Kuala Lumpur Hospital latest casualty of faulty air-conditioning system

KUALA LUMPUR: The country's premier public hospital has become the latest casualty of a faulty air-conditioning system.

Kuala Lumpur Hospital (HKL), the national referral centre, plans to have operations scheduled for the next one week moved to the Selayang Hospital while work was being carried out to repair the 13-year-old system.

HKL performs about 1,000 surgeries a month at its 33 operation theatres.

Admitting that there had been problems with the air-conditioners since August, HKL director Dr Jalal Halil Khalil said five of the 15 compressors needed to be replaced at a cost of RM1.5million.

He said work started on Tuesday and was only expected to be completed on Oct 6.

Dr Jalal added that the orthopaedic and urology departments were also affected by the faulty compressors.

Asked why it took so long to replace the compressors, Dr Jalal said this was because the units, costing RM150,000 each, had to be ordered from the United States.

However, he stressed that emergency operations would still be carried out at HKL.

This is the third hospital whose services, including operations, have been disrupted by faulty air-conditioning.

On Sept 15, The Star reported that services at the Tengku Ampuan Rahimah Hospital in Klang had been badly hit by faulty air-conditioning. All elective operations were postponed at the hospital, which schedules about 20 daily.

Three days ago, the Sultan Ismail Hospital in Johor Baru had to be temporarily closed after fungus was found on the walls and in some of the clinical equipment. The fungus was also due to a faulty air-conditioning system (See report).

Dr Jalal said the decision to move the scheduled operations to Selayang was a precautionary measure as the repair work may trip up the electrical system and cause a rise in temperature at the operating theatres.

The temperature must be maintained at between 18°C and 20°C, otherwise it might contribute to a higher risk of infection for patients.

“The operation theatre committees of both hospitals held an emergency meeting this afternoon on the matter.

“It is better to have the surgeries done at Selayang Hospital than to face the risk of getting infected.

“All departmental heads at HKL have been alerted to the potential interruptions for the next one week where the temperature may rise for a while,” Dr Jalal told The Star last evening.

“There is yet evidence on the rise in such infections,” he said on claims that such infection rates had gone up by two- to three-fold in the past two months. Infection rates are usually below 5%.

However, a doctor at the HKL operating unit, Dr A.T. Kumararajah, said his colleagues had been sweating it out due to the air-conditioning problem.

A check at an unoccupied theatre showed that the temperature was at 25°C.

During the same visit to the three-theatre complex, a senior nurse was even heard telling a doctor not to bring too many people inside as it was hot.

Dr Kumararajah said the air-conditioning system at the theatres had been faulty for the past six months.

“The heat has become intolerable. There were even occasions when there were flies inside the operation theatre,” he claimed, adding that it had increased the risk of contamination, making surgeries riskier than they should be.

Dr Kumararajah said he had brought up the matter to the hospital’s support services provider, Radicare (M) Sdn Bhd, who informed him that two of the five cooling units were not in working condition.

“They told me that it costs RM200,000 to repair each unit and that they had submitted a proposal to the hospital a few weeks earlier,” he sai

Places in public medical schools to go up

PUTRAJAYA: More places to study medicine in public universities will be up for grabs from next year.

Higher Education Minister Datuk Dr Shafie Salleh said the total number of places would be increased from the present 4,625 to 6,045 by 2009.

The 31% increase, he said, would provide more top scorers with the opportunity to pursue their dream of becoming doctors.

“We are adopting a strategy of increasing the number of places in public universities incrementally so that our resources, especially lecturers, will not be overstretched,” he told reporters after chairing his ministry’s post-Cabinet meeting on Wednesday.

Next year, the number of places in the country's six public medical faculties will be increased by 200. The number will go up by another 245 in 2006, 285 in 2007, 335 in 2008 and 355 in 2009.

M'sia slaps heavy penalties, fines for underaged smokers

KUALA LUMPUR (dpa) - Malaysia has announced it has amended its laws to allow for heavier penalties for smokers, including a hefty 1,000 ringgit (US$263.2) fine for those aged below 18 who are caught smoking, news reports said Tuesday.

The new amendments, which were tabled in parliament on Thursday, aimed to reduce the number of teenage smokers in the country, said Health Minister Chua Soi Lek.

"About 3.6 million smokers in Malaysia are youths and the government is targeting to reduce the number," Chua was quoted as saying by the Star daily.

Youngsters caught lighting up now stand to face a fine of up to 1,000 ringgit, while those found to be selling cigarettes to teenagers will be slapped with a hefty 10,000 ringgit (US$2,632) fine, he said.

The new amendments also extended the list of non-smoking areas in the country to include public toilets, internet cafes, places of worship and school buses.

Previously, non-smoking areas included air conditioned shops and restaurants, learning institutions, government offices and shopping malls.

Chua also said those found displaying cigarette advertisements in their premises face a two-year jail term and fine of 10,000 ringgit.

The harsh new laws are part of the government's plan to cut the high number of smoking-related diseases in the country such as heart and respiratory problems, said Chua

ACA begins probe on hospital

JOHOR BARU: The state Anti-Corruption Agency (ACA) has started an inquiry to determine any irregularity in the construction of the Sultan Ismail Hospital.

Its director Abdul Razak Idris said the case was serious as it involved public interest and “we are not going to wait for someone to come forward to lodge a report.”

“The statement from the minister as reported in the press was sufficient to warrant an inquiry,” he said yesterday, in reference to a statement by Health Minister Datuk Dr Chua Soi Lek.

Abdul Razak said the hospital project was handled directly by the ministry and the Public Works Department in Kuala Lumpur.

“I think our headquarters will continue with what we have initiated,” he added.

The Health Ministry ordered the RM500mil hospital, formerly known as Pandan Specialist Hospital, to temporarily close after fungus was found on the walls and in some of the clinical equipment.

On Saturday, Dr Chua said the fungus, scientifically known as “penicillium” and “aspergillus,” had been detected since two months ago when the hospital was opened to the public.

He said the fungus was caused by the high humidity inside the building due to the inefficiency of the air-conditioning system.

In Kuala Lumpur, the Works Ministry wants the contractor to install heat pumps to reduce the temperature so as to get rid of the fungus.

Minister Datuk Seri S. Samy Vellu said the heat pump was only a short-term solution and the hospital should hire an air-conditioning technician.

“The problem arises from the air-conditioning system installed by the contractor because the temperature is too high and encourages fungus growth.

“We can rectify the problem using heat pumps but after that, the hospital must hire a technician to monitor and control the temperature in the hospital,” he told reporters at the Parliament lobby yesterday.

Doctor loses patience trying to offer services to government

KLANG: General practitioner Dr K. Balachandran wanted to register to work part-time in government hospitals and clinics, so he got on the phone to find out how to go about it.

Instead of getting the help he needed, he spent a frustrating morning yesterday making over 10 calls and being given the runaround by various departments under the Health Ministry.

“By the end, I was really fed up with the whole thing. Here I am responding to the Health Minister’s call to serve but my intention is hampered by lack of information on the ground,” he said.

Minister Datuk Dr Chua Soi Lek had expressed disappointment on Sunday that only one private doctor had taken up the RM40 an hour part-time job in government hospitals and clinics since the offer was opened a month ago.

Dr Chua had said private doctors should stop making accusations or giving excuses as to why they could not take up the offer, adding that those interested could contact their respective state health departments.

According to Dr Balachandran, 52, he first called the Klang health office.

“The staff members I spoke to said they did not have the registration form nor did they know the details of the programme.

“They suggested I try the Tengku Ampuan Rahimah Hospital. I did, but it was also not much help there,” he said.

Undeterred, he tried the Malaysian Medical Association (MMA) and Malaysian Medical Council (MMC) but found that they were not involved with the registration.

On the MMC's suggestion, he tried the Health director-general's office, which referred him to first the Selangor health department and then the minister's office.

Dr Chua's office finally told him to try a certain officer at the state health department.

However, when contacted, the officer said he was not in charge of the registration and referred him to yet another officer.

“This other officer also said she was not the right person to talk to. She suggested I call the MMA. By now, I am so angry that I have decided to call The Star for help,” he said.

Dr Balachandran said the ministry should have the proper procedure spelt out and ensure that the relevant departments were informed.

“How many other doctors out there have endured the trouble I went through and have just given up trying?” he asked.

In Petaling Jaya, MMA president Datuk Dr N. Arumugam said many private doctors were willing to offer their services but there must be a definite system for them to do so.

“I personally don't know who the officer in charge of this is.

“We are still waiting for official information from the ministry on how private doctors can volunteer their services,” he said when contacted on Monday.

Dr Arumugam said many doctors had tried calling for further information but did not know who to talk to.

“People are not going to go out of their way to find out how they can volunteer,” he added.

Dead officer’s slimming pills believed to be illegal

KUALA LUMPUR: The slimming pills bought by Health Ministry officer Rosni Mat two days before she died last Friday is believed to be an illegal product.

The ministry’s enforcement unit seized 500 bottles of the herbal-based Bioflush in 500mg pills and other products, which were not registered under the Sales of Drugs Act, from a shop in the Klang Valley.

