and chickens on Thursday.

They had been isolated at a special ward for observation after complaining of fever and cough.

Despite the good news, health authorities reaffirmed that they would not take any chances.

Another veterinary officer, Dr Zarina Mohamed, 32, was admitted to the Kota Baru Hospital complaining of a sore throat and cough.

Her children, aged between two and six, years were also admitted to the hospital’s isolation ward on Saturday as a precaution.

In Seremban, Health Minister Datuk Dr Chua Soi Lek said the official and her children did not have any fever.

“The results of throat swabs taken from the family will only be known tonight.

“If the tests are negative, the official and her children will be discharged tomorrow.

“Right now, they are still under supervision by the hospital authorities.”

Dr Chua called on the public not to worry as everything was under control.

“We are not hiding anything at all. So far, there are no human beings suffering from the disease. Only chickens had the disease, not humans.”

He advised the public not to listen to rumours.

“The outbreak of avian flu is only confined to Tumpat,” Dr Chua said, adding that his confidence was based on the round-the-clock effort by his Ministry, the Agriculture and Agro-based Industries Ministry and other authorities to check the disease.

“I have full confidence that the disease will not spread to other areas.”

To contain the virus in the village in Tumpat, residents in the area are not allowed to resume rearing chickens or birds for at least three weeks, the Veterinary Services Department announced yesterday.

Its director-general, Datuk Dr Hawari Hussein, said to ensure the virus did not re-appear or spread, the department had also disinfected the areas where chickens and birds had been culled. — NST

Tabs on passion pills

Negri Sembilan Health Department officials have gone ‘undercover’ to bring to book operators of private clinics and pharmacies which sell ‘sex booster’ capsules to customers.

This follows complaints by consumers that such capsules were sold in the State, especially Seremban town to walk-in customers.

The department has begun closely monitoring pharmacies and private clinics as such capsules are known to have a negative health impact on the consumer.

Its enforcement deputy director Abd Halim Abd Aziz said department officials recently seized several types of so-called ‘king of sex’ capsules from shops in Port Dickson and Lenggeng..

Among the items seized were Enjoy capsules, V-stone, Abang Boleh and fake Viagra from China.

"Although the seizures did not involve a big quantity of capsules, we will intensify operations.

“We will not compromise with errant traders or individuals found to be selling such capsules...we will prosecute them.”

He reminded the public, particularly men who are suffering from erectile dysfunction, not to be easily influenced into buying the capsules.

The department has set up a public complaints bureau to enable those with information on the sale of the capsules as well as traditional medicines, to get in touch with them.

"The public must not just buy the medicines or capsules but check the labels and if possible, get in touch with us first, to avoid being taken for a ride," he said.
Tabs on passion pills

Negri Sembilan Health Department officials have gone ‘undercover’ to bring to book operators of private clinics and pharmacies which sell ‘sex booster’ capsules to customers.

This follows complaints by consumers that such capsules were sold in the State, especially Seremban town to walk-in customers.

The department has begun closely monitoring pharmacies and private clinics as such capsules are known to have a negative health impact on the consumer.

Its enforcement deputy director Abd Halim Abd Aziz said department officials recently seized several types of so-called ‘king of sex’ capsules from shops in Port Dickson and Lenggeng..

Among the items seized were Enjoy capsules, V-stone, Abang Boleh and fake Viagra from China.

"Although the seizures did not involve a big quantity of capsules, we will intensify operations.

“We will not compromise with errant traders or individuals found to be selling such capsules...we will prosecute them.”

He reminded the public, particularly men who are suffering from erectile dysfunction, not to be easily influenced into buying the capsules.

The department has set up a public complaints bureau to enable those with information on the sale of the capsules as well as traditional medicines, to get in touch with them.

"The public must not just buy the medicines or capsules but check the labels and if possible, get in touch with us first, to avoid being taken for a ride," he said.
Malaysia, Brunei promote health cooperation

Kuala Lumpur, Aug 21 (VNA) - Malaysia and Brunei will sign a Memorandum of Understanding (MoU) to improve cooperation on health matters, Malaysian Health Minister Chua Soi Lek told reporters on Friday after a closing meeting between health delegations of the two countries.

Brunei was represented by Health Minister Abu Bakar Apong.

The draft of the 12-point MoU had been agreed upon at the second bilateral meeting on health between Malaysia and Brunei held in the Genting Highland resort in Malaysia, said Chua.

The meeting serves as a framework for the implementation of bilateral cooperation on health matters for the mutual benefit of both countries.

The 12-point agreement will include such issues as emerging diseases, the exchange of information, human resource development, food safety and more regular visits of health personnel from both countries.

It is necessary to promote health cooperation between the two countries in order to minimise the spread of disease across the border as well as to enhance the capability of health services in improving health of people in each of the countries, said Chua.

Sunday, August 22, 2004

UPM takes a step forward for cancer research

A LOCAL university seems poised to take cancer research to a higher level.

Universiti Putra Malaysia's (UPM) lecturer Dr Johnson Stanslas, together with students from the university's department of biomedical sciences, is spearheading this work.

“The group's research focuses on the discovery and development of novel anti-cancer therapeutics from nature,” said Dr Stanslas about the work of the Cancer Research and Drug Discovery (CRDD) group.

“As I am based in the faculty of medicine and health sciences, a big chunk of my research focuses on the pre-clinical in vitro and in vivo evaluations of potential anti-cancer agents,” he said at the signing of a research and consultancy agreement between UPM and Autoimmune Sdn Bhd.

Under the agreement, Autoimmune Sdn Bhd's managing director, Patriek Yeoh, said UPM would evaluate some of Autoimmune's botanical-based formulations to produce scientific data which supports medical efficacy.

“This means UPM will be evaluating the in vitro (artificial environment) anti-cancer potential of Autoimmune's plant extracts and the in vivo potential of the company's purely herbal-based product known as Hepat for the treatment of liver toxicity,” he explained.

Yeoh explained that the evaluation is expected to take a year to complete, with scientific findings reported every three months.

“This is a significant step forward in increasing scientific documentation of herbal-based medicine, and would help to raise the overall safety and efficacy standards of such medicine,” he said.

“Other than evaluating single chemical entities as anti-cancer agents, we have also started evaluating herbal preparations for the treatment of cancer.

“We follow the guidelines set by the national committee for research and development in herbal medicine based at the Institute of Medical Research, and strictly conform to the regulations laid out by the National Pharmaceutical Control Bureau to ensure that our herbal products achieve the expected therapeutic effects,” said Dr Stanslas.

He added that the CRDD aimed to identify local natural resources that could provide leads to the treatment of cancer, promote drug discovery in Malaysia, establish international collaborations, and establish UPM as a centre of excellence in cancer research.

“The vision of CRDD is to facilitate the establishment of a national level cancer institute which can spearhead pre-clinical and clinical research on cancer.

“To achieve this, we need a lot of support from the university and the government,” he added.

Ministry deregisters five Indon clinics

KUALA LUMPUR: Five clinics in Indonesia have been deregistered for falsely declaring some foreign workers bound for Malaysia as fit.

Another nine clinics in the country and one each in Cambodia and India have been placed under close scrutiny after stern warnings were issued to them.

Health Minister Datuk Dr Chua Soi Lek said some of the clinics gave a healthy person's X-ray results and blood samples to ill workers.

“Some clinics overseas are not up to mark,” he said, adding that such cases were discovered during random checks on foreign workers upon their arrival.

The Government has approved 81 clinics in nine countries to carry out pre-entry medical examinations on foreign workers.

However, random checks on 16,899 workers (or 5% of the total number of foreign workers entering the country) last year found that 840 were suffering from communicable diseases, mainly Hepatitis B (52%), tuberculosis (12%), syphilis (7%), drug abuse (7%) and HIV infection (1.5%).

Dr Chua said the Government was now studying a proposal to set up a supervising and monitoring agency in the countries of origin to screen the workers.

