How methadone works for addicts

"THEY are patients, not addicts," says Professor Dr Hussain Habil, of people who are addicted to narcotics such as heroin.

According to the head of University Malaya's psychological medicine department, drug addiction was considered a moral issue in the past.

"It is only of late that it is understood to be a brain disease, a biological phenomena.

"Now, we hope that drugs such as methadone can help deal with addiction problems." This form of drug substitution therapy is founded on the premise that some people are susceptible to drug addiction because of a biological imbalance in the brain. A prescription-only drug, methadone is a kind of narcotic analgesic taken in either syrup or tablet form.

It is a synthetic opiate that overcomes the withdrawal symptoms. The cravings may take years to go away but with proper counselling and support, most patients should be able to rise to the challenge of beating the addiction.

Based on the many patients he has seen and counselled over the years, Hussain says there is a need for greater availability of treatment and specific medications to treat, for instance, withdrawal and relapse.

"We can't just pack them off to the Serenti centres and expect them to be okay." Almost 80 per cent of former Serenti inmates fall back into their habits of addiction upon release. One of the most crucial elements missing from the "Serenti approach" is family support. The methadone programme, however, allows the patient to remain at home, and only visit the physician for the prescribed dose. In the long run, this also may reduce the cost for the government. The preliminary results of a research group study at the University of Malaya Medical Centre revealed that after one month, almost 70 per cent tested negative for heroin. By the second month, 100 per cent tested negative. The study, which involved prescribing methadone to confirmed heroin users who had someone to consistently care for them, will undoubtedly give hope to many users who have tried various means to kick the habit.

Relationships got better for some and many displayed a marked improvement in work performance. None lost their jobs. In fact, two patients actually found jobs because of their improved condition.

There was no crime involvement and neither did they indulge in high-risk behaviour such as unprotected sex. Physically, several reported minor side-effects, such as itching on the face, but this was resolved by splitting the dose.

There have been long-term effects reported by other patients, such as loss of sexual desire, increased perspiration and constipation but most disappear with time, dose adjustment, dietary changes and general improvement in lifestyle. According to former drug users who are in the programme now, the cravings are still there although methadone has taken away much of the withdrawal symptoms. They say the drug has done wonders for them. Families have been reunited. Many have friends.

Hussain, however, stresses that while the turnaround in their lives is fantastic, the success does not just lie in the drug alone. "There must be adequate supervision, counselling and necessary lifestyle changes too." The experts also say there is a need for guidelines to monitor the use of methadone to ensure no abuse takes place and to prevent a spillover to the black market. The Government plans to overhaul the conventional drug rehabilitation system using methadone. A study involving 50 former Pusat Serenti inmates will soon be conducted by the National Drug Agency, UMMC, Universiti Sains Malaysia and Duopharma (M) Sdn Bhd, the drug manufacturer and sponsor.

The results of the study will determine whether the drug therapy will be adopted in its Pusat Serenti rehabilitation programmes, thus heading in the direction of community-based treatment as opposed to institutionalised therapy

Chua: We will not issue the licence

The Andalas Medical Centre in Klang, which is embroiled in a controversy over the alleged illegal employment of foreign workers, will not be issued a licence, as far as the Health Ministry is concerned.

This is because the centre has run foul of the law by not meeting several technical conditions, such as the lack of fire safety measures and the use of unapproved X-ray machines.

“We have already said it will not be approved because it does not meet the technical conditions. It is operating illegally,” Health Minister Datuk Dr Chua Soi Lek told The Malay Mail after chairing the Ministry’s post-Cabinet meeting yesterday.

Following Dr Chua’s disclosure on Monday that the centre has been operating illegally since September 2001, the medical centre challenged the Minister’s right to question its legality.

In a statement issued on Tuesday night, the medical centre claimed that it wished “to remind the Minister that only through a legal process can any business entity be deemed illegal”.

The statement, which was unsigned, said the centre had submitted all relevant details to the Ministry of Health since September 2001 for the purpose of licence renewal.

“Since then, we have responded to the numerous enquiries and requests for clarification from the Ministry of Health. We are awaiting the approval from the Ministry,” it said.

It also hit out at Dr Chua for “issuing damaging statements through the Press”.

In response, the Minister yesterday reminded the centre that submitting an application for a licence does not legalise an establishment.

“The fact that they are operating does not mean that they are legal. The fact that they are applying for a licence also does not mean they are legal,” he said.