Minister Datuk Dr Chua Soi Lek said the raid was conducted yesterday morning and the ministry and police were investigating.

Rosni, 24, a part-time research officer, was found foaming in the mouth and gasping for breath early Friday morning by her housemates at their rented house in Taman Bukit Angkasa, Pantai Dalam, here.

She was dead upon arrival at the nearby University Malaya Medical Centre.

One of Rosni's colleagues said that Rosni bought a bottle of slimming pills on Tuesday evening and was found frequenting the toilet often on Thursday.

Post-mortem results are expected to be out in two weeks.

Radicare aims for main board listing next year

NON-CLINICAL hospital support services provider Radicare (M) Sdn Bhd is aiming for a listing on the main board of Bursa Malaysia next year, said executive chairman Datuk Seri Syed Anwar Jamalullail.

“We would prefer to go for the listing on our own and not through a reverse takeover or by the back door. Radicare is set to expand and respond to the challenges in the public and private healthcare support sector,” he added.

A provider of hospital waste management, cleansing and laundry services, the group was streamlining its operations to become more efficient in preparation for the listing, Syed Anwar said.

Chua disappointed by lack of response

KUALA LUMPUR: Only one private doctor has taken up the RM40 an hour part-time job in government hospitals and clinics since the offer was opened a month ago.

In expressing disappointment over the poor response, Health Minister Datuk Dr Chua Soi Lek said the Malaysian Medical Association (MMA) should take up the challenge.

“It is ironic that some private doctors had even pledged to volunteer their services free of charge earlier.

“Some even accused the ministry of not opening to private doctors and I don’t want to hear any more accusations and excuses from now on.

“I hope private doctors will respond to this part-time scheme as a form of social service and a chance to gain more clinical experience.

“The ball is now at the MMA’s feet,” he told The Star here yesterday.

There are about 8,000 doctors and specialists in the government sector and almost the same number in the private sector.

The ministry is trying to rope in private doctors to help the government health sector which treats some 75% of the total number of patients in the country.

In a year, government doctors treat about 48 million people who seek outpatient treatment while another 1.7 million are warded.

Dr Chua said the Treasury had approved the RM40 new rate while government doctors who did part-time in government clinics after office hours would be paid RM30 an hour.

“Some complained that RM30 is too low. We raised it to RM40 but the response from the private doctors is pathetic,” he lamented.

Dr Chua said the flexi-hours under this part-time scheme should be attractive, particularly to female doctors who needed to juggle between family commitments and career and pensioners who wanted to earn some extra money.

He said private doctors could work a maximum of eight hours a day and it was up to 10 hours a week for private specialists.

Those interested could apply through their respective state health departments, he added.

Prior to this, the government’s part-time scheme for private doctors at RM25 an hour only saw seven takers since its implementation in 2002.

Response from private specialists for the RM120 an hour for those in surgical disciplines and RM100 an hour for the non-surgical ones in government hospitals was equally pathetic.

“Only 19 private specialists signed up for a two-year contract beginning last year so far,” Dr Chua said.

The 19 include one in Selayang Hospital, three in Kuala Lumpur Hospital, seven in Johor and eight in East Malaysia.

On the bad response to the part-time scheme, a private medical specialist said there were other deciding factors besides the payment.

He cited the “not-so-conducive setting” in government hospitals and clinics as among the deterrents.

He said some authorities in government hospitals were somehow “ hostile” towards private specialists.

He acknowledged that working in government hospitals would be beneficial for one’s experience, as there were more complicated cases compared with the private sector.

New hospital closed after fungus found on walls

JOHOR BARU: The Pandan Specialist Hospital near here has been temporarily closed after fungus was found on the walls and in some of the clinical equipment.

Health Minister Datuk Dr Chua Soi Lek said the RM500mil hospital, barely two months in operation, would be closed immediately.

The decision to close the hospital was made by a special committee comprising representatives from the Health Ministry, Public Works Department and scientists from Universiti Malaya, he said on Saturday.

He said the fungus, caused by high humidity inside the building, had been detected on the day the hospital was opened to the public.

“At first, the authorities thought it was a minor problem and they could overcome it without having to postpone the opening.

“But after about two months, the fungus had spread beyond control and the problem needed immediate attention,” he said after launching a lantern festival in Kulai on Saturday.

Dr Chua said initial investigation showed that the high humidity was caused by inefficiency of the hospital’s air-conditioning system.

There were two other serious defects at the hospital which also needed immediate attention, he said.

“The oxygen piping and the sewerage system are also posing problems,” he said, adding that many of the hospital’s equipments did not meet the specifications set by the ministry.

“These problems are serious and we are not taking any risks. We are of the opinion that it is best to close the hospital so that we can carry out remedial work without obstruction,” he said.

Dr Chua said the hospital’s contractor would carry out remedial works, which were expected to complete within three to six months.

Chua: Provide statistics or face the consequences

MALACCA: A few private hospitals, which are promoting health tourism, are still not providing statistics on their foreign patients.

Health Minister Datuk Chua Soi Lek said they had until the end of the year to do so or face the consequences.

He said only 20 of the 35 hospitals promoting health tourism since 1988 had been submitting regular returns to the ministry through the Association of Private Hospitals.

“We need the figures and statistics on foreign patients at our hospitals to strategize and plan our activities,” Chua said at the 10th anniversary of Mahkota Medical Centre here.

He said a study by the government in 2002 estimated that the foreign patient market, worth about RM90mil in 2002, grew by about 30% annually.

“This year our foreign patient revenue is estimated to be around RM154mil, with a large percentage coming from Asean, with Indonesia topping the list,” he said.

He added that cardiology topped the list of health services demanded by the foreign patients followed by general surgery, cardio thoracic and orthopaedic surgery.

Replying to a question, Dr Chua said the influx of foreign patients should not lead to a rise in healthcare costs for the locals.

He said the Middle Eastern countries had been identified as a big market for Malaysia’s tourism drive.

He said medical tourism contributed 30% of the revenue of Mahkota Medical Centre

Sudden death shocks ministry staff

KUALA LUMPUR: Staff at the Health Ministry headquarters here are still reeling in disbelief over the sudden death of their colleague, Rosni Mat, believed to have been caused by herbal-based slimming pills.

Instead of heading home to join their families when work ended at 1pm yesterday, a few of her colleagues huddled together on the second floor of their Jalan Cenderasari office, recalling Rosni’s last few days.

At first, they were hesitant to share their thoughts with The Star but they opened up when convinced that her fate could be an eye-opener for others.

They said the 24-year-old Universiti Malaya graduate – who joined the ministry as part-time research officer on May 24 and whom they described as bubbly, friendly and hardworking – had never taken a day of sick leave.

And yet she was found foaming at the mouth and gasping for breath early Friday morning by her housemates at their rented house in Taman Bukit Angkasa, Pantai Dalam here, and taken to the nearby University Malaya Medical Centre.

“She was already dead when the ambulance arrived at the hospital,” said a colleague.

Rosni, from Tanah Merah, Kelantan, left behind some clues in the last 48 hours of her life that might help shed some light on the tragedy.

“She bought a bottle of slimming pills on Tuesday evening and kept going to the toilet on Thursday,” recalled a colleague.

Rosni, it was learnt, was about 164cm in height and weighed between 80kg and 90kg.

“Her brother said she had never complained of being unwell,” said another colleague, who had helped the family to arrange to send her body back to Kelantan for burial.

The dangers of slimming pills made headlines in 2002 when Singapore television host Andrea De Cruz had to undergo a liver transplant after taking one such product from China.

It has been found that certain herbs can damage the liver and kidneys and some herbal-based products are tainted by dangerous substances like steroids.

The slimming product Rosni had bought is advertised on the Internet.

In the advertisement, 13 different products – said to be herbal-based – have been listed under the brand and they boasted a wide spectrum of health benefits and cures.

Among other things, they claim to promote slimming and youthfulness, enhance sex life, boost the intelligence of children, reduce high blood pressure and prevent cardiovascular diseases.

The Star made a call yesterday to the number listed but it was “not in service.”

Renal failure cases on the rise

There is also a dramatic increase in the intake of new dialysis patients during the same 24-year period — from 43 in 1980 to 2,400, adding to the almost 10,000 who had already registered. Nephrologists believe that the number registered may not reflect the actual situation in the country as there could be many suffering in silence due to lack of facilities. Some could also have resorted to traditional or alternative treatment.

It is estimated that There are some about 100 new end-stage renal cases per million population every year. This, however, is a conservative estimate and believed to be "under-provided" as no proper survey has been undertaken thus far. According to National Kidney Foundation of Malaysia (NKF) medical director Dr T. Thiruventhiran, these figures were growing in tandem with the rise in the number of diabetics and hypertension patients — two major contributors to chronic kidney disease.

In Malaysia, he said, the most common cause of kidney disease was diabetes mellitus. About one-third of patients suffering from diabetes mellitus will go on to develop kidney failure.

He added that about 50 per cent of advanced kidney failures were due to diabetes mellitus. Other causes of kidney failures are high blood pressure, stones in the kidney, abuse of painkillers, infections and reflux diseases in children, Dr Thiruventhiran said early detection of kidney disease can prevent progression to kidney failure.