“We are looking at a proposal from the private sector in Indonesia on the setting up of a surveillance and enforcement mechanism to curb fraud,” he told reporters after launching the Foreign Workers Medical Examination and Monitoring Agency's (Fomema) new logo and office here yesterday.

Currently, the monitoring mechanism is only available locally and managed by Fomema – an agency given a 15-year concession to examine and monitor the health of all foreign workers prior to their yearly visa renewal.

Dr Chua said Fomema's screening process was effective because the “unfit” rate among foreign workers showed a reduction with every visa renewal – 3.2% among first-timers compared to 1.4% among those with repeated renewals.

At the launch, Fomema announced a new on-line system for employers to register their foreign workers for medical examinations and to check the status through SMS (short message service) later.

The new features would cut waiting time by half during medical examinations and do away with repeated visits to Fomema offices.
Ministries to submit paper on improving health services

THE Higher Education and Health Ministries will submit a working paper to the cabinet containing proposed solutions to improve the country’s health service.

Higher Education Minister Datuk Dr Shafie Mohd Salleh said the working paper would address problems such as the shortage of doctors in government hospitals as well as the quality of foreign doctors employed here.

“The Cabinet directed the two ministries to come up with the working paper on long term measures for the numerous problems of government hospitals. Among the areas covered are increasing the number of local doctors in government hospitals, wooing back Malaysian doctors and specialists serving abroad by making the service more attractive."

He said the two ministries had to work closely together towards this end as universities “supply hospitals with the doctors they require”.

“To accommodate these additional medical graduates in the future, hospitals must have better infrastructure, better facilities and must be expanded,” he said.“That is why it must be a joint initiative by both ministries,” he told reporters after opening the new Universiti Malaya Medical Centre Emergency and Trauma Centre recently.

Friday, August 20, 2004

Malaysia Teenager in Hospital for Bird Flu Checks

KAMPUNG PASIR PEKAN, Malaysia (Reuters) - A teenager from the village at the center of a bird flu outbreak has been hospitalized with cold symptoms, Malaysia's health minister said on Friday, as poultry farmers counted their losses.

The World Health Organization warned the virus, which has killed 27 people in Asia this year, could mutate into a highly contagious form that starts the next human flu pandemic.

The 16-year-old girl was taken to hospital after health officials checked 297 families living near where the virus was found in two chickens in the village of Pasir Pekan, Health Minister Chua Soi Lek told reporters.

But he played down the risk that she would be the outbreak's first human victim.

"To this day, we don't think it's avian flu because she's having no fever, only a cough, sore throat and runny nose," he said. "There's no symptom of lung infection."

Poultry farmers, banned from selling eggs and poultry in their key export market of Singapore, said they would lose up to 3 million ringgit ($790,000) a day, and faced a headache about what to do with chickens that would be overweight and drop in value within a day or two.

"Not only exports have stopped, local consumption has also dropped," said Abdul Rahman Md. Saleh, executive consultant for the Livestock Farmers' Associations of Malaysia.

Malaysia's 25 million people are among the world's largest consumers of chicken, eating around 68 lb each a year.

Human cases of bird flu have occurred in people living or working in close contact with birds, but Japan and Taiwan have also banned Malaysian poultry products.
Bird Flu Outbreak In Tumpat An Isolated Case, Says Ministry

KUALA LUMPUR, Aug 19 (Bernama) -- The virus which infected two chickens in Kampung Pasir Pekan, Wakaf Baru, Tumpat, is the pathogenic H5N1 strain, the Agriculture and Agro-Based Industry Ministry confirmed Thursday.

The ministry's secretary-general, Datuk Abi Musa Asa'ari Mohamed Nor, told a news conference here that the outbreak was an isolated case.

"Only two of the 103 'ayam kampung' bred by the villagers have been infected with the bird flu virus, of the H5N1 strain.

"However, we have taken the decision to cull all the chickens today itself," he said.

Abi Musa Asa'ari said that the outbreak was expected to be curbed within three weeks.

Asked whether a ban has been imposed on chicken export from the country, he said that it would be left to the importing countries to decide.

"The decision is up to the importing countries. We have told them that we are containing the case. Just hope the importing countries will not ban.

"If the countries are willing to accept (the chickens), we will go on," he said.

Malaysia exports about 130,000 chickens to Singapore every day from its various farms.

Abi Musa Asa'ari said that the Agri-Food and Veterinary Authority of Singapore (AVA) has been informed of the case and the AVA has decided to ban for a while the importation of Malaysian chickens.

He said that the AVA would be updated from time to time on the development of the isolated case.

Abi Musa Asa'ari also said that following the outbreak, the Veterinary Service Department had advised exporting farms to defer the dispatch of their consignments.

This was to prevent a glut in the event that the consignments were refused entry into the importing countries, he said.

He said the ministry was taking all the necessary precautions to contain the outbreak in the village.
Malaysia joins resurgence of H5N1 avian flu

ug 19, 2004 (CIDRAP News) – H5N1 avian influenza has today been confirmed in a privately owned flock of chickens in northern Malaysia near the Thai border. The country joins three others, Vietnam, China, and Indonesia, in which the disease has resurfaced in recent weeks following the widespread outbreaks across Asia earlier in the year.

Secretary-General Abi Musa Asa'ari Mohamed Nor of the Malaysian Health Ministry made the announcement at a press conference, according to a Xinhaunet story. The H5 virus was identified yesterday in two birds near the village of Baru Pasir Pekan, and further testing confirmed it as H5N1, the subtype that can infect humans and has caused 27 deaths in Asia this year.

The Malaysian government yesterday immediately quarantined a 6-mile area around the farm and halted exports of poultry and poultry products. All of the birds in the village, reported as about 300 by Reuters, are to be killed today as a precautionary control measure, and all movement of poultry is banned in the Kelantan state where the village is located. People and birds in the area are being monitored and tested, says the story.

Singapore, which abuts Malaysia to the south, has banned imports of all poultry and poultry products from its neighbor, as has Japan. Malaysia typically exports about 130,000 chickens and 2 million eggs to Singapore daily. Malaysia's 4 million residents themselves consume 120,000 domestic chickens, 20,000 ducks, and 2 million eggs every day, according to BBC News.

Meanwhile, the World Health Organization (WHO) said in a statement yesterday that a small team will be going to Vietnam this weekend to work with that country's Ministry of Health to assess the risk of recent avian flu cases there to public health. Arrangements are being made to send samples from the 3 Vietnamese patients who have died of the disease since the beginning of August to a laboratory in the WHO Global Network. There, analyses will be carried out to determine whether the H5N1 virus strain has mutated. The concern is that it could evolve to become transmissible between humans, which could cause an influenza pandemic.

Wednesday, August 18, 2004

Many Malaysians ‘not suitable liver donors’

KUALA LUMPUR: Many Malaysians are not suitable liver donors because of the high rate of Hepatitis B infections while some livers have too much fat, said Hospital Selayang Hepatobiliary Surgery Department head Dr Harjit Singh.

He said some donors were Hepatitis B carriers while others showed signs of past infections.

“Livers with more than 30% fat are also not suitable,” he said when briefing Health Minister Datuk Dr Chua Soi Lek here yesterday.

At a press conference later, Dr Chua said there were very few cadaveric donors (brain-dead patients) in Malaysia.

Of the total, 80% were Chinese, 10% Indians and the rest were from other ethnic groups.

Selayang Hospital liver transplant consultant surgeon Dr Russell W. Strong said a holistic approach should be adopted to deal with liver transplants, including looking at the socio-economic background of the related donors and recipients.

“A transplant does not end in operation,” he said, adding that a liver transplant patient had to undergo life-long treatment which costs some RM100,000 yearly.
Sabah MMA: Tackle root cause of exodus

Kota Kinabalu: The root cause of doctors leaving public service is linked to better pay and working conditions and the Government should seek a comprehensive solution to the problem.