He said that besides not meeting fire safety conditions, the medical centre was hauled to court by the Ministry more than a year ago for offering X-ray services without a licence. The case is still pending.

Dr Chua said all X-ray machines needed to be approved by the Ministry on a yearly basis.

Dr Chua, who pledged to weed out the bad apples in the industry, hopes the public would be more aware of such centres, following adverse publicity in the Press.

The status of the Andalas Medical Centre came to light after the The Malay Mail published on March 31, a report quoting the centre’s former employee, Indian national S. Malini, as alleging that she had not been paid her salary since January, and that her passport was being withheld by the medical centre for the purported purpose of applying for a work permit.

She had come to Malaysia to work as a radiographer with the medical centre, and alleged that the centre did not apply for a work permit for her and had been giving excuses each time she enquired about her passport.

Consumer Association of Subang and Shah Alam (CASSA) president Jacob George had also said that the association took the matter up with the Health Ministry and Immigration Department.

George had also alleged that the medical centre recruited more than 30 foreigners illegally and that CASSA’s lawyers would defend Malini on her allegations against the centre.

Pharmaniaga unit served with notice of dishonour

Pharmaniaga Bhd unit Safire Pharmaceuticals (M) Sdn Bhd was served with a notice of dishonour by Siemens Financial Services Gmbh claiming for US$12 million (RM45.6 million).

Siemens claimed that it was earlier issued with 10 promissory notes of US$1.2 million (RM4.56 million) each by Safire, which were guaranteed by another Pharmaniaga subsidiary Pharmaniaga Logistics Sdn Bhd.

The promissory notes, however, were dishonoured when they were presented for payment on March 25, said Siemens.

Pharmaniaga said it believed the promissory notes were issued without proper authorisation by the special administrators.

In a statement yesterday, Pharmaniaga said the promissory notes were issued when Safire was placed under the SA who were appointed by Pengurusan Danaharta Nasional Bhd in 2001 and subsequently discharged in 2003.

It said it had investigated the notes and would “unequivocally state that the alleged signatures appearing on the notes and other supporting documents were forged”.

Safire had decided that Siemens’ claim was “without merit nor basis” and had appointed solicitors to defend itself, it added.

Pharmaniaga also said the claim by Siemens would not have any impact on its financial and operational performance.

TH Group expands Nilai cancer centre

TH Group Bhd is strengthening its healthcare business by expanding its Nilai Cancer Institute (NCI), Malaysia’s first private specialist cancer centre.

Under the expansion plan, a new wing will be built and more cancer treatment facilities – including 30 beds, more radiotherapy equipment, two operating theatres, an intensive care unit, a research lab and a stem cell transplant unit – will be added.

TH Group said the expansion was in view of the great potential of the healthcare industry in the country.

The industry is currently valued at RM900 million and is expected to grow to RM1.2 billion by 2005.

“NCI is in a very unique position in the industry. Due to our status as one of the leading centres for cancer clinical trial, we are able to offer patients who do not respond to standard treatment the opportunity of participating in new therapy,” it said in a statement.

It said the healthcare sector was identified as the company’s fourth core business because it presented high-growth opportunities and was relatively unaffected by economic conditions.

The first three core businesses of the company are oil palm plantations, construction and software development.

“Cash flow generated from our plantation sector will initially grow the healthcare sector, which is expected to eventually mitigate the cyclical nature of our traditional businesses,” it said.

Mercy keen on recruiting more young volunteers

KUALA LUMPUR: Mercy Malaysia will focus on projects at home to achieve a higher level of expertise in medical relief work and encourage more youth to volunteer, said its president Datuk Dr Jemilah Mahmood.

“We have organised monthly outreach programmes, which include medical, dental and public health services in the interior of Sabah and Sarawak.

“We would like to see more participation of young volunteers,” she added after receiving a RM5,000 cheque from the association of women journalists (Pertama) for the Mercy Humanitarian Fund.

Pertama was represented by its secretary Bahara Kamarak and treasurer Fadzillah Haron.

Dr Jemilah said Mercy's Volunteer Department was active in recruiting students from universities, such as Universiti Teknologi Mara and Multimedia University, and colleges to become associate members of the organisation.

A sure hand with special children

YOUR child is different from others. He is unable to communicate with you and is aloof. He throws tantrums for no particular reason. He is autistic. What, as his parent, can you do to help?

Autism, a complex developmental disability that appears in early childhood and persists throughout adulthood, causes children difficulties in verbal and non-verbal communication, social interaction and leisure and play activities. The symptoms and characteristics of autism can vary. Whatever the diagnosis, children with autism can learn and function productively and show gains with appropriate education and treatment.