In view of the rising trend, the NKF is now on an aggressive campaign to create awareness of among Malaysians on kidney diseases, its causes and prevention.

NKF Board of Managers vice-chairman Datuk Dr Zaki Morad Mohd Zaher said with the increase in diabetics, the number kidney disease cases was also expected to increase correspondingly. The ageing population is another contributory factor to the high incidence of kidney cases.

According to the World Health Organisation, Southeast Asia will have the highest rate of increase in diabetics, from 35 million in 2000 to 80 million in 2025.

Currently, More than eight per cent of Malaysian adults suffer from diabetes. And by 2010, this figure is expected to reach 12 per cent.

Dr Zaki, a consultant nephrologist with the Ministry of Health, said when more people suffered from the disease, it would be a burden on the country's resources. In the United States, it costs about US$15 billion (RM57 billion) a year to treat kidney patients. In Malaysia, he said, the Government spent more than RM1 million annually to directly or indirectly provide dialysis treatment to kidney patients.

"Many of these patients now live longer because of good and affordable treatment provided by government hospitals, non-governmental organisations, social security organisations and private centres. The Government is also now focused on managing diabetic and hypertension patients well." About 40 per cent of patients receive dialysis treatment dialysed in the Government's 81 centres, 35 per cent in 73 centres run by NGOs and 25 per cent in 76 private dialysis centres. Death rates of patients undergoing haemodalysis have remained at 10 per cent or lower a year for the last 24 years. Continuous Ambulotory Peritonea Dialysis (CAPD) death rates were higher at 10 to 20 per cent.

On renal transplants, Dr Zaki said the number of people coming only about 25 donors, or 1.2 per million population, come forward to donate their kidneys was still small.

"This number is very small compared to the number of people waiting for renal transplants.

"If we can get more people to donate their kidneys, then there will be fewer people on dialysis." he added.

Dr Zaki said their main concern now was to prevent kidney failure among Malaysians because if the number was big it would be an additional tax burden on the country's coffers. He also advised those in the high-risk group to go for regular screening to detect kidney diseases early.

Malaysia's youngest kidney victim is an eight-year-old. And the average survival period of a kidney patient is between eight and 10 years. Meanwhile, NKF Public Education Unit programme adviser P. Sarada Devi said brochures on kidney diseases were available at all their outlets nationwide. She said talks, exhibitions and public forums were also held from time to time. For details call Sarada at Tel: 03-7954-9048 or nkf website: www.nkf.org.my

4,151 vacancies for doctors

THE Government needs to fill 4,151 vacancies for doctors this year to improve the present ratio of one doctor to 1,755 patients, according to Berita Harian.

Health Ministry parliamentary secretary Lee Kah Choon said the Government needed new doctors as the present 9,313 doctors in service were not sufficient to meet the needs of the people.

“We are presently engaging the services of 93 local medical officers and 723 foreign specialists on contract basis to meet the shortfall,” he said at Parliament House.

Lee was quoted as saying that the highest number of foreign medical officers on contract were from India (268), Pakistan (167), Egypt (122), Myanmar (84) and Bangladesh (29) while the rest were from other countries.

He also said the Government was giving out contracts to specialists and non-specialists who had retired to meet the shortfall.

Gov't to eliminate negative perception against gov't hospitals

ALOR STAR Sept 24 - The government is endeavouring to improve services in government hospitals to change the public perception that the standard of service in government hospitals is unsatisfactory, said Health Minister Datuk Dr Chua Soi Lek.

He said several approaches had been taken lately to ensure that the standard of services at government hospitals could be enhanced to the satisfaction of the general public.

He said that among the approaches taken was to update the records and pharmaceutical department to reduce the waiting time for patients to 90 minutes compared to two hours previously.

"In addition, the ministry has also transferred manpower from the less busy hospitals to the busy ones so that the workload of the staff at the busy hospitals can be reduced," he told reporters after visiting Alor Star Hospital, here Friday.

He said the public should also discard the notion that private hospitals provided better services.

Chua said that in efforts to give specialist treatment, the ministry had identified several hospitals which could provide specific specialist treatment.

"Alor Star Hospital, for example, will offer expertise in arthroplasty and spinal surgery," he said.

On the new Alor Star Hospital, which is being built at Jalan Langgar, he said the project had reached 77 percent completion.

He said the hospital, costing more than RM500 million, was expected to be ready early next year.

5 sailors being observed for bird-flu in Sabah

KUALA LUMPUR -- Malaysia checked five sailors for bird flu Friday in the first possible cases outside a northern state where an outbreak erupted five weeks ago.

The sailors already were showing signs of recovering at the Queen Elizabeth Hospital in Kota Kinabalu, capital of Sabah state on the tip of Borneo island, said Ramlee Rahmat, director-general of Malaysia's Health Department.

The navy personnel fell ill with flu-like symptoms after coming across the remains of dead swallows on Layang-Layang island, part of the disputed Spratlys group, Dr Ramlee said.

The dead birds were being checked for traces of bird flu, said Hawari Hussein, director of the Veterinary Department.

It would be the first time bird flu Malaysian authorities detected bird flu outside the northern state of Kelantan, which was placed under a quarantine a month ago because of an outbreak of the disease.

Test results on the sailors were unlikely before Monday.

Though it was unknown where the birds came from, Malaysia has been dreading the spread of the deadly H5N1 flu strain since the first case was found Aug 17 in a village in the northern peninsular state of Kelantan.

The entire state was placed under quarantine last week after the disease jumped outside an initial 10-km restricted area. The disease came from fighting cocks smuggled from nearby Thailand.

The Spratlys, which are claimed in whole or part by six nations, lie more than 1,000km west of Kelantan.

The World Health Organization says that migratory birds are spreading the disease and believe it is entrenched in parts of Asia after first appearing this year.

No humans have been infected so far in Malaysia, but H5N1 has killed at least 28 people in Thailand and Vietnam.

Veterinary workers have culled more than 7,000 chickens, ducks and pet birds in Kelantan to stop the spread of the disease, touching off a debate in the deeply conservative state over whether the practice is Islamic.

Kelantan Chief Minister Nik Aziz Nik Mat said on Thursday that the cull - in which birds are stuffed into plastic bags and gassed - was as humane as possible but should be done out of public view to avoid upsetting people. -- AP

Doctors about to retire will be re-employed, says Chua

SUNGAI PETANI: The Health Ministry will re-employ local doctors who are due for retirement to reduce the shortage in the country.

Minister Datuk Chua Soi Lek said the move would be implemented with immediate effect.

He said they would be recruited on a yearly contract basis and only those with good track records and had done clinical work would be re-employed.

He said there were about 800 foreign doctors employed by the Government now, adding that the new proposal did not mean that foreign doctors would not be recruited.

Earlier, Dr Chua said the operating budget for the public health sector had increased by six-fold this year compared with 1999, adding that the Government could no longer afford bear an increasing operating cost.

The Government had allocated between RM6mil and RM7mil yearly as operating and development budget for the health sector, adding that it had allocated RM7.8bil for the purpose next year.

Thailand, Malaysia to cooperate to combat bird flu


Thailand and Malaysia have agreed to cooperate to tackle bird flu along their common border and monitor poultry passing between the two countries.

The agreement, following a meeting between officials, included setting up border quarantine posts and a warning system to alert their neighbour of any new outbreak.

The two countries are among six Asian nations hit by a second wave of bird flu since July.

Cambodia has detected its first new cases of bird flu in chickens since March.

The disease has left 28 people dead in Thailand and Vietnam this year and killed millions of birds across the continent.

Short breaks for private clinic docs

DOCTORS at 24-hour private clinics should not have breaks that are longer than 30 minutes, said Malaysian Medical Association president Datuk Dr N. Arumugam

According to Sin Chew Daily, the association's code of ethics stated that private clinics should not accept patients if the doctors are not around.

Dr Arumugam also said the nurses should inform the patients if there are no doctors at the premises.

He was speaking at the launch of the association's homepage in Kuala Lumpur on Saturday.

Internal Security Ministry parliamentary secretary Datuk Abu Seman Yusop said private hospitals should not collect payments from patients who needed blood.

He said it was irresponsible of the private hospitals to collect such payments as they are getting their blood supply from government hospitals, adding that he would raise the matter with the Health Ministry.

Make sure you have enough blood, hospitals told

KUALA LUMPUR: All hospitals, private or Government, must ensure that they have enough stock in their respective blood banks.

Deputy Health Minister Datuk Dr Abdul Latiff Ahmad told The Malay Mail that hospitals can open accounts with the National Blood Bank in case they run short of supply.

Dr Abdul Latiff was commenting on the woman who bled to death after delivering a baby at a private hospital in Kuala Lumpur last Saturday.

“Patients choose hospitals of their liking for many reasons. It is the responsibility of the hospital concerned to see to the patient’s needs,” he said, adding that this death could have been avoided if the hospital had taken steps to deal with any eventuality.

"In this case, the hospital should have ensured they had enough supply in its blood bank.

“Private hospitals should not think of only making profits.”

Dr Abdul Latiff said he is waiting for a report on the incident from the hospital concerned.