Failure to do so would leave the perennial problem of shortage of doctors in government hospitals unsolved, said new Malaysian Medical Association (MMA) Sabah branch Chairperson Dr Melinda Tong Mui Leng.

She said despite many proposals, some of which had been implemented, the fundamental reason had yet to be adequately addressed.

Other steps taken by the Government include employing foreign doctors and local specialists on contract. Others in the midst of implementation were opening private wings in selected hospitals, training more medical students and deploying hospital administrators in clinical work.

“However, the fundamental reason why doctors are leaving public service has yet to be adequately addressed. It will be fair to say that they are seeking better pay and working conditions.

“They are not asking for parity with the private sector,” said Dr Tong said at the MMA Sabah Branch 21st Installation and Annual Dinner at Albatross Hall, Sabah Golf and Country Club, near here, Saturday. She replaced Dr K.S Sarvananthan.

She said so much resources and time were spent on training a single doctor that it would not be unreasonable to expect some return in keeping with what has been expended.

“If society wants to continue to entrust healthcare to the hands of its brightest then it must make it worth their while. Otherwise we will lose our best to greener pastures,” she said.

Dr Tong commended the national MMA Section Concerning House Officers, Medical Officers and Specialists (Schomos), which had been untiring in its efforts to improve the lot of government doctors.

She also congratulated the State MMA Schomos, under the leadership of Dr Mohd Hatta Tarmizi, for receiving the Best State Recognition Award at the recent MMA AGM for services rendered to government doctors in Sabah.

On another note, she said with a new Prime Minister and a new Health Minister, the general mood in the country had so far been one of hopeful, expectancy and buoyancy.

“Our doctors have been able to get their work passes processed without much problem, thanks to efficiency of the Immigration staff,” she said.

Outgoing Chairman Dr Sarvananthan earlier expressed gratitude to the State Government to the quicker and less-hassle processing of work pass for doctors serving in Sabah.

Meanwhile, Dr Tong said MMA Sabah hoped to expand its Continuing Medical Education (CME) programme beyond the main town hubs in the state to smaller towns such as Keningau, Kudat, Lahad Datu and Labuan.

“I would like to encourage fellow colleagues working in smaller towns to participate in the existing CME programme held in the district hospitals by visiting specialists,” she said.

Dr Tong also proposed medical officers in government hospitals to take up the challenge in coordinating the CME activities in their respective districts.

At the same time, MMA would continue to encourage drug companies to include the smaller towns whenever they organise CME programme
Tighter rules for health and beauty salons

KUALA LUMPUR: Health and beauty salons, especially those conducting cosmetic surgery, must be registered with the Health Ministry under a new set of regulations to be implemented next year.

Health Minister Datuk Dr Chua Soi Lek said the regulations – under the Private Healthcare Facilities and Services Act 1998 – was now at the Attorney-General's Chambers for gazetting.

He said the rules would also govern the practices of these salons to protect the public.

The standards would cover professional qualifications, facilities, treatment procedures, advertisements, offences and penalties.

Topping the list to come under the regulations are treatments involving cosmetic breast surgery, weight loss programmes, Botox and lamb cell injections as well as laser technology.

Dr Chua cautioned the public that they were exposing themselves to dangers when undergoing treatment by non-medical practitioners.

“Right now, these beauty businesses are just registered as companies and practise almost whatever they want.

“They called themselves beauty technicians or beauty therapists and advertise their practice,” he said in an interview here.

On the mushrooming of beauty salons – many with claims to be able to transform a person from top to toe according to their ideal image – Dr Chua admitted:

“My ministry is handicapped in the absence of the regulations.”

In the absence of regulations, there are no official records or statistics on such beauty treatments except for the botched jobs that end up in court.

In 1994, a restaurant owner, Soo Yok Lin, sued beautician Linda Lee Yoke Sim for damages for a botched breast surgery allegedly done by Lee.

Lee was ordered to pay RM87,920.62 to the mother of four, who lost her breasts after a botched breast enlargement treatment.

Dr Chua said those adamant at going under the knife for beauty reasons should go to a recognised plastic surgeon and not be taken in by advertisements.

According to a ministry official, the regulations would cover health and beauty treatments using modern methods, while the traditional ones like reflexology and massages would come under a new law – the proposed Traditional Medicine Act.

Tuesday, August 17, 2004

Policy on organ transplant to be reviewed

KUALA LUMPUR - The policy allowing transplant of organs from unrelated living donors is to be reviewed, said Health Minister Chua Soi Lek yesterday.

He said the medical fraternity worldwide viewed the practice as unethical as it could encourage trade in human organs.

Malaysia is one of only three countries that allow such transplants.

'We have specialists who argue that unrelated organ transplant...is unethical and should not be encouraged,' Dr Chua said.

'We will evaluate the policy if it can be allowed or not. We want to protect the image of the Malaysian medical fraternity...we are looking into it seriously.'

Such transplants are authorised after donors are evaluated by specialists, a three-week process.

'When the authorities evaluate the donors, the media says that three weeks is too long and that it is a bureaucratic process or red tape that was hampering efforts to save a patient.

'The other two countries which allow unrelated organ transplant take up to six months to give their approval,' Dr Chua said.

But transplants involving related donors would not be banned, he added.

He encouraged Malaysians, particularly Muslims, to opt for organ donation, allowing organs to be removed after they die.

According to Health Ministry statistics, Chinese accounted for 80 per cent of the people from whom organs had been removed after death, Indians 10 per cent and other races the rest, he said.

'I am surprised with this because as far as I am made to understand, Islam does not disapprove of Muslims donating their organs after their death,' he added. -- Bernama
Overloading at QEH

Kuala Lumpur: The nationwide re-deployment exercise of doctors and nurses involving 117 government hospitals has been prompted by “overloading” as experienced in the Queen Elizabeth Hospital in Sabah.

Health Minister Datuk Dr Chua Soi Lek said the failure to distribute manpower based on “actual workload” has resulted in either under-utilisation in some hospitals or “overloading” in others.

“Last year, 61 of the 117 hospitals nationwide had a bed occupancy rate of below 50 per cent, the lowest being Hospital Daro in Sarawak with 9.8 per cent.

“This is in contrast to those filled to the brim, like the Queen Elizabeth Hospital in Sabah with 99 per cent bed occupancy rate and over 1,000 outpatients daily,” he said.

Dr Chua attributed this to the rigid deployment method used - one doctor for 28 beds and one doctor for 50 out-patients daily.

He said a minimum of seven doctors have been allocated for each district hospital but some have up to 10.

Increase in hospitals in recent years further aggravated the “so-called” shortage of some 3,000 doctors and 4,000 nurses in the country, he added.

There are 11,500 doctors and 28,000 nurses in the government hospitals nationwide.

Dr Chua said construction of new hospitals would also be put on hold for the Government to focus on the consolidation exercise.

The 177 hospitals have 28,633 beds with 5,456 beds available in special medical institutions like Pusat Tibi Negara, Hospital Bahagia, Hospital Permai, Hospital Bukit Padang, Hospital Sentosa and RCBM Sarawak.

“Deployment from now on will be based on the actual workload,” he said, adding that transfers would be confined within the State to reduce the impact on those involved.

Nurses would undergo the same exercise.

Malaysian Medical Association President Datuk Dr N. Arumugam said that redeployment would be a complicated process.

“It will make some difference but it will only ease the problem slightly.

There are doctors who are idling in some places. They should be shifted only if the bed occupancy rate is constantly low and not fluctuating,” he added.

On the Ministry’s statement that it had repatriated between 10% to 20% of 700 foreign doctors because of sub-standard performance, Dr Arumugam said problems emerged when the doctors were placed in smaller hospitals and expected to do a wide scope of jobs.

“We have had complaints on the language problem. There is also a need to restudy the salary structure, which is not fantastic compared to that of developed countries.