One school in Malaysia that provides education and care for special children is The Centre For Individual Education Programme or Surea. Managed by KRISTA Centre For Special Children Sdn Bhd, Surea takes in children with various mental disabilities, such as autism, Down’s Syndrome, dyslexia, attention deficit disorder, attention deficit hyperactive disorder and speech or language impairment. Surea conducts a special programme known as the 3S programme: Sure Learn, Sure Work and Sure Joy.

Sure Learn is based on developing cognitive, language and social skills. Sure Work prepares the children to acquire skills in areas covering career, home and community living. Sure Joy builds the children’s physical, aesthetic and personal development skills in an enjoyable and fun-filled environment.

These skills vary with the degree of development among the children. They are taught how to play, learn and care for themselves and even learn vocational skills. Teachers use a fun approach to enable the children to understand what is being taught. For example, every month they come up with a new theme such as animals, plants and colours, and conduct activities with the students according to the theme.

The children also attend swimming and taekwondo lessons organised by the school. "We conduct most of the activities outside the classroom as the children learn better that way. They can’t sit or concentrate long on one thing, so there has to be a variety of activities to keep them going," says Cynthia Lauren Arul, the school principal.

Nawarmani Balakrishnan, the managing director, said that the most important skill a teacher needs is patience. "These children can have unpredictable mood swings at any time and tend to throw tantrums. The teacher needs to be calm in order to reach out to the child. Aggressiveness will only lead to the child behaving badly and not co-operating with the teacher," she added.

Teachers also need to be flexible with their methods in order to keep the child’s attention on a certain subject.

"They learn fast once they get adjusted to the teachers," says Corrina Caroline Allvisse, one of the teachers in Surea. She has been with the school since it started two years ago.

Siti Zurul Ain Abdul Jabar, the freelance speech therapist who has been working with these children for the last six months, says eye contact is very important for the therapy to be effective.

Nevertheless, teachers at Surea say the most important role in a special child’s development belongs to the parents. "Parents need to come to terms with the fact that their child is special," says Arul. "Understanding their child’s behaviour and learning how to reach out to them will make their relationship with the child stronger. This is very important because if the parents don’t bother about what the child learnt in school and are not consistent in teaching him the same thing at home, the child will not improve and will in fact become worse."

"Six hours in school alone cannot help the child get better. Parents should also pitch in," says Cynthia.

Surea provides a communication book for parents to keep track of the happenings in school even if the child is unable to talk. The book will state what was taught in school for the day and tell parents what they can do to help the child at home. They also have a monthly assessment to show how much the child has learnt or improved. Cynthia says 80 per cent of parents co-operate with the school to ensure their child’s development.

A teacher says that one autistic girl who came to the school at the age of five did not know how to speak, read or write. But after attending the school for a year, she improved tremendously and is now attending a mainstream kindergarten.

Another autistic boy, aged 12, was very aggressive when he first arrived. He disturbed all the other children and caused havoc at home, too. The individual programme helped him to calm down. The parent’s positive and consistent work together with the teachers also improved his behaviour further. He is now attending a normal secondary school.

The school provides services for children between the ages of four and 18, and has classes from 8am to 2pm on weekdays. Now it has 16 children. Surea has four teachers and one speech therapist who comes in twice a week. All the teachers have at least eight to 10 years’ experience in teaching children with special needs. Fees are affordable. With education, life can be rewarding for a child with autism. While it isn’t always easy, you can learn to help your child find the world an interesting and loving place.

* Parents can contact the school at 03-7958-8535

Organ transplant law under review

MALAYSIA—The Ministry of Health is currently reviewing the Human Tissues Act of 1974.