He said cases of mothers bleeding to death after a delivery is very rare in Malaysia. Statistics show such incidents occur in about six to seven out of 100,000 deliveries.

Dr Abdul Latiff said Malaysia has among the lowest rate of deaths after delivery in the world.

Last Saturday, Zou Huiyi, 28, died after giving birth to a baby boy, her first child.

It was reported that she bled after the delivery and the private hospital did not have enough supply in its blood bank.

She was rushed to the Kuala Lumpur Hospital but died 15 minutes after admission.

Her baby is said to be healthy.

Zou’s husband, Huang Dexiang, 31, could not be reached for comment.

It was also reported that the couple got married in November last year and was warned by doctors that Zou may not be able to deliver naturally as her uterus was sagging.

Zou was taken to the hospital at 9pm on Friday and doctors said they would have to induce the birth.

About 4pm the next day, nurses told Huang that Zou's cervix was still not dilated enough. Four hours later, she was ready for birth.

Huang left his wife for about 10 minutes to fetch his mother and when he came back, he was told that the delivery was successful but Zou was in a serious state.

An hour later, he was informed that she had lost a lot of blood and that he should rush her to the KLH.

Pharmaniaga enters herbal product market

PHARMANIAGA Bhd yesterday launched its latest product brand – InnoHerb – marking the pharmaceutical company's maiden entry into the Malaysia herbal products and alternative therapies market worth RM2bil, managing director Azhar Hussain said.

“It's a huge market and we hope to capture a slice of it,” he told reporters at the launch of InnoHerb, witnessed by Deputy Health Minister Datuk Dr Abdul Latiff Ahmad, in Subang Jaya.

Azhar said the local market for traditional medicine and alternative therapies was bigger than modern medicine, which was estimated to be worth RM1.2bil.

“We are targeting to achieve RM12mil sales from the InnoHerb range over the next 12 months,” he said, adding that it was still early days for the company in terms of marketing herbal products.

For the financial year ended Dec 31, 2003 Pharmaniaga registered turnover of RM632mil, which was derived mainly from the sales of conventional medicine.

“The introduction of this new range of herbal products in the local market is due to our tie-up with a French company, which took 23 years to develop the technology,” he said.

Pharmaniaga is licensed to produce the new range of herbal products for the Malaysian market and potentially for export in a couple of years.

Azhar said the company also planned to introduce more herbal products over time.

“There is also a possibility we will market our locally developed range of herbal products using Phytogranules technology in future,” he said.

He also said the company was interested in developing Malaysian traditional and alternative medicines in collaboration with local research institutes and centres.

The InnoHerb range of herbal products is available at most pharmacies nationwide.

Sultan: Upgrade hospital with heart surgery facilities

KUANTAN: People from the east coast states should be able to receive heart surgery at Hospital Tengku Ampuan Afzan here, said the Sultan of Pahang Sultan Ahmad Shah Sultan Abu Bakar.

He said the Health Ministry should introduce this service at the hospital here so that heart patients no longer need to travel to Kuala Lumpur for such treatment.

“The hospital has been around for 100 years and I hope we will not have to wait for another 100 years before heart operations are performed here,” he said in his royal address during the hospital’s centennial celebrations here yesterday.

The Sultan also advised his subjects to adopt a healthy lifestyle to ensure that they could contribute effectively to the state and nation.

“Take appropriate steps to have health checks and accept medical advice given by health personnel,” he said.

He urged doctors to be open in adopting the growing technologies in the medical field and to ensure that the hospital was upgraded continuously.

The Sultan later presented medical aid to several patients, including two children, aged nine and three, suffering from thalassaemia.

He also presented gifts of appreciation to active blood donors and organisations which organised blood drives to ensure that the hospital’s blood bank had adequate stock.

Whole of Kelantan under quarantine for bird flu

KUALA LUMPUR - Malaysia yesterday placed the entire state of Kelantan under quarantine to prevent the spread of bird flu, as three more villagers were hospitalised after developing symptoms of the disease.

The move restricting the movement of poultry into or out of the state came after the bird flu virus was found on Tuesday to have jumped outside the original quarantine zone around the first village in the state hit by the disease.

'Yes. We are seeing a trend that it is showing up in areas outside the original quarantine zone, so we have to take steps to ensure that it does not spread,' Agriculture Minister Muhyiddin Yassin told reporters. 'We have set up roadblocks at border checkpoints.'

Veterinary officials said the checkpoints are meant to prevent the transportation of birds into or out of the state.

They are beefing up surveillance throughout Kelantan, especially in infected areas.

In neighbouring Terengganu state, Menteri Besar Idris Jusoh said checkpoints had been set up to stop Kelantan birds from being brought in.

The Health Ministry's disease control director, Mr Ramlee Rahmat, said three people who were hospitalised over the weekend had been cleared of the disease.

But he said three children - a 12-year-old boy, a 14-year-old boy and a four-year-old girl - had been admitted for observation on Tuesday after developing cough and flu-like symptoms.

'All three have a history of contact with the dead animals. We are isolating them as a precaution pending test results,' he said, adding that culling activities were continuing.

Officials said the disease was first brought into Malaysia by fighting cocks exposed to the virus in Thailand, and that the new outbreaks were caused by the continued smuggling of chicken meat.

Earlier this week, Tan Sri Muhyiddin suggested using the Internal Security Act to detain without trial poultry smugglers and curb rampant smuggling across the border.

Malaysia is also seeking an urgent meeting with the Thai authorities to discuss measures to combat the spread of the virus, including strengthening border security.

Bird flu has killed 28 people in Vietnam and Thailand this year and led to the slaughter of millions of birds.

Thailand decided yesterday to keep a ban on vaccines for all birds as nine more people were put under surveillance, officials said.

Eighty people have now been put under observation since the reappearance of the virus in July, with all but 12 of them cleared of having the deadly H5N1 virus, said the Thai Public Health Ministry.

One person died last week and another 11 were awaiting test results, it said.

The World Health Organisation (WHO) has criticised Thailand for not doing enough to monitor birds capable of carrying the avian flu virus after the country's ninth human death last week.

The WHO fears that the H5N1 virus could mutate into a highly contagious form, triggering a global human flu pandemic.

Yesterday, the European Union said it had extended its ban on Asian poultry imports for three more months to March 31 next year. -- AP, AFP, Reuters

Financial jab for Klang hospital

KLANG: The faulty air-conditioning at Tengku Ampuan Rahimah Hospital here has been repaired and the Government has pumped in money to ensure that equipment there will be in tip-top condition.

Following The Star report yesterday on the disruption of services at the hospital, the Health Ministry immediately approved RM90,000 for the purchase of 27 split air-conditioners.

These will be installed in all the critical units.

In addition, the hospital will be given RM13mil for mechanical and electrical repairs, Deputy Health Minister Datuk Dr Abdul Latiff Ahmad said after launching the Hospital Support Services Standards and Eastwood Park Malaysia Training Academy at the Westin Hotel in Kuala Lumpur yesterday.

“Our officials are negotiating with the Finance Ministry to see if we can do it on a negotiated tender basis rather than open tender, as otherwise it will take at least 90 to 100 days before things can be corrected,” he said.

The Star reported that faulty air-conditioning had disrupted services at the hospital, which has the country’s second busiest emergency ward.

All elective surgeries have been postponed at the hospital, which schedules about 20 such operations daily.

Dr Abdul Latiff said preventive maintenance had been carried out at the hospital, adding that breakdowns were unpredictable.

Selangor state executive councillor in charge of health, Datuk Dr Lim Thuang Seng, said the RM13mil was for replacing the ageing air-conditioning system, upgrading the oxidation pond and overhauling the wiring system.

The air-conditioning started working again at 12.15am yesterday after round-the-clock repairs.

“Let this be a reminder to all hospitals in Selangor to be vigilant in inspecting and maintaining their infrastructure,” said Dr Lim, who visited the Tengku Ampuan Rahimah Hospital with Health Ministry deputy director-general (medical) Datuk Dr Abdul Gani Mohd Din.

He said the air-conditioners would be installed in critical areas like the emergency ward, elective surgery unit, intensive care unit and the neo-natal intensive care units.

The breakdown of the air-conditioning system over the weekend is said to be the worst since the system started giving problems in 2002.

A team from Radicare worked round the clock to fix the system.

Pantai to expand overseas support services ops

PANTAI Holdings Bhd plans to further expand its healthcare and clinical support services, especially in the Indonesian and Middle East markets.

Chairman Datuk Dr Ridzwan Abu Bakar said: “We see great potential in these markets and hope to enhance our profits based on the increasing number of foreign patients under our health tourism business.”

Last month, Pantai Holdings opened a marketing office in Jakarta to attract more Indonesian patients and to provide clinical support services such as waste management and equipment maintenance to Indonesian hospitals via its subsidiary, Pantai Medivest Sdn Bhd.

The group had also set up a joint venture company with Jeddah-based Al Sharif group in July last year to provide healthcare services and to set up two hospitals in Saudi Arabia, Dr Ridzwan said after Pantai Holdings' EGM in Kuala Lumpur yesterday.

On the local front, he said group subsidiary Fomema Sdn Bhd, an agency involved in medical examination for foreign workers in Malaysia, had also been contributing positively to group revenue, owing to the increasing number of foreign workers, especially Indonesians, in Malaysia.