“The selection process of up to six months is also a long time and the candidates might take up posts elsewhere,” he added.

Setting up private wings need study, says MMA

MMA President Datuk Dr N. Arumugam urged MMA Sabah to look seriously into the shortage of doctors in Sabah.

He said what made this acute in East Malaysia are distance and geographical factors.

He also said MMA hoped the Health Ministry would consider implementing related courses for doctors, especially in the public service, instead of the Skill Level Exam, which has caused much confusion, under the Malaysian Remuneration Scheme.

On the proposed setting up of a private wing in select hospitals, he said this needed to be implemented carefully since a study by MMA showed that there were apprehensions among certain quarters.

He urged doctors to continue gathering and update knowledge especially through Information Technology.

He said there were many advanced and sophisticated medical tools available and this was a challenge for doctors, to keep the healthcare cost at the optimum level while providing the best healthcare service.

He said the MMA had also take the initiative to create the software for the electronic medical record keeping to help better administrative of records.

Dr Arumugam was pleased to note that MMA Sabah had admitted medical college students as members and hoped more could be enrolled into the association.

The MMA Sabah branch 2004/2005 committee are Chairperson Dr Melinda Tong, Vice-Chairman Dr Jagdev Sidhu, Secretary Dr Anil Kumar Kukreja, Treasurer Dr Mariam George, Schomos Chairman Dr Mohd Hatta Tarmizi, PPSMMA chairman Dr Sarvananthan Shanmugam, CME chairman Dr Liaw Yun Haw, committee members Dr Elizabeth Emmanuel, Dr Pulivendhan, Dr Sharon Paulraj and Dr Sumithra Sannasey.

Monday, August 16, 2004

Doctors and nurses to be redeployed

KUALA LUMPUR: A nationwide re-deployment exercise of doctors and nurses involving 117 government hospitals is underway to serve the people better.

“Last year, 61 of the 117 hospitals nationwide had a bed occupancy rate of below 50%, the lowest being Hospital Daro in Sarawak with 9.8%.

“This is in contrast to those filled to the brim, like the Queen Elizabeth Hospital in Sabah with 99% bed occupancy rate and over 1,000 outpatients daily,” he said in an interview here yesterday.

Dr Chua attributed this to the rigid deployment method used – one doctor for 28 beds and one doctor for 50 out-patients daily.

He said a minimum of seven doctors have been allocated for each district hospital but some have up to 10.

The mushrooming of hospitals in recent years further aggravated the “so-called” shortage of some 3,000 doctors and 4,000 nurses in the country, he added.

There are 11,500 doctors and 28,000 nurses in the government hospitals nationwide.

Dr Chua said construction of new hospitals would also be put on hold for the Government to focus on the consolidation exercise.

The 117 hospitals have 28,633 beds with 5,456 beds available in special medical institutions like Pusat Tibi Negara, Hospital Bahagia, Hospital Permai, Hospital Bukit Padang, Hospital Sentosa and RCBM Sarawak.

“Deployment from now on will be based on the actual workload,” he said, adding that transfers would be confined within the state to reduce the impact on those involved.

Nurses would soon undergo the same exercise, he added.
KL stops hiring foreign doctors

MALAYSIA has kicked off a major revamp of its health-care sector with plans to phase out its reliance on foreign doctors and to redeploy manpower nationwide to tackle the problem of overworked hospitals and underutilised ones.

The Health Ministry has terminated the services of 22 foreign doctors, citing communication problems and incompetence as reasons, as it moves towards phasing out foreign doctors completely by 2009.

'We are not keen to continue our reliance on foreign doctors,' Health Minister Chua Soi Lek said on Friday.

The only foreign doctors still being recruited are from Myanmar as they can speak English and were trained in Britain, he said.

About RM40 million (S$18 million) is spent annually on salaries for some 730 foreign doctors from Bangladesh, Indonesia, India, Pakistan, Egypt, Myanmar and Canada.

A nationwide redeployment of doctors and nurses at 117 government hospitals is also under way.

'Deployment will be based on actual workload,' he said.

There are 11,500 doctors and 28,000 nurses in government hospitals nationwide.

Last year, 61 hospitals had a bed occupancy rate of less than 50 per cent. -- New Straits Times, The Star/Asia News Network

Sunday, August 15, 2004

Firetraps in hospitals

PETALING JAYA: Some private hospitals are potential firetraps and also operating without a valid licence from the Health Ministry.

Sources said such hospitals, including one in Kuala Lumpur that was well-known, had not obtained fire safety certificates from the Fire and Rescue Department because they had failed to meet safety requirements – staffing and physical facilities on fire safety – as required under the Private Hospitals Act 1971.

“The electrical wiring of some of these hospitals are also in question while some did not have fire insurance coverage,” said a source, who noted that the Act to regulate private hospitals stopped short of empowering the ministry to shut down such illegal hospitals.

“Such illegal hospitals are simply exposing patients, in particular, to danger,” said a senior medical specialist.

He pointed out that the quality of electrical wiring in hospitals was important because hospitals used various equipment, including those needing a high voltage.

The specialist also said that hospitals should conduct regular fire drills to train and familiarise staff on how to cope with emergencies – from the handling of equipment like fire extinguishers to evacuating patients, who were not so mobile, to safety.

“The ministry should expose hospitals operating illegally for the public to make an informed choice.

“Patients can also ask hospitals whether they had a valid licence before deciding to seek treatment,” said the specialist.

Fomca adviser Datuk Prof Hamdan Adnan said the Fire and Rescue Department should alert local authorities, who were empowered to close down illegal premises, to act on illegal hospitals.

“The department is equally responsible if it failed to alert the authorities concerned should a fire break out in the illegal hospitals,” he added.
Mercy Malaysia needs RM2 million for Sudan relief

KUALA LUMPUR, Aug 13 (Bernama) -- The Malaysian Medical Relief Society (Mercy Malaysia) needs to raise at least RM2 million to fund the medical assistance and support the administration for Sudan relief work.

Mercy Malaysia Team Leader and Exco member Dr Heng Aik Cheng said Mercy Malaysia planned to use 96 per cent of the fund for medical aid and the remaining four per cent for administration.

He said Mercy Malaysia proposed to set up a proper Maternity and Child Health Clinic for the women and children who made up 75 per cent of the population in West Darfur.

So far, Mercy Malaysia had collected about RM5,000.

"We are also appealing for medical volunteers as well as non-medical personnel to contact us for the project. Besides, we also need Arabic-speaking volunteers to serve as translators," he told a press briefing on Mercy Malaysia's visit to Sudan at its headquarters here Friday.

Dr Heng said there were only 84 beds to accommodate 8,000 internally displaced persons in El-Geneina hospital in West Darfur.

The worst part was that 8,000 IDPs are only from the Al-Riyadh camp, one of four camps in El-Geneina with 8,000 to 12,000 population per camp which faced main health problems such as Hepatitis B, malaria, bloody diarrhoea and malnutrition.

"I led a team of four to El-Geneina last two weeks and we returned yesterday. During our visit, we observed the condition of the hospital.

"From the observation, we have also decided on what kind of medical assistance need to be given to the IDPs in Al-Riyadh camp," he said.

To build cooperation in terms of medical assistance, Mercy Malaysia had signed a Memorandum of Understanding (MoU) with Sudanese Minister of Health Abu Salam.

"The MoU spells the readiness of Mercy as the only Asian country non-governmental organisation (NGO) to renovate the hospital, put up shelters and provide the doctors and child specialists," he said.

Six relief teams involving about 60 staff would be sent to Sudan, with the first team scheduled to leave on Aug 20.

Saturday, August 14, 2004

Government ‘dissatisfied’ with foreign doctors

PENANG: Malaysia spends RM40mil a year on foreign doctors but is not getting the expected standard of healthcare service from them, the Health Ministry said.