The Act, the first and only statute of its kind in the country, governs the transplantation of cadaveric tissues. It is based on and almost identical to England's Human Tissues Act of 1961.
Discussing the shortcomings of the Act, former health minister Dato' Chua Jui Meng said it was significant that the word “tissue” was not defined under the Act.
This raised complex and ethical questions as to the scope of its definition, he said. There is also no definition of "the person lawfully in possession of the body." This is significant as he is the person who is empowered by the Act to authorize the removal of tissue.
There is also no articulation in the Act of a hierarchy of relatives who are deemed to be the next-of-kin. The articulation of such a list will prove difficult In a multi-cultural society like Malaysia, where the hierarchy of relatives with the right to claim decision-making powers will vary between cultures.
The definition of death is not listed in the current Act. Section 3(2) of the Act only requires that two fully registered medical practitioners satisfy themselves by personal examination of the body that life is extinct.
The Act needs to be amended to include brain death as a method of determining death and to specify that doctors certifying brain death should not participate in the subsequent procedures for the removal and transplantation of the organs and tissues.
Chua was speaking at the launch of the Certificate in Medical Law and the book titled Issues in Medical Law and Ethics published by the International Islamic University.
“The current Act does not ban the sale or purchase of organs and there is also no provision for any sanction in the event of a breach of any section. The Ministry will therefore make amendments to the Act to prohibit commercial transactions and advertisements of human organs and tissues. The Act will also be amended to include criminal sanctions in the event of a breach of any provision,” he said.
The Act will be amended to allow only gazetted hospitals to conduct transplant procedures and only well-qualified practitioners to register as transplant specialists to safeguard public interest and to maintain a safe and equitable transplantation program.
A register of organ transplantations will be provided in the Act to monitor and coordinate the harvesting and allocation of donated organs and tissues under consistent and equitable rules.
There is presently no legislation in the country governing the removal of organs from live donors, Chua also pointed out.
In the absence of any clear legal authority, it is presumed that live donations are legally permissible by way of valid consent obtained from the donor. While awaiting the formulation of an appropriate law on this, the Ministry of Health is in the process of developing guidelines on organ donation and transplantation from living donors.
From the time of the first corneal transplant until December 31 2003, a total of 7,671 organ and tissue transplants have been performed in the country. These included 4,170 tissue graft, 1,267 cornea, 1,007 kidney, 634 bone marrow, 483 bone, 45 liver, 43 heart valve, 15 heart and 7 skin transplants

No, Sir, You Are Wrong!

The Andalas Medical Centre in Klang has challenged the right of Health Minister Datuk Dr Chua Soi Lek to question its legality.

In a faxed statement to The Malay Mail last night, the centre said it was “deeply disappointed and perplexed by the remarks issued by the Minister of Health on the case”.

“Instead of going through the proper channels and procedures to address any potential issues with regard to the medical centre, he chose to issue damaging statements through the Press.

“We wish to remind the Minister that only through a legal process can any business entity be deemed illegal,” the statement said.

The statement, which was unsigned, said that the centre had submitted all relevant details to the Ministry of Health since September 2001 for the purpose of licence renewal.

“Since then, we have responded to the numerous enquiries and requests for clarification from the Ministry.

“We are awaiting the approval from the Ministry of Health,” it said.

Yesterday, The Malay Mail had front-paged a report quoting Dr Chua as saying that the centre had been operating without a licence since September 2001.

Dr Chua had said the centre had problems in getting its licence renewed due to failure to comply with the Ministry’s requirements.

Dr Chua had said that three reminders had been sent to the centre over the last two years, the last being in February this year.

However, he had said that the centre had yet to fulfil the requirements.

He said even though the Ministry officers were aware of the centre’s illegal operation, it did not have the power under legislation to act against the centre.

Dr Chua said although the Private Hospitals Act 1971 could be applied on the Andalas Medical Centre for its failure to comply with regulations, there was nothing much the Ministry could do due to its limited enforcement powers.

His statement came after The Malay Mail had published on March 31 a report quoting the centre’s former employee, Indian natinoal S. Malini, as alleging that she has not been paid her salary since January and that her passport was being withheld by the medical centre as they were applying her work permit for her.

She had come to Malaysia to work as a radiographer with the medical centre.

No Licence To Heal

KUALA LUMPUR: A private medical centre in Klang has been operating illegally over the past two years without a licence.

Health Minister Datuk Dr Chua Soi Lek told The Malay Mail that the Andalas Medical Centre was due to renew its licence in September 2001 but had failed to do so.

"The centre appears to have a problem in getting the renewal (for its licence). (So) it is illegal," said Dr Chua at his office in Kuala Lumpur yesterday.

He said the centre was required to submit a fire safety certificate to the Health Ministry to ensure that it had adhered to safety aspects. It was also to obtain a permit from the Ministry for an X-ray licence and to offer related (X-ray) services. These were part of the yearly licensing process.

However, the centre did not comply with the requirements.

"Since two years ago, we have sent them three reminders, the last being in February (this year) but they had not fulfilled the requirements," said Dr Chua.

"We are aware they are running it illegally but we have no Act to act (against them)!," he said.