“Fomema's business fits in well with our core businesses, and is an important revenue contributor to the Pantai group.”

Earlier, Dr Ridzwan said the group expected to complete the acquisition of the remaining 49% stake in Cheras Medical Centre Sdn Bhd, in which it already owns a 51% interest, by next month.

“This acquisition will save us about RM2.2mil in rental per year and will help to enhance the margins of this medical centre, which returned to the black four years ago,” he said.

Cheras Medical Centre is one of the seven hospitals owned by Pantai Holdings nationwide.

For the financial year ended June, the group reported a net loss of RM112.1mil compared with a net profit of RM8mil a year earlier as a result of its share of losses in an associate company, Avenue Capital Resources Bhd.

However, Dr Ridzwan said the group was optimistic that its core businesses of hospitals and healthcare support would contribute positively to group revenue in the current financial year.

Probe into private hospital mortality rates

The higher- than-expected mortality rate in some private hospitals has prompted the Government to scrutinise all of them in its annual review, said Health Minister Datuk Dr Chua Soi Lek.

Private hospitals will soon be made to report their mortality and morbidity rates to the Patient Safety Council, for all such medical cases to be documented and dealt with systematically.

Dr Chua said he hoped to implement this in the next six months. At present the ministry lacks the data to address the problem.

He said the council would also collect data on medical errors and negligence, investigate their root causes and recommend measures for patient safety.

The council will also address larger issues of patient safety and care, and work towards preventing the recurrence of certain kinds of errors or mishaps.

Dr Chua said he hoped the council would also be a channel for complaints.

Private hospitals, he added, should have an in-house review of mortality and morbidity cases. Many do not do so because the doctors have no time to attend such reviews.

He said hospitals should be concerned if their morbidity and mortality rates were high, and doctors should know when to say "enough is enough".

The council, approved by the Cabinet in January 2003, will be chaired by Health director-general Tan Sri Dr Mohamad Taha Arif and comprise senior ministry officials, directors of university hospitals, presidents of professional bodies, representatives from the private sector and non-governmental organisations and the president of the Federation of Malaysian Consumers Associations.

The council has met twice to fine-tune its role and mission, terms of reference and strategies. Six sub-committees will look into data and information, consumer education and empowerment, continuing education, medical safety, transfusion safety, safe staffing and quality of work life.

Some 30 experts will be involved in the council and its sub-committees to get feedback from both public and private hospitals.

The Health Ministry’s incident-reporting programme monitors 30 types of incidents in hospitals so that lessons are learnt to prevent their recurrence.

These include medical errors, adverse outcomes of procedures, falls in the wards, adverse transfusion reactions, wrong procedures, complications in the ICU, injuries to neonates during delivery, and problems faced by patients under anaesthesia. Incident reporting will also be mandatory in the private sector.

Few Malays donating organs

THE Malays, who are generally Muslims, have shied away from pledging their organs although a fatwa (religious edict) allows them to donate or undergo an organ transplant.

Out of nearly 80,200 Malaysians who have pledged their organs, 65% were Chinese and 22% Indians while the Malays made up just 9%, according to Berita Harian.

The paper quoted deputy director-general of Health Datuk Dr Ismail Merican as saying that the lukewarm response was due more to cultural than religious convictions.

“Malays are conservative. They would even avoid a post mortem or have any organs separated from the body as it would be deemed disrespectful to the deceased,” he said.

However, the Malays top the list of those waiting for organ transplants.

Clinic raided for hiring unqualified doc

THE Selangor Health Department “raided” a clinic at the Sultan Sulaiman business centre in Port Klang for allegedly hiring an unqualified foreign doctor, China Press reported.

The 24-hour clinic was also supposedly involved in selling medical certificates for RM10 each, it said.

It is learnt that the clinic has an on-going court case in which it had been charged with hiring an unqualified doctor three years ago, the newspaper reported.

According to the newspaper, the department’s medical division assistant chief, Yap Lam Soon, said that during the raid, a 27-year-old Sri Lankan was caught examining a patient at the consultation room.

He said the man, who was paid RM15 per hour, had no working permit or medical qualifications, it said.

He said the man had diagnosed 32 patients in his two days of work at the clinic.

Yap added that they also took some medicine samples from the clinic for examination.

Malaysia checks over 7,000 people in bird flu-hit villages

KUALA LUMPUR, Sept. 13 (Xinhuanet) -- The Kelantan State Health Department has checked 1,593 houses and 7,689 people in the five villages affected by bird flu, said a local official on Monday.

Director Dr Ahmad Razin Ahmad Maher was quoted by local BERNAMA news agency as saying that his department had assigned 173 staff to deal with the bird flu outbreak after the virus was detected in five villages in the northern state.

"These health examinations are necessary to prevent the disease from spreading as it can be fatal to individuals who contract it," he said.

The virus of H5N1 strain, which was first detected in BaruPasir Pekan Village, Tumpat District on Aug. 17, emerged on Sept. 3 in Belian Village in the same district before it was detected in three other villages last week. The H5N1 strain has the ability to cause severe disease in humans.

He said the department was cooperating closely with Kelantan Veterinary Services Department (JPH) to deal with the problem.

"Checks were held from house to house in the affected villages," he said.

Dr Ahmad Razin said two people from Belian Village had been placed in isolation ward at Kota Baharu Hospital on suspicion of having bird flu, but tests produced negative results. The poultry farmers in the country face losses of one millionringgit (263,157 US dollars) a day from Singapore's ban on Malaysian chicken imports after bird flu was detected in Kelantan.

Hardest-hit are 500 farms in southern and central states of Johor, Malacca, Negri Sembilan and Selangor, which normally export the bulk of 130,000 live chickens and 2.3 million eggs to Singapore daily.

Budget 2005: Doctors give it the thumbs-up

The Budget 2005 received the thumbs-up from medical practitioners who described it as “people-friendly, futuristic and well-encompassed”.

In promoting the tourism sector, Prime Minister Datuk Seri Abdullah Ahmad Badawi has included health tourism and education tourism, stating that there is great potential for growth in health tourism.

Abdullah, who is also Finance Minister, said Malaysia had succeeded in attracting 103,000 foreigners under the health tourism packages in 2003, with total revenue of RM58.3 million.

To further increase its contribution, he proposed to organise health tourism packages through coordinating efforts between hospitals and hotels, as well as establishing an international referral network; to encourage hospitals to obtain international accreditations and forge strategic alliances with leading medical centres in the world.

He also encouraged the private sector to establish Malaysian multinational health companies, relax immigration conditions for entry of foreign medical specialists, therapists and patients; and to support clinical research in health institutions to promote the emergence of clinical centres of excellence.

Association of Private Hospitals of Malaysia secretary Dr Chong Su-Lin said, the budget is positive, although there is no mention of specific tax incentives.

“I guess the details will come later,” she said, adding that incentives are needed to upgrade the hospital facilities.

“Hospitals have always been working together with the hotels nearby, in providing accommodation for patients or their family members.”

She said hospitals are working towards being a one-stop centre for patients.

“By doing so, the patient’s family does not have to run around looking for a place to stay while the patient is recuperating,” said Dr Chong.

Malaysian Association of Hotels (MAH) executive director B. Sarjit Singh said MAH is a member of the medical tourism committee chaired by the Health Ministry.

He said the Tourism Ministry is also a member of the committee.

“There are special rates between the hospitals and the neighbouring hotels for patients and their family members. These rates vary from hotel to hotel.”

He is confident that with the Government’s seriousness in promoting health tourism, hotels would be able to provide better packages.

“We do not have to stop at providing accommodation at hotels but also at resorts and spas. While island resorts can be a good place to recuperate, spas can provide a form of therapy.”

Malaysian Medical Association (MMA) president Datuk Dr N. Arumugam said: “Allowing private patients to be treated at Government hospitals will also help retain doctors in the (government) service.”

He welcomed the additional sum of RM19.2 million being provided for the Public Health Programme, as in the last few years there had been the outbreak of communicable diseases like SARS.

On the intake of paramedic students, which according to the budget will be increased by 1,000, Dr Arumugam said there had always been a shortage of personnel in this area.

“The figure (1,000) is a good start.”

Working out costs of private wings

LABIS: The Government is looking at working hours and salaries of doctors and nurses and fees to be charged in the proposed private wing set up at government hospitals.

Health Minister Datuk Chua Soi Lek said services to be provided at the private wing would be at par if not higher than those offered by private hospitals.

In his Budget speech last Friday, Prime Minister Datuk Seri Abdullah Ahmad Badawi said the Putrajaya and Selayang hospitals will be the first hospitals to treat private patients from next year to make the public medical sector more attractive.

High failure rate of trainee nurses rings alarm bells

HALF of the trainees in government nursing schools failed to make the grade in their final examinations, reported China Press.

The daily quoted Health Minister Datuk Dr Chua Soi Lek as saying that the number of such trainees had reached a worrying rate.

He said the ministry would investigate the reasons for such a situation through a committee led by the ministry’s parliamentary secretary, Lee Kah Choon.