Parliamentary secretary Lee Kah Choon said between 10% and 20% of the 700 foreign doctors in the country had to be repatriated because of sub-standard performance.

“We are looking into employing more doctors from Myanmar as most of them meet our expectation. This could be due to the British system still used in their medical curriculum.

“We need to employ foreign doctors to fill the shortage (in the healthcare service). But at the same time, we do not want to be compromised by sub-standard doctors,” he told reporters during a visit to the Penang Hospital yesterday.

He said the foreign doctors employed currently were from countries such as Indonesia, Bangladesh, India, Pakistan and Egypt.

Lee said one-stop ambulance call centres would be set up in eight locations including Penang, Kuala Lumpur, Perlis and Johor Baru by the end of the month.

Penang Hospital Emergency Department head Dr Teo Aik Howe said the Penang Emergency Ambulance Radio Link (PEARL) would start by the end of the year to link all ambulance operators in the state.

Among those involved in the PEARL project were the state health department, Penang Hospital, Malaysian Communication and Multimedia Commission, Penang Municipal Council and Motorola.

He said the department planned to set up motorcycle squads, which will provide first aid to those who need it urgently while waiting for the ambulance to arrive.

Lee said ambulances from health clinics would, starting next week, be used to help in emergencies, adding that such a community-based ambulance service would ease the burden on government hospitals.
Up to 20pc foreign docs booted out: Ministry

Penang: Health Ministry Parliamentary Secretary Lee Kah Choon disclosed that between 10 and 20 per cent foreign doctors and medical experts recruited by the Government to work in Malaysia had to be sent back as their service was not up to the standard required.

Language, background and cultural differences were among the reasons why they had failed to perform their duties well, he told reporters when visiting Penang Hospital, here, Friday.

He said at present, most foreign doctors in Malaysia were from Indonesia, Bangladesh and Pakistan, and lately, the Government was eyeing to recruit more doctors from Myanmar as they had been said to have the capability in providing good service.

On the cost borne by Government in recruiting foreign doctors, Lee said the Government spent about RM40 million annually to pay their salaries.

“The Government need not have to spend that much money if we have enough local doctors,” he said, and added that the Health Ministry was currently facing a shortage of not only doctors, but also nurses and pharmacists as well.

Despite the shortage, the Government would continue to provide the best health service including recruiting foreign doctors so that service to the people would not be affected, he said.

Presently, there were between 600 and 700 foreign doctors and medical experts working in hospitals nationwide, especially in Sabah and Sarawak, he said.

On the shortage of ambulance service, Lee said the Health Ministry would establish eight ambulance co-ordinating centres to optimise the use of work force and vehicles.

With the setting up of such centres, all ambulances belonging to hospitals and health clinics would be co-ordinated to give wider coverage, he said.

“We do not want to see some drivers and paramedics not fully utilised in certain areas,” he said adding the project would be implemented in phases starting this month. - Bernama

Friday, August 13, 2004

Five million Malaysians suffer from mental woes

ABOUT five million Malaysians are suffering from different types of mental problems, and the number is on the rise, reported China Press.

It said that in 1996, adult mental patients accounted for 11% of the population and children, 13%.

The number of adult patients had now gone up to 20-25%, it said.

The daily quoted Health Ministry parliamentary secretary Lee Kah Choon as saying that the jump in the number of such patients resulted from the fast diagnosis of the problems and public awareness of the illness.

“The public has started to realise that mental problems are not incurable and that has resulted in more patients coming forward to ask for help,” he said.

However, he said that many people still felt that having mental problems was a stigma, which prevented them from seeking help from doctors and experts.

He said in order to overcome the problem, the ministry would promote various activities, including encouraging the people to have a mindset change towards mental patients.

Malaysian Mental Health Organisation president Dr Rabindran Gonzaga told the daily that 90% of these patients would not hurt others.

He said many people tend to stay away from these patients as they were frightened by sensational news.

Thursday, August 12, 2004

200 medical students left in the lurch

OVER 200 students pursuing medical degrees overseas are now left in the lurch, as the universities they had enrolled in are not recognised by the Malaysian Government, Tamil Nesan reported.

Quoting MIC vice-president Datuk S. Veerasingam, the paper said students who returned to Malaysia with these unrecognised certificates face numerous problems when applying to practise medicine in the country.

Indian students were among those studying medicine abroad due to the shortage of places in local public universities, he said, advising those concerned to check with the Education Ministry on the suitability of their courses.

Veerasingam, who was speaking at a Puteri MIC gathering in Tapah, Perak said students applying for overseas courses could consult the MIC.

On a related matter, the daily reported that Education Minister Datuk Hishammuddin Tun Hussein would launch a three-day seminar for Tamil schoolteachers tomorrow.

Quoting MIC president Datuk Seri S. Samy Vellu, the paper said the seminar would be held at Universiti Malaya.

Malaysia Nanban reported on the places for non-bumiputra students at the Mara Junior Science Colleges.

It quoted Mara director-general Datuk Jamani Mohd Nor as saying that only 70% of the 400 places allocated for non-bumiputra students in these colleges had been taken up.
Uni to accept offshore doctors

MONASH University will set up the nation's first offshore medical school next year in a move that could allow more than 100 foreign graduates from its Malaysian campus to practise in Australia without further training.

The Australian Medical Council, the body responsible for accrediting graduates from medical schools, is holding talks with the Melbourne institution about whether to permit the graduates to practise in Australia without additional study.

"It's a bit up in the air because the AMC, under its present constitution, can't accredit courses outside of Australia," said the council's executive officer, Ian Frank. But Monash vice-chancellor Richard Larkins said the Malaysian course would be on par with the medical degree offered in Melbourne, so there should be no issue with Australian accreditation of international students.

"There would have to be the AMC accreditation of the program, but since it's the same program that occurs in Australia, and we're making sure the quality of the facilities and all the other activities are comparable, we don't anticipate any problem," Professor Larkins said.

Mr Frank said he was concerned Monash had indicated it would not differentiate between graduates from its Australian school and the Malaysian school.

Wednesday, August 11, 2004

Malaysian women have one-in-19 chance of getting breast cancer

A Malaysian woman has a one-in-19 chance of getting breast cancer in her lifetime if no other causes of mortality are in operation throughout her life.

However, what is more worrying is that many Malaysian women tend to seek traditional remedies for the disease and only turn to the hospital when it is too late.

“It is a common trend that almost all the (cancer) patients we see go for herbal or traditional treatment first before coming to us, and by then it is sometimes too late,” said Dr Hisham Abdullah, head of the Endocrine Department at Putrajaya Hospital.

“We are not against traditional medicine (practitioners) but if they have a magic bullet to treat (cancer), then come forward and share it with us. We can put it on trial and do some research.”

He told reporters this after the launching of the ‘Avon Kiss Goodbye to Breast Cancer Campaign’ and the handing over of an ultrasound machine to Hospital Putrajaya which was officiated by Health Minister Datuk Dr Chua Soi Lek yesterday.

According to Malaysia’s first National Cancer Registry Report in 2002, breast cancer accounted for 30.4 per cent of the 4,337 cancer cases among Malaysian women of all ethnic and age groups beyond the age of 20, making it the commonest type of cancer among women.

A recent report in the World Journal of Surgery also showed that breast cancer in Malaysian women occurs more commonly in younger women aged 40 to 49 compared with Western women who develop it when they are 50 to 59.

Dr Hisham said the incidence of breast cancer among the younger group was high and studies were being done to determine the cause, apart from genetic factors.

“There are a lot of possibilities and some research is being done to look into this,” he said.

Earlier in his speech, Dr Chua said that according to the Penang Cancer Registry, only 15.4 per cent of breast cancer patients go early for medical treatment, unlike in the West, where almost 75 per cent seek early treatment.

“It is likely that a negative socio-cultural perception of breast cancer, and strong belief in traditional medicine in developing countries have contributed to this delay in seeking treatment at hospitals and clinics,” he said.