Dr Chua said although the Private Hospitals Act 1971 could be applied on the Andalas Medical Centre for its failure to comply, there was nothing much the Ministry could do due to its limited enforcement powers under the "present rules and regulations".

To a question whether the centre could be shut down considering its illegal operations, Dr Chua said: "We can't do much under the Act, for instance, close it down... as it does not give us the bite for enforcement," he said.

Dr Chua said the Ministry could lodge a police report for action to be taken against the centre for operating an illegal establishment.

"Then, if the matter is brought to court, the operator could be charged and fined a maximum of RM1,000." However, he declined to comment whether a police report would be lodged against the medical centre which is believed to have been in operation for more than five years.

"The Ministry's Pharmaceutical Services Department could also act against the medical centre's doctors if they are foreign nationals who have not been registered as practitioners in the country, a mandatory requirement by the Ministry," he said.

"This can be enforced under the Poisons Act if the (foreign) doctors were caught in the act of writing prescriptions," he explained.

As enforcement powers are lacking in the current Private Hospitals Act (1971), Dr Chua said a new Act, called the Private Health Care, Facilities and Services Act 1998, is being drawn up.

He said that when enforced, it would cover, among others, medical clinics, dental clinics, haemodialysis centres and hospices (palliative care for cancer patients).

It will then give the Ministry the powers to seal, inspect, prosecute and impose a fine of RM300,000 or imprisonment not exceeding six months, or both.

The new Act (1998) is in the final stages and could be enforced this year.

It was reported in The Malay Mail yesterday that Indian national S. Malini had claimed that she had not been paid her salary since January, and that her passport was being withheld by the medical centre as they were applying for a work permit for her.

Malini, who had been in Malaysia since September to work with the medical centre as a radiographer, alleged that it (the centre) had never applied for a work permit for her and had been giving excuses each time she inquired about her passport.

However, her claims have been denied by the medical centre which stated that Malini was on attachment with them, and was never on its payroll.

The medical centre's finance and human resources manager, R. Sushela, had said that Malini was brought from India by her sponsors to attend an "on-the-job interview".

Move to boost health tourism

KUALA LUMPUR: Benchmarking Universiti Malaya’s Medical Faculty and other hospitals in Malaysia with international bodies is important to boost health tourism in the country.

Health Minister Datuk Dr Chua Soi Lek said that in line with the government’s quest for new sources of income, health tourism was one avenue that could earn the country as much as RM2bil by 2010.

“There is a need for a concerted effort by university hospitals and private hospitals to raise their services to international standards so that more foreigners will come here for operations and hospital care.

“When patients want to come to Malaysia, they always refer to credible doctors who use benchmarking as their criteria.

“It is therefore important that we come up with a benchmark that is recognised internationally.

“There are about 33 hospitals that can cater to international medical needs,” he told reporters after launching the Parasites: South-East Asian Diagnostic (Para: SEAD) laboratory here yesterday.

Dr Chua said he has directed ministry officials to work with the private sector to make Malaysia a leading health tourism destination.

The university’s Vice-Chancellor Prof Datuk Dr Hashim Yaacob said the university was committed to earning an international benchmark so that the graduates and its services were recognised worldwide.

“We are seeking recognition from Australia, New Zealand and the United States, and a special committee has been set up for this task.”

The British General Medical Council withdrew recognition of Universiti Malaya in 1988.

The Medical Faculty’s dean, Prof Datuk Mohd Amin Jalaludin, said the university would aim to benchmark itself with Australian and New Zealand medical authorities.

“We are studying these countries’ overall methodologies and procedures ... how they will benchmark us. During their visit to the faculty this month, they will give us an overview of how they will do it.

“We have also invited the Irish Medical Council University for the same purpose,” he added.

Chua wants waiting time at hospitals cut

From the Chinese Press

NEWLY appointed Health Minister Datuk Dr Chua Soi Lek has given his staff one month to come up with a report on the reasons for long waits at government hospitals and suggestions on how to overcome the problem, Sin Chew Daily reported.

He was quoted as saying that the time needed for patients to register, see a doctor and collect their medication was too long.

“An acceptable waiting time will be one-and-a-half hours,” he told reporters on Thursday at the ministry after a briefing by his officers.

Dr Chua added that the ministry should study ways to increase efficiency and streamline procedures to shorten the process for patients.

Mercy gets RM200,000 from firm

The Sultan of Perak Sultan Azlan Shah (centre), who is also Mercy Malaysia patron, receiving a contribution of RM200,000 from Pharmaniaga Bhd chief financial officer Roshidah Abdullah (left) at the aid organisation's annual dinner in Kuala Lumpur on Friday.