He said trainees in private nursing schools, who also went through the same training programme, had achieved a 100% passes in their examinations.

It was speculated that the unsatisfying entry qualification of nurses in government schools was the main reason these nurses did not do well.

MyVista ready for market

THE information technology (IT) marketing arm of the Primary Care Doctors Organisation of Malaysia (PCDOM, www.pcdom.com.my) is ready to market its open source Primacare and MyVista healthcare management systems.

Speaking to In.Tech at ACM 2004, PCDOM’s president Dr Molly Cheah said: “We’re targeting MyVista at government hospitals and have already submitted our proposal to the Health Ministry.”

“Our goal is to establish a reference implementation of an open source mission-critical hospital management application in Malaysia and to develop a business case for investment in medical systems,” said E-Cology Corp president, Joseph Dal Molin.

Canada-based E-Cology is collaborating with the IT arm of PCDOM, GHC Medical Informatics Sdn Bhd, on MyVista development and marketing.

Dal Molin also is a director of WorldVistA (www.worldvista.org), a non-profit organisation committed to the development of the VistA integrated hospital management software currently used in 173 Veterans Affairs hospitals run by the US Government, as well as other hospitals worldwide.

With the help of paid staff and volunteers, GHC ported and customised the public-domain VistA to produce the open source MyVista application specifically for Malaysia.

“MyVista is the first nation-specific VistA in the world,” claimed Dal Molin.

Its web-based e-telehealth function lets individuals view their personal medical records online, as well as add self-measured blood pressure, blood sugar and other readings – all of which can also be accessed by their doctors.

“At the same time, doctors will have full access to all their patients’ multimedia medical records from anywhere. We are currently testing interoperability between patient information captured at the primary care level with detailed medical records maintained at the hospital level,” said Dal Molin.

“This is in line with the Malaysian Government’s aim to maintain lifetime medical records on all citizens and it also allows more efficient use of medical specialists in supporting primary care,” said Dr Cheah.

So far, GHC and E-Cology have been testing the interoperability of patient information between MyVista and the Primacare electronic medical records and clinical management system developed by PCDOM.

Primacare earned PCDOM the 2004 ICT Excellence award in the Open Source Software category at ACM 2004 (see In.Tech, Sept 7).

Top psychiatrist turns 75, but isn’t retiring yet

IPOH: Tan Sri Dr M. Mahadevan, the country’s foremost psychiatrist, is turning 75 today but has promised to keep on going until he “can no longer move.”

Although retired from government service since 1984, the bachelor has yet to retire from his profession.

Dr Mahadevan runs a clinic at his home in Ukay Heights, Kuala Lumpur, for a small number of patients, whom he continues to treat by appointment.

The country’s former chief psychiatrist (from 1974 to 1984) is also famous for transforming the treatment of the mentally ill – from custodial to community care.

He set up the Re-entry Association for the Emotionally Disabled in the early 1960s, which provides rehabilitation at a house in Tambun Heights here and the Perak Society for the Promotion of Mental Health in 1970, also in Tambun.

Both societies were the first institutions in the country to provide mentally ill patients with supervised occupational therapy without being locked up.

“In the old days, custodial treatment for the mentally ill was to protect the general public rather than considering the well being of the patients,” said Dr Mahadevan, who is the founder and first president of the Malaysian Psychiatric Association.

He is also the former president of the Malaysian Society for Clinical Hypnosis, a founding fellow of the Asian Chapter of International College of Psychosomatic Medicine, vice-chairman of Riding for the Disabled and Perak Turf Club committee member.

His renowned case studies include that on the state of mind of Wong Swee Chin alias Botak Chin, the notorious gangster who was hanged in the 1970s.

“Botak Chin was not mentally insane but a distorted and misguided genius,” said Dr Mahadevan, who was awarded the Corresponding Fellowship by the American Psychiatric Association on May 19, 1997.

Dr Mahadevan is also the oldest polo player in the South-East Asian region.

He and his polo team emerged champions in the “Mad Heaven Tournament” at the Royal Selangor Polo Club last weekend.

Dr Mahadevan takes pride that many of his patients have been fully cured and leading normal lives.

“I have employed two former patients to look into my personal needs and to take care of my home.

“Friends have also graciously fostered former patients to give them another chance in life,” he added.

An old boy of St John’s Institution here, Dr Mahadevan studied medicine in Mysore, India, as a Colombo Plan scholar and later specialised in psychiatry in Ireland and in the United States.

Malaysia's first Prime Minister Tunku Abdul Rahman, who was a family friend, then asked him to head Hospital Bahagia in 1967.

Dr Mahadevan's illustrious career is now the subject of a book. The biography, entitled Mad Heaven: The Biography of Tan Sri Dato’ Seri Dr M. Mahadevan, is written by Aneeta Sunderaraj.

Raja Muda of Perak Raja Nazrin Shah will launch the book at Carcosa Seri Negara in Kuala Lumpur today.

New option to study medicine

PETALING JAYA: Students intent on pursuing medicine will have a new local option from next year.

Monash University Malaysia (MUM) will commence its medical programme early next year, with an initial intake of 50.

Approved by the Higher Education Ministry and recognised by the Malaysian Medical Association, the five-year MUM medical degree will cost RM65,000 per year.

However, until their “purpose-built medical facility” is completed in 2007, students will spend their first two years of study at the Monash campus in Melbourne at no extra cost.

They will pay the same fees before returning for their clinical study at the Sultanah Aminah Hospital in Johor Baru, said Prof Richard Larkins, vice-chancellor and president of Monash University.

“This is an important milestone for Monash and Malaysia too in view of the country’s manpower needs and the demand for medical programmes here. Although the first two batches of students will do their two years in Australia, they will be paying the MUM rate which is considerably less that what international students pay in its Australian college.

“From 2007 however, the entire programme will be conducted at MUM, although students will have the option to do a semester or two in Australia as both programmes are on par,” he said.

Entry into MUM’s medical programme, said Prof Larkins, would be competitive, taking into account not only academic performance but also the applicants’ aptitude and personality.

“We require high academic scores, at least 2As and 1B at A-level or equivalent. On top of this, applicants will have to go through a structured interview, which covers specific areas and an aptitude test on logic and problem solving abilities as well as the candidate’s personality.

“Unlike many other programmes, the human component is very important in Medicine,” Prof Larkin said during a media briefing at the MUM campus here yesterday.

He added that the university was currently in the process of appointing a dean for the faculty as well as hiring “quality lecturers.”

Interested candidates are advised to look out for enrolment advertisements in the local print media next month.

Kidney failure alarming

NIBONG TEBAL: Ten thousand Malaysians are expected to suffer from kidney failure in the next five years due to lack of exercise and poor eating habits, said Health Minister Datuk Dr Chua Soi Lek.

He said RM30mil had been allocated to equip every district hospital with a minimum of four haemodialysis machines each by the end of this year.

“But these machines will never be enough to cater to the alarming increase in the number of kidney failure patients,” he told reporters after launching the Sungai Bakap Hospital’s haemodialysis unit yesterday.

He said there were now about 9,000 patients in the country seeking haemodialysis treatment, with an average 2,500 new cases reported annually.

About 35% of the patients, Dr Chua said, sought treatment at government hospitals and another 35% at dialysis centres run by non-governmental organisations. The remaining patients were receiving treatment at private hospitals and dialysis centres.

“It is more efficient and cost effective in the long term for the ministry to promote health education and the importance of a healthy lifestyle to reduce the number of chronic disease cases, including kidney failure.”

He said that under the coming Ninth Malaysia Plan, more money would be spent on fitness-related programmes and less on building new hospitals.

Believed to be set up in 1891, the Sungai Bakap Hospital, with 130 beds, is one of the oldest hospitals in the state.

Two Malaysians in hospital for bird flu checks

KUALA LUMPUR, Sept 7 (Reuters) - Two Malaysians have been isolated in hospital after displaying symptoms of bird flu, which has killed 28 people elsewhere in Asia this year, a senior health official said on Tuesday.

A veterinary worker and a 10-year-old boy from a village at the centre of a second bird flu outbreak in Malaysia's north were hospitalised with cold symptoms, the official told Reuters.

Ramli Rahmat, director of the Health Ministry's disease control unit, said the isolation of the pair was a precautionary step after the latest discovery of infected poultry in Kelantan state.

"Both were in the affected area and had shown bird flu symptoms like fever and cough, so we have to isolate them," he said, adding that blood samples had been sent for tests.

Ramli said the boy was among more than 800 people screened during house-to-house surveillance conducted by the ministry in the area.

The Veterinary Services Department said on Monday 30 chickens and quails had died from the disease near an area where the virus was first detected in Malaysia last month.

Culling of some 1,200 chickens, ducks and birds within one km of the affected area began on Monday.

The H5N1 strain of bird flu has been blamed for the deaths of 28 people in Asia this year. Birds in the latest outbreak in Malaysia were also suspected to be infected with the same strain.

The World Health Organisation says the H5N1 strain has a unique capacity to jump from one species to another and cause serious illness, with high mortality, in humans.

A 14-month-old Vietnamese boy died from bird flu at the weekend, but it was unclear if he was infected by the H5N1 strain, a Health Ministry official said on Tuesday.