He said many Malaysian women do not practise breast self-examination and a survey by the Ministry in 1996 showed that only a third of women practised self-examination or had their breasts examined by health care providers.

“This figure is low compared to the proposed rate of over 60 per cent that would be necessary for a significant lowering of morbidity and mortality from breast cancer,” said Dr Chua.

Women above 20 are advised to perform breast self-examination regularly while those above 30 are advised to get an annual breast examination by health care providers.

However, a limited study by the National Population and Family Development Board in its clinics in 2002 found that 89 per cent of the respondents did breast self-examination.

“Let us hope this is reflective of the trend nationwide,” said Dr Chua, stressing that women should use the services of the breast clinics in all State hospitals as well as the district hospitals in Muar, Kluang and Taiping.

The RM250,000 Medison Sonace ultrasound scanner donated by Avon Malaysia helps to detect lumps in a patient’s breast upon which further examination can be done using the Mammotome Breast Biopsy System which the company also donated to the hospital last year.

The funds for the purchase of the ultrasound scanner was raised through the sale of Avon’s Pink Ribbon Pin and Woman of Earth Purse Concentre.

Also present were Putrajaya Hospital director Dr Abu Bakar Mohamud, Avon Malaysia president Mansoor Wan Abdullah and Avon’s Celebrity spokesperson Erra Fazira.

MMA lauds government directive on clinical service

PETALING JAYA: The Malaysian Medical Association (MMA) has given the thumbs-up to the Government’s directive requiring all district-level hospital directors and health officers to do clinical work.

MMA president Datuk Dr N. Arumugam said the move might help overcome some of the critical shortage of doctors experienced in many districts.

The directive was announced by Health Minister Datuk Dr Chua Soi Lek on Monday.

Under the directive, directors and health officers are required to be on call and do ward rounds and to treat patients at the outpatient department.

However, he said it was up to the officers to decide how many hours they want to set aside for clinical work.

Monday, August 09, 2004

Clinical work made compulsory for hospital directors and health officers

KUALA LUMPUR: Clinical work is now compulsory for about 300 district-level hospital directors and health officers as part of the Health Ministry's efforts to boost its human resources.

Health Minister Datuk Dr Chua Soi Lek said these doctors should handle management and administration besides clinical governance.

"Doing clinical work will increase their knowledge and skills. It will be a condition as part of their competency evaluation for promotion.

"Their clinical work will be incorporated into the competency level. If they don't do it, it will be susahlah (difficult). This will also lower the perception that doctors who are directors are only warming their seats," he told reporters on Monday after meeting state health officers, hospital directors and division officers.
Health: Beware the deadly link

PEOPLE who have diabetes are two to four times more likely to suffer from cardiovascular disease, be it heart attack or stroke.

The risk of heart failure for them is two to three times greater than for non-diabetic people, while stroke occurs twice as often in people with diabetes and high blood pressure, compared with those who only have high blood pressure.

Professor S.P. Chan, president of Malaysia Diabetes Association, says that many people tend to be unaware of the link between diabetes and cardiovascular diseases. For diabetics, this lack of awareness can be dangerous.

“People are generally more worried about their heart, but do not realise that a heart attack or stroke is highly predisposed to those with diabetes,” says Chan, an endocrinologist and diabetologist at Universiti Malaya Medical Centre who has more than 20 years’ experience in the field.

“Therefore, if one is a diabetic, one should also be treated for cardiovascular diseases.”

Chan says the Collaborative Atorvastatin Diabetes Study (CARDS), which was presented recently at the annual meeting of the American Diabetes Association, plays an important role in reducing the risk and burden of diabetes and cardiovascular-related deaths.

CARDS, the largest endeavour specifically designed to study the effects of statin (a cholesterol-fighting drug) in diabetes patients, ended almost two years earlier than expected due to the emergence of significant findings.

Through the study, more than 2,800 people with Type 2 diabetes, no history of heart disease and relatively low levels of cholesterol, were found to have notable reduction in heart attacks and strokes after being treated with atorvastatin 10mg, a cholesterol-lowering medication. Patients treated with this drug had a 37 per cent reduction in major cardiovascular diseases, which included heart attacks, strokes and cardiac resuscitation, among others.

CARDS, which was initiated in Britain and Ireland, is a collaboration between Pfizer, University College London, Diabetes United Kingdom and the British Department of Health. This second landmark atorvastatin study ended early due to a significant cardiovascular benefit seen in patients.

Type 2 growing at epidemic rate

Says Chan: “Type 2 diabetes or non-insulin dependent diabetes is increasing at epidemic proportions worldwide, and an estimated 170 million people worldwide suffer from diabetes, which is a leading risk factor for cardiovascular disease. The majority of people with diabetes, roughly 65 per cent, will suffer a heart attack or stroke, a rate that is up to four times higher than adults without diabetes.”

Of the estimated 1.2 million diabetic cases in Malaysia, 98 per cent have Type 2 or non-insulin-dependent diabetes, a situation where the body is unable to make enough or properly utilise insulin.

“To make it worse, most diabetics were not aware that they had the disease, as half of them do not show any classical symptoms of diabetes. It comes as a big shock to them to learn that they have diabetes,” says Chan.

“Cardiovascular complications also occur at an earlier age in people with diabetes. More than half of all the diabetic patients have high blood pressure or elevated total cholesterol levels, and many have both these conditions.”

The scenario is worsened by the fact that cardiovascular disease is responsible for between 50 and 80 per cent of deaths in people with diabetes. Chan says the majority of the global burden of diabetes is due to an increased risk of cardiovascular risk.

“In 2002, heart disease and related diseases of pulmonary circulation was the second principal cause of death in government hospitals, making up some 15 per cent. The majority of heart patients in Malaysia are in their 40s and 50s, while in other parts of the world, it is 50 and above. We are seeing a trend in Malaysia where younger people are becoming diabetics, and experts are attributing this growth to genetics, obesity and lack of exercise.

“Besides that, 70 to 75 per cent of diabetics die due not to kidney failure or limb amputations, but to a heart attack or stroke. I think the urgency in preventing diabetes and keeping it at bay has not sunk in with the general public. There is no realisation that diabetes and heart attack are connected. Diabetes is one of the main reasons why diabetics develop cardiovascular diseases.”

Chan says that over the years, she has found more cases of younger people becoming diabetics.

“The focus has to be on preventing diabetics from suffering cardiovascular complications. If you have diabetes, do not overlook the risk factors like hypertension and lipid disorder. It is crucial that they be treated aggressively to prevent diabetics from developing malignant complications,” she says.

“The wrong emphasis has resulted in diabetics ignoring the risk factors. They get so worried about wanting to look after their heart that they forget that it is the diabetes that has caused the heart problem. Diabetes is insidious and it can take five to seven years before it surfaces and is detected.”

Lifestyle, says Chan, is an obvious factor that determines the development of diabetes.

“People are more and more sedentary in their lifestyles, and many are underestimating their individual risk in contracting diabetes. Because they do not think they are at risk, they therefore do nothing to prevent diabetes,” says Chan.

“And our achievement-oriented approach to life is not helping. Instead of looking after our health, people are spending long hours at work and children too are no longer going out to play. If this goes on, the greatest worry is that we will see a further increase in Type 2 diabetes, especially among the young.”

Benefits of using statins

National Heart Institute senior consultant cardiologist and Cardiology Department head, Datuk Seri Dr Robaayah Zambahari, said the CARDS data has added to the growing evidence that supports the early and significant benefits of treating patients with statins.

“We now have the option to treat high-risk patients at an earlier stage and hence, better the chances of preventing a heart disease or stroke,” she says.

“The CARDS results have shown that cholesterol-lowering treatment such as atorvastatin is beneficial to patients with diabetes.”

The National Heart Institute had been administering the atorvastatin drug in its heart patients for almost six years now.

“We look at the heart patient’s cholesterol level because different statins have different strengths. Atorvastatin is the most potent of the statins, but not all patients will need it. A patient with a mildly elevated cholesterol level can do with a mild statin but a patient with a high cholesterol level will require the most potent statin and in bigger doses, together with a combination of other medication.

“I believe we should look at the quality of life. We advise patients to cut down on high cholesterol in their food and if they cannot achieve the targeted cholesterol level, then they can use a statin. It is very safe.”

Perak MCA seeks more volunteer docs

IPOH: Perak MCA is looking for volunteer doctors from outside the Kinta Valley to join its community medical team which provides free service to the poor.

Its chairman, Datuk Ong Ka Chuan, said some of the doctors in Taiping, Parit Buntar and Kuala Kangsar had shown interest in serving with the community medical team.

“We hope to expand our service to areas outside Kinta Valley so that more people, especially those from the lower income group, can benefit from it.

“Currently we can only provide the service in the Kinta Valley as some of the volunteer doctors are on call even on weekends,” Ong said, adding that the team was established in May.

He said the team, comprising 10 doctors, was led by the Perak MCA Medical Bureau chief Dr Choo Kwong Foong.

“We hope to create an awareness on health and enable those from the lower income group and rural areas to get proper medical care.

“In the long run, we hope to build a community hospital to benefit the poor,” he told reporters after launching the programme at the Ampang Baru community hall here yesterday.

About 200 villagers came for health check-ups and a talk on health by Dr Koh Wai Ke
Guess what you should not be eating

The next anti-cancer advertising line could just be this: ready-to-cook, ready-to-serve, ready-to-eat ... and ready-to-die?

For, a year-long study has found that 70 per cent of Malaysians struck by the deadly disease consistently down yummy items like Ikan bilis, ikan masin, belacan and udang kering bought off the shelves of supermarkets.

The study, conducted by Universiti Kebangsaan Malaysia's Faculty of Allied Health Science, found that cancer patients, especially those living in coastal states, liked such salty and highly-preserved foods.

"There might be something in the food which causes cancer," said National Cancer Council (Makna) president Datuk Mohd Farid Ariffin.

"We have asked the faculty to do further studies on this. We believe that such foods may be loaded with salt and preservatives." The study, sponsored by Makna, is headed by the Faculty's Department of Nutrition and Dietetics head, Associate Professor Dr Fatimah Arshad.

An official announcement on the study will be made once the research is completed.

Farid said when people ate such food and did not do exercise regularly, the toxins that accumulated in their bodies could not be eliminated easily.

"We know that high levels of nitrate in preservatives are carcinogenic," he said, adding that Malaysians should pay attention to the foods they bought.

"They go into supermarkets and buy ready-to-cook and ready-to-serve and ready-to-eat food items. These may be genetically modified or overly processed. They may not have many nutrients." He said although he did not want to alarm Malaysians, they had to pay attention to their diet as 40,000 new cases of cancer were being seen yearly.

A total of 26,089 cancers were diagnosed in 2002. More than 11,800 were men and over 14,200 were women.

"Cancer is on the rise," said Farid after witnessing the launch of the first major cancer awareness and screening campaign at a hotel today.

In men, the most common cancers are leukaemia, lung, nasopharynx, colon, rectum and prostate. In women, they are leukaemia, breast, cervix, colon, ovary and lung.

Malaysia has the world's highest rate of nasopharyngeal (nose) cancer for females and the second highest rate for males.

Farid said Makna, together with UKM, would also do studies to determine whether diet, cooking oils and cooking styles were factors which caused cancer.

The Chinese tend to suffer from breast, lung, and nasopharyngeal cancer; Indians, mouth, larynx, oesophagus and tongue cancer, and Malays, thyroid cancer, lymphatic leukaemia and lymphoma.

Earlier, Health Ministry's parliamentary secretary Lee Kah Choon said medical advances had made a third of all cancers preventable and a further one third — if diagnosed early — potentially curable.

He said a woman in Malaysia had one in 19 chance of getting breast cancer and of 100 women afflicted, 30 would have breast cancer. The Makna, Pathlab and Parkson cancer screening campaign offers general health screening, cancer marker screening and breast cancer screening. The campaign will run from Aug 5 to Dec 31 at various Parkson outlets

Sunday, August 08, 2004

Microbiologist honoured by university

Microbiologist Datuk Dr Lam Sai Kit, 66, who headed a medical team that discovered the Nipah virus, has been appointed Professor Emeritus of Universiti Malaya.

Dr Lam was named Professor Emeritus at the university's Convocation by its Vice-Chancellor Datuk Prof Dr Hashim Yaacob.

He was among 12 academics conferred the title.

In a citation read out by the UM Medical Microbiology Head of Department, Assoc Prof Dr Hamimah Hassan, Dr Lam, who had served for 37 years with the university, was described as a man who possessed admirable vision, dedication and commitment.

“Like a beacon on a hill, he provided the path for those he trained and guided them to achieve excellence,” Dr Hamimah said.

“The motto commitment to the path to excellence has served well for those who worked with him,” said Dr Hamimah.

Dr Lam's involvement in emerging infectious diseases led to the discovery of the new virus like the Nipah Virus through the research team that he headed.

The finding automatically placed Universiti Malaya as the main university for viral research particularly after the research's team's efforts in controlling and identifying the cause of several outbreaks like the Enterovirus 71 encephalitis in 1997, the Nipah virus encephalitis in 1998 and the Chickugunya polyarthritis in 1999.

Ipoh-born Dr Lam join UM's Department of Medical Microbiology as a lecturer after earning his PhD in science from the Australian National University in 1966.

Although retired, he is still actively involved in scientific research and currently is the president of the Asia Pacific Society for Medical Virology, which has more than 400 members in 37 countries. – Bernama

Saturday, August 07, 2004

More housemanship hospitals to solve shortage of doctors

BATU PAHAT: More hospitals will be designated for medical graduates to do their housemanship to ensure that new doctors can practise when they have completed the compulsory one-year stint.

Health Minister Datuk Dr Chua Soi Lek said the move would help to solve the problem of shortage of doctors, especially in “busy” hospitals, adding that housemen could help out in providing treatment to patients.

He said five hospitals would be upgraded for the purpose, including the Batu Pahat Hospital which would receive between 12 and 20 housemen next year.

In the next three years, a hospital each in Perak, Selangor, Sabah and Sarawak would also be used for the same purpose, he said.

“More medical students will be graduating in the near future and if we cannot provide places for them to do their housemanship, then they cannot practise as doctors,” he said after visiting the Batu Pahat Hospital yesterday.

To date, only 28 of 124 government hospitals take in medical graduates to do their housemanship and from the 1,246 who graduated last year, only 91 could do so due to limited space.

Dr Chua anticipated that about 1,200 medical students from local institutes of higher learning would graduate annually and another 300 would return with a medical degree from abroad.

He said medical students would carry out their housemanship in five areas of specialisation – medical, obstetrics and gynaecology, general surgery, orthopaedics and paediatrics.

Dr Chua said that about RM500,000 had been approved to upgrade equipment and facilities at the Batu Pahat Hospital in anticipation of receiving housemen next year.

On another matter, Dr Chua said government hospitals faced problems in getting foreigners seeking medical treatment here to pay higher rates as they “just refused to pay.”

“For humanitarian reasons, we cannot shoo them away but we will have to find a way to settle this issue,” he said.

Wednesday, August 04, 2004

Guidelines on aid for NGOs

KUALA LUMPUR: The authenticity of NGO health-related activities and the financial background of these organisations will be checked before they qualify for financial assistance under the new Health Ministry guidelines next month.

Minister Datuk Dr Chua Soi Lek said there were no guidelines at the moment to monitor aid given to NGOs for such activities, which mainly dealt with providing treatment at haemodialysis centres.

“NGOs are also not required to reveal their accounts prior to their applications and the guidelines will allow our officers to check their financial standing.