Malaysia remains free of any confirmed human infection from the virus. Seven people were hospitalised with cold symptoms during the first outbreak but they were cleared.

Fresh bird flu hits Malaysia

MALAYSIA announced today its second outbreak of deadly bird flu in three weeks, near a northern village close to the border with Thailand where the disease was first detected.

The Veterinary Department said the lethal H5N1 strain of avian influenza was believed to be the cause of the deaths of 10 chickens and 20 quail in Kampung Belian, a village five kilometres from the outbreak announced August 17.

The discovery dashed plans to declare Malaysia free of the disease, which has caused massive losses among poultry farmers because of import bans imposed by the European Union, Singapore, Hong Kong, Japan and the Philippines.

Hawari Hussein, director-general of veterinary services, said the dead chickens and quails were recovered by inspection teams Friday and that tests showed H5N1 was the likely culprit.

"The infection is still within the 10km radius and within the 21-day quarantine period," Mr Hawari said. "Therefore, we regard this as an isolated case."






The owner of the chickens has been screened and is healthy.

The discovery means that teams will cull 1200 chickens, ducks and birds within one kilometre of the village by tomorrow night to stop it from spreading.

A fresh 21-day quarantine on the area has been imposed, and Malaysia cannot be declared free of the disease until that time elapses and no new cases are discovered.

Malaysia's first outbreak was discovered in fighting cocks in the village of Pasir Pekan. A 10km quarantine was thrown up and half a dozen people hospitalised. None tested positive.

Chickens and pet birds in the area were slaughtered and inspections were stepped up at thousands of poultry farms nationwide.

The H5N1 strain of bird flu has been blamed for the deaths of at least 27 people this year in Vietnam and Thailand, and Asia has been on edge for months to stop it from spreading.

About 100 million chickens have perished or were slaughtered in government-ordered culls, but the World Health Organisation says that H5N1 appears to be entrenched and flare-ups can be expected regularly.

Researchers in China caused a scare recently when they announced that H5N1 had been detected in pigs, but it was unclear whether the swine were truly infected or merely had traces on their skin or snouts.

Health experts fear that H5N1 could recombine with other forms of flu in pigs and be more easily transmitted to humans.

Malaysian officials believe that the flu entered the country from Thailand and have stepped up border controls, seizing thousands of live and frozen smuggled chickens.

Separate test for docs soon

MALACCA: Medical practitioners, who had to sit for a government examination previously with other civil servants to gain promotions, will have their own competency test drafted and proposed by the Health Ministry.

The test, designed for the medical profession, is being drawn up by Health Ministry secretary-general Datuk Ismail Adam.

Minister Datuk Dr Chua Soi Lek has instructed Ismail to review the content after he submitted an interim report.

The proposed test followed grouses by doctors and specialists that the government examination had nothing to do with the nature of their work.

The competency test for medical practitioners would replace the government examination, Dr Chua said in response to a question raised at a meeting with them at the Malacca Hospital here yesterday.

The Health Ministry has also come out with a proposal to give more attractive allowances to doctors, specialists on call and nurses.

The Cabinet committee on health, chaired by Prime Minister Datuk Seri Abdullah Ahmad Badawi, would make a decision on the proposal, said Dr Chua.

Ismail had also been given the task to look at this proposal, which also considered nurses with diploma and degree qualifications.

Dr Chua said government hospitals needed more nurses as only 40,000 vacancies out of 170,000 available had been filled.

“It would take another 16 years to fill the vacancies.

“At the moment, about 3,000 people are trained as nurses every year but we need to double it.”

Dr Chua said six nursing colleges were built under the Eighth Malaysia Plan and more would be set up under the next five-year plan.

In his speech, he told the gathering that 48 million people sought outpatient treatment at government hospitals last year while 1.7 million were warded.

His ministry would carry out a health promotion drive to educate the people about healthy living, he said, adding that Abdullah would launch the fitness programme on Sept 12.

Patient Safety Council gets into gear

All medical mishaps, large and small, which occur in public hospitals will be documented and dealt with systematically by a Patient Safety Council.

Long in coming but nevertheless welcomed, the council will collect data on medical errors and negligence; investigate the root causes of such cases and recommend strategies for the safety of patients.

Above all, the council, to begin operations soon, will publish regular reports to keep the public informed of such matters — an indication of how critical patient safety has become in the overall agenda of the Health Ministry.

Currently, despite the rise in complaints reported in the New Straits Times on Sept 1, there are no statistics to help the ministry address the problem effectively.

Although an incident-reporting programme exists in public hospitals to help reduce the recurrence of certain kinds of errors or mishaps, the council will likely address larger issues surrounding patient safety and care.

Deputy Director-General of Health Datuk Dr Ismail Merican, who announced this today, said the council will also advise the minister on how to prevent and reduce adverse incidents in public hospitals.

The council will emphasise clinical governance and clinical risk management, he said at a Health Risk Management conference today.

The council, approved by the Cabinet in January 2003, will be chaired by Health Director-General Tan Sri Dr Mohamad Taha Arif. It will comprise senior ministry officials, directors of university hospitals, presidents of professional bodies, the private sector, non-governmental organisations and the president of the Federation of Malaysian Consumers Association.

Thus far, two meetings have been held to finalise the council’s role and mission, terms of reference and strategies.

Six sub-committees will look into data and information, consumer education and empowerment, continuing education, medical safety, transfusion safety, and safe staffing and quality of work life.

Some 30 experts will be involved in the council and its sub-committees with the objective of getting feedback from both public and private hospitals and to ensure that findings are transparent.

"All of us in the health sector are aware that clinical risks and medical errors that infringe on patient safety do occur. The question is how many such incidents have occurred and where, how many get reported, how many are preventable, how many are considered serious, how many have resulted in deaths and what can we do to prevent or minimise such risks," said Dr Ismail.

He stressed that healthcare risk management entailed putting in place policies, processes and procedures for the prevention of risks and the averting of medical errors and facility failures which may otherwise lead to injuries, deaths and financial losses from insurance claims and lawsuits.

The "systems approach" to reduce errors was imperative, he said.

Although there should be acceptance that humans were fallible and errors had to be expected even in the best of organisations, he said mishaps tended to fall in recurrent patterns, regardless of the people involved.

Among the reasons why errors occur in the workplace is time pressure, understaffing, inadequately trained staff, inadequate equipment, fatigue and inexperience.

"The magnitude of an error can vary from a ceiling fan falling off to a generator-set exploding," he said.

But cases may not be reported or documented or may be considered insignificant unless they involve death or severe injury, he added.

He also pointed out that errors in procedures, mistakes in blood transfusion, diagnosis and treatment due to faulty laboratory results, radiological interpretations and mistakes in the administration of medications could lead to undesirable or fatal consequences.

Dr Ismail said that clear strategies to improve patient-doctor communication was essential in the outpatient setting.

The Health Ministry’s incident reporting programme monitors 30 types of incidents in hospitals so that lessons may be learnt to prevent a recurrence of such cases.

These include medical errors, adverse outcomes of procedures, falls in the wards, adverse transfusion reactions, wrong procedures performed, complications in the ICU, injuries to neonates during delivery, and problems faced by patients under anaesthesia.

Dr Ismail said these incidents were monitored every six months nationwide. Incident reporting is also required in the private sector under the Private Healthcare Facilities and Services Act 1998, which is yet to be implemented.

Medical aid for islanders

KOTA KINABALU: An outreach project to provide medical aid to communities in islands off Sabah was launched by Mercy Malaysia in a first joint effort with the Royal Malaysian Navy.

About 13 volunteers, including five doctors, sailed off on KD Gaya on a four-day trip to provide healthcare to over 1,000 people on Pulau Mantanani and Pulau Balambangan at the north of Sabah.

Navy chief Laksamana Datuk Seri Mohd Anwar Mohd Noor, who launched the “Sabah Island Relief Project,” described it as an opportunity for the navy to broaden its services in the country.

“This is an extension of our role of providing security to the nation,” he said before seeing off the volunteers at the marine police jetty here yesterday.

“The navy not only provides a safe and dependable means of transport but also ensures the security of our volunteers,” she added.

The volunteers, led by Mercy Malaysia vice-president Dr Mohamed Ikram Mohammed Salleh, will conduct health awareness programmes and medical examinations covering health screening, dental screening and deworming.

Medicines were provided by Pharmaniaga Berhad.

The islanders would normally have to take a three-hour boat ride to the mainland to reach the nearest medical facility and most of them only seek treatment in emergencies.

“The project introduces these communities to a standard of living typical for town dwellers and healthcare can be received on a regular basis,” Dr Jemilah said.

She said she hoped it would raise not only health standards of the islanders but also their living conditions.

Chua: Illegals contributing to rise in TB and dengue cases

MALACCA: Illegal immigrants contributed to the 345 cases of tuberculosis reported at the Malacca Hospital last year, Health Minister Datuk Dr Chua Soi Lek said.

There were just 186 cases reported in 1993, he added.

Dr Chua said dengue cases were also on the increase, with 632 cases recorded last year, compared to only 104 cases in 2000.

Until August, 459 dengue cases had been reported, he said during a visit to Malacca Hospital yesterday.