“Under the guidelines, officers will go down to the ground to check if the NGOs’ activities are genuine,” he said at a press conference after a cheque presentation to underprivileged children organised under the Munchy’s Make Me Well Charity Campaign here yesterday.

Dr Chua said that last year the ministry gave out RM20.2mil to NGOs, of which RM17mil were for treatment subsidies for haemodialysis patients at 68 NGO centres.

From the remaining amount, RM2mil was paid out as matching grants for eight new haemodialysis centres and the rest shared by 13 other NGOs.

Dr Chua said this meant that NGOs had to rely on fund-raising campaigns or private donations, adding that the private sector should exercise their social responsibility to help them.

Dr Chua said he was confident the guidelines would allow aid to be given out within three months of receiving aid applications from NGOs.

“Previously, financial assistance was given out on an ad hoc or case-by-case basis.”

Dr Chua said although there was no limit to the assistance given to NGOs, the government’s “ringgit for ringgit” matching grant for haemodialysis centres was capped at RM380,000.

Earlier, Dr Chua handed out RM100,000 raised under the campaign for nine disabled centres and two children requiring funds for immediate heart and bone marrow surgery.

Five-month-old Paul Prevaiz Gill and Norshafika Izzat Zakaria were the recipients.

Tuesday, August 03, 2004

Ministries to discuss shortage of docs

Melaka: Health Minister Dr Chua Soi Lek says the country’s doctor shortage has prompted him to discuss with officials from the Higher Education Ministry on ways to alleviate the problem.

The country’s doctor-patient ratio of 1:1,420 is still way behind the 2020 target of 1:650, he said, adding that while the situation in Kuala Lumpur may be good at 1:440, for Sabah, Sarawak, Kelantan and Terengganu, the ratio of 1:2,600 was not satisfactory.

“The Government’s aim is not just to increase the number of doctors but also to maintain their quality, as international and local recognition will enable them to do post-graduate courses overseas,” he said at the second convocation of the Melaka Medical College-Manipal where 141 graduates received their scrolls.

At present, he said, the Government recognised medical degrees from 450 foreign universities in 30 countries, as well as degrees from six public and four private local universities.

Two public and seven private universities have also been given the go-ahead to run medical courses, he added.

Medical graduates from universities not recognised by the Government, he said, could undergo training at Universiti Malaya, Universiti Kebangsaan Malaysia or Universiti Sains Malaysia before being allowed to sit for examinations and register with the Malaysian Medical Council if they passed in less than three sittings.

There are some 200 medical graduates from unrecognised universities, mostly from Indonesia, India and China. - Bernama

Monday, August 02, 2004

Helping families with disabled members

ALTHOUGH Malaysia aspires for developed status, there is still a lot that needs to be done in terms of support services given to families with disabled members.

According to Prof Steven Daley from California State University, Sacramento's Department of Special Education, Rehabilitation and School Psychology, special education and rehabilitation services are universally available to all children with disabilities and their families.

''In Canada, the United States, countries in Western Europe and Japan, there is an explicit legal mandate that serves as a foundation for special education and rehabilitation services.

''When special education services are framed by enabling legislation, the critical factor of equal access is squarely addressed in a way that insures all children with disabilities will be provided with free and appropriate public education,'' he says.

In developing nations, Prof Daley says it is important to implement federally mandated services that reflect international standards.

''Vision 2020 articulates a brilliant and persistent commitment to the development of a caring society. The next logical step for the country is to implement federal legislation that will provide full access to special education services for all of Malaysia's children with disabilities,'' he opines.

Organised by the Universiti Malaya (UM) Centre for Family Development with the support of Yayasan Budi Penyayang Malaysia and the Women, Family and Community Development Ministry, the one-day forum brought together parents, government representatives and experts in special education.

The theme of the forum, Nurturing Family Life: Effective Partnerships encapsulates the most pressing issues faced by individuals with special needs and their families.

Organising committee chairman Sandiyao Sebestian says families are the building blocks of society and strong family units build a healthy society.

''The families of persons with disabilities are very much a part of society and every effort should be made to ensure that these families feel included through effective partnerships,'' he says.

Prof Daley believes families are strong, critical partners in the development and implementation of high quality special education services.

“Families know their child the best and they have keen insight on what constitutes both the developmental goals and educational outcomes desired.

“The education of a child with special needs is a full-time job and families cannot be expected to manage this on their own,'' he says.

Teachers work with the child in school while parents have the lion's share of the responsibility for raising a child who often presents many challenges.

“Collaborative partnerships also require the provision of training and ongoing support to families so that they may better cope with the many demands of having a child who has special needs,'' he says.

Sebestian who is a UM lecturer, says when the United Nations extended its Asian and Pacific decade of the disabled, the 'Biwako-Millennium Framework' was formulated.

The main thrust of this regional framework is to work towards an inclusive, barrier-free and rights-based society for persons with disabilities.

Being a signatory to the framework, Malaysia is committed to making those targets a reality. A major step would be the fostering of effective partnerships.

“Inter-ministerial cooperation, for instance, among the ministries related to special needs such as education, health, works and women, family and community development, would make the lives of disabled persons and their families much easier,” he says.

At the same time, non-governmental organisations (NGOs), parents and families can also cooperate to promote an inclusive, barrier-free and rights-based society, he adds. Terry Brougham, who previously worked as a teacher for the hearing-impaired in the United Kingdom as well as a former advisory teacher in special education, shared a model of early intervention in the UK.

In the UK, children at risk are monitored by a health visitor (a nurse who has additional training and qualifications) and are usually referred to a paediatrician.

“If the diagnosis is confirmed, a referral is then made to the local education authority (LEA). A visiting special education teacher who is an expert in the field will work closely with colleagues from other disciplines and also the child's parents.” A visiting teacher will also visit the child's home and assess his educational needs. A statement of special educational needs will then be prepared,” he explains.

Brougham who is presently doing his masters in special education at UM, says the role of the visiting teacher is to work with and help the family to maximise the child's development opportunities.

During the dialogue session, a panel comprising individuals from the education and health ministries, fielded questions from the audience.

In answer to a mother who asked whether her daughter who is dyslexic would have a different set of exam papers from the other students in the UPSR, Special Education Department planning and research division director Dr Haniz Ibrahim explained that she could apply for extra time but would not get a different paper.

He also said the Education Ministry will be placing students with various disabilities together in one residential vocational secondary school for the first time.

“The new move would involve 100 students who are visually or hearing impaired or have learning disabilities,” he says. Kamariah Mohd Amin, who has a son with Down's Syndrome, also shared her experiences on how she and a group of parents worked to get special needs pupils accepted into mainstream schools while Wong Huey Siew from the Malaysian Association for the Blind, talked about the issues and challenges faced by parents with special needs children.

“I know my parents had problems in dealing with government agencies as they could not speak Bahasa Malaysia well,” he shares.

Wong had started his talk by explaining how a sighted person should lead someone who is sight-impaired. “Let the sight-impaired person hold your right elbow or shoulder. Don't hang onto his hand or walking cane,” he says.

Various workshops on the child's needs from early childhood, childhood, adolescence and adulthood were also held.

At the end of each workshop, participants were asked to come up with suggestions on how all the different parties could work more closely together to meet the needs of the disabled.

These included the need for a one-stop and coordination centre for more information, more inter-agency coordination, all teachers to be exposed to special education so they could recognise a child who had special needs, counselling for young parents to deal with having a special needs child and provision for disability pension.

The organising committee will compile a list of parents' needs from their evaluation forms as well as from the proposals from the workshops. “Once this has been done, we will prepare an action plan which will then be forwarded to the relevant government agencies,'' says Sebestian.

Prof Daley says the provision of special education services in an inclusive, barrier-free, rights-based context is an attainable goal.

“The quality of life for all Malaysians, those with and without special needs, will be further enhanced by developing partnerships between the relevant parties.”