He said the state's rapid development and the stagnant water at construction sites also contributed to the increase in dengue cases.

On his ministry's projects in the state, Dr Chua said 15 projects, including the construction of a new hospital in Jasin, had been completed while another 11 projects are in various stages of implementation.

“Another 16 projects are still in the planning stages and are expected to be carried out next year,” he added.

He said a RM5mil Magnetic Resonance Imaging unit would be installed at the Malacca Hospital before the year-end while the Alor Gajah district hospital and two rural clinics in Batu Berendam and Tengkera would be upgraded next year.

“We also have to look into requests for more wards for orthopaedic, paediatric and neurosurgery at the Malacca Hospital,” he said.

Permanent doc mans clinic in Pangkor

IPOH: A permanent doctor is now manning the Pulau Pangkor health clinic.

State Health and Environment Committee chairman Datuk Tan Chin Meng said the doctor, who started work on Aug 1, had previously served as one of the replacement doctors at the health clinic, after its permanent doctor left for further studies.

“A few replacement medical practitioners had manned the clinic during the absence of the permanent resident doctor.

“Earlier reports that the health clinic was manned by a hospital attendant and that the resident doctor had been transferred out are not true.

“The earlier resident doctor had left to pursue a Masters Degree in Public Health,” he added.

Tan said the Manjung Health Department had made arrangements to station replacement doctors at the health clinic while waiting for a permanent doctor.

Bird flu-free status within a week: Latiff

Kota Kinabalu: Malaysia is set to be declared bird flu-free in a week when the 21-day quarantine period imposed in Kampung Baru, Pasir Pekan in Kelantan ends.

Deputy Health Minister Datuk Dr Abdul Latiff Ahmad said that surveillance in the area had not detected any new cases of bird flu infection.

“All the chickens affected by the virus have been culled...in a week’s time Malaysia should be declared bird flu-free,” he said after opening the Second Asian Congress of Paediatric Infectious Diseases and 26th Annual Congress of the Malaysian Paediatric Association (MPA) at Magellan Wing Sutera Harbour Resort and Spa, here, Thursday.

At the moment, three government agencies were conducting both active and passive screening at the areas and “we will wait for another week, it is according to the World Health Organisation (WHO) standard.”

“We monitor and hope for the best,” he said when asked to comment on the situation there ever since the avian flu virus was detected in chickens.

He also stressed that no humans had contracted the avian flu virus in Kelantan.

In his speech earlier, Dr Abdul Latiff said emerging infectious diseases, once thought a thing of the past, were making a comeback not only in Malaysia but in industrialised nations as well.

“Resurgence has been made more apparent with the emergence of HIV/AIDS. Trans-boundary migration of workers and tourists has also made medicine and infectious diseases borderless,” he said.

Dr Abdul Latif said in this respect, the Asian region was vulnerable due to the wide disparity in healthcare and system structures between different countries.

“It is, therefore, highly probable that a disease contracted in one country can be detected in another within hours as air travel becomes more affordable and common,” he said.

Despite advances in modern medicine, infectious diseases remain a persistent scourge and the leading cause of mortality and morbidity particularly in developing countries.

“In Malaysia, 100 per cent of one-year-old children are immunised against tuberculosis, 94.1 per cent against diphteria-pertusis and tetanus, 93.4 per cent against polio, 86.2 per cent against measles and 91.1 per cent against hepatitis.

“The fact that we fall short of 100 per cent across the board means that there are still a lot of people out there who fail to realise the potentially fatal consequences of a single (vaccine-preventable) infection,” he said.

Toward this end, Dr Abdul Latif said an effective response to any new infectious disease threat would involve mobilising public health activities, requiring cooperation and open communication among various departments.

“Malaysia’s success in curbing infections such as the enterovirus 71, nipah virus (in the 1990s) and more recently the SARS infection, is owed to the cooperation of departments in the ministry, universities and private sector,” he said.

According to him, resistant organisms posed a major problem not just in the hospital where multi-resistant Staphylococcus aureus and Klebsiella have evolved due to the many antibiotics used in these hospitals.

Resistant tuberculosis has also made it harder for us to treat these patients, with poor compliance leading to the current problem, he said.

Dr Abdul Latif said newer and more expensive antibiotics were now required and the government needs to keep abreast with these advances. “The cost of newer antibiotics would eventually have to be capped in order to accomplish our quest of providing health and medical attention for the whole nation,” he said.

He also urged doctors to notify all cases of infectious diseases (in the notifiable diseases list) they encounter to facilitate production of data for the country.

Dr Abdul Latif also expressed gratitude to the MPA for working with the Government such as during the introduction of a combination of vaccines that saw the Ministry using Mumps-Measles-Rubella (MMR) vaccine nationwide for the first time following a re-evaluation of the country’s immunisation schedule in 2001-2002.

He commended MPA for the assistance in re-educating their less-informed colleagues (who initially resisted because they failed to understand the rationale for the campaign) on the advantages of the nationwide mass measles vaccination campaign introduced this year.

The three-day congress ending Saturday is aimed at discussing new ideas, approaches, systems and practices that can be adapted, improved and expanded to overcome challenges in paediatric infectious diseases.

Nearly 700 local and foreign delegates are taking part in the congress that would see papers on respiratory infections in children, paediatric SARS diagnostic and therapeutic challenges, update on community and hospital acquired infections and a special session on the avian flu.

Also on hand were MPA President cum organising chairman Pro Dr Zulkifli Haji Ismail, Asian Society of Paediatric Infectious Diseases (ASPID) President Dr Rosalinda Soriano and State Health Department officials as well as Queen Elizabeth Hospital senior officers.

Other ways to check fakes

PETALING JAYA: The Health Ministry has been urged to work with the pharmaceutical industry to minimise parallel imports and counterfeit products.

Pharmaceutical Association of Malaysia president Dr Choe Tong Seng said the ministry should work together with the industry’s players before implementing the use of hologram on pharmaceutical products as there were other approaches that could be used.

He said the ministry’s current move to enforce the use of hologram on pharmaceutical products by Jan 1, next year, alone was inadequate if other measures were not taken at the same time.

“We support the use of hologram but other measures such as monitoring the distribution channel, carrying out heavier penalties, having more enforcement officers and educating consumers, should also be carried out,” he said.

Dr Choe was commenting on an announcement by the ministry’ pharmacy services division director Datuk Mohd Zin Che Awang yesterday, who said all OTC (over-the-counter) products, controlled items containing poison, traditional medicine and health supplements must bear the hologram by Jan 1, while products that need to be used in the form of injection must have the hologram by next July.

Mohd Zin said the aim was to curb counterfeit and parallel products and only cosmetics and exported products would be exempted.

“The ministry had signed a contract with a French hologram manufacturer and a local agent, Mediharta Sdn Bhd, and will be responsible for distributing and selling the holograms as well as keeping records of buyers,” he said yesterday after attending the bilateral meeting between Health Minister Datuk Seri Chua Soi Lek and Indonesian Health Minister Dr Achmad Sujudi here.

Mohd Zin also said it would be difficult to fake the multi-layered hologram as it would take a lot of time to produce an imitation.

“Each hologram will have a serial number and the agent will record the name of the buyer every time the buyer makes his purchases,” he said.

A leading international pharmaceutical company pointed out that the use of hologram was proven to be ineffective as they had tried using it before.

“We have been using hologram for the past three or four years on our products but counterfeit and parallel imports still exist,” a source from the company said.

10,000 pedometers for visitors at launch of fitness council

KUALA LUMPUR: The first 10,000 people arriving at the National Stadium for the launch of the National Fitness Council later this month will each be given a pedometer – an instrument that gauges the number of steps taken during a walk.

“We hope those given the pedometers will use them and record at least 1,000 steps daily,” said Youth and Sports Minister Datuk Azalina Othman Said.

Prime Minister Datuk Seri Abdullah Ahmad Badawi would launch the council on Sept 12 before more than 30,000 people at the stadium in Bukit Jalil.

Azalina said Malaysia’s health aspect was becoming a problem.

“We need to exercise to stay active, healthy and united.

“But it would be pointless to exercise then eat nasi lemak and drink teh tarik after that,” she told a press conference at the stadium yesterday.

Azalina said the council would help in her ministry’s efforts to encourage Malaysians pursue life-long healthy lifestyles, good eating habits and sufficient exercise.

Three ministries, including hers, and the National Unity and Integration Department have banded together to form the council, to make Malaysians a more active and healthy lot.

The Housing and Local Government and Health ministries are the other two agencies involved in the council.

Azalina said the collaboration of the four agencies would also contribute towards the government’s effort to create a generation committed to excellence, glory and distinction.

Health Minister Datuk Dr Chua Soi Lek, who was present, said more Malaysians were suffering from diet-related diseases like diabetes and hypertension because of unhealthy eating habits.

“We need to start paying attention to having a balanced diet with plenty of vegetables, fruits and grains, and reduce salt and sugar intake,” he said.

Also present were Minister in the Prime Minister’s Department Datuk Dr Maximus Ongkili and Housing and Local Government Ministry parliamentary secretary Datuk Dr Subramaniam K.V. Sathasivaram.