At right is Mercy Malaysia president Datuk Dr Jemilah Mahmood.

The donation is for the procurement of medical supplies and Mercy Malaysia's outreach programmes, which includes medical, dental and public health services for the indigenous people in Sabah and Sarawak.

Dr Jemilah said the body needed RM2mil to sustain its relief projects annually.

She added that the organisation, which started with only 10 volunteers, now had 3,000 registered volunteers.

NSI looking for new means to improve performance of athletes

The National Sports Institute (NSI) is finding new hi-tech training methods through the application of sports medicine and science to enhance the performance of athletes to compete against international athletes.

"Being part of the National Sports Council (NSC), it is our obligation to help athletes achieve a high level of performance through the application of science in training and treatment," said NSI Director Dr Ramlan Abdul Aziz after attending the 3rd NSI Sports Medicine Conference, officially opened by Gen (rtd) Tan Sri Zain Hashim.

The Olympic Council of Malaysia vice president Datuk Dr M. Jegathesan and NSC Director Datuk Wira Mazlan Ahmad were among those who attended the conference.

Dr Ramlan said the four-day conference was held to find new methods to improve the performances of athletes and to assess new discoveries in the field of science and medicine to be applied in the enhancement of athletes.

Lecturers from the United States, Australia and New Zealand together with 22 local sports science lecturers will present papers in the conference.

Nationwide campaign to immunise 4.5mil Malaysian children against measles

MORE than 4.5 million children in Malaysia are going to be immunised against measles over the next three months, a preventive measure against an impending outbreak of the disease

Health ministry officials say that based on recent trends, they expect an outbreak next year or in 2006. The last spike in the number of cases was in 1999, when 2,068 cases were recorded, resulting in 10 deaths.

To prevent a recurrence, schoolchildren between the ages of seven and 15 will be immunised with a combination vaccine against measles, mumps and rubella.

This is the first time that a national campaign is being carried out by the Health Ministry,

RM50,000 fake stimulants seized

Kota Kinabalu: The sale of imitation and unregistered Viagra on five-foot ways here has become rampant, according to Deputy Director of Pharmaceutical Services, Dr Ahmad Mahmud.

“The fake Viagra tablets are sold very cheap by the peddlers with one strip costing between RM20 to RM25 compared with the original price of more than RM100,” he said, following the biggest seizure of RM50,000 worth of imitation sex stimulants from such pedlars in 20 spots at Kg Air, Tuesday.

The raid was led by Dr Ahmad and assisted by 18 enforcement officers from all over the country, including four from Sabah and assisted by four policemen from the KK headquarters.

The unregistered products seized comprised ointments, balms, supplement, and shampoos, among others, most of which were from Indonesia and Philippines.

They were brought in by wholesalers from Tawau, Kuching and even from Kuala Lumpur.

“They don’t have a warehouse here to keep the products. So, they will just have a direct transaction in supplying the products to retailers here,” said Dr Ahmad.

Three locals and two Indonesian men aged between 30 to 50 years, were arrested. The locals were released on bail while the two foreigners would face appropriate police action.

All will be charged under the Poisons Act 1952 for selling such products, including unregistered Viagra.

Those found repeating the offence risk being charged under the Sales and Drug Act 1952 (Amended 2000) which carries a maximum fine of RM50,000 or up to five years’ jail or both, upon conviction. For companies or corporate, a maximum fine of RM100,000 will be imposed under the same act.

“They could face a maximum fine of RM5,000 or up to two years’ jail or both, upon conviction,” he stated, when met at the unit’s office, at KWSP, Wednesday.

The team recovered most of the sex stimulants and fake Viagra inside the booths of a Honda City and Proton Tiara owned by two of the suspects, as well as four briefcases at the scene.

Last Septemper, the unit seized a total of 480 packets of Chinese-made imitation Viargra worth some RM21,000 during a raid on a lodging house at Jalan Pantai, here. The suspect, a Chinese national, was jailed six months by the Sessions Court on Nov. 7, last year.

He advised consumers against buying the imitation Viagra and other sex stimulants, as the products were yet to be evaluated for their efficacy, quality and content.

From the label of the Pfizer Viagra, Dr Ahmad explained that the product was specially produced and packaged for the Australian market, but a Chinese national supplied the product to the suspects.

Nevertheless, he stressed that public should not purchase such product as it is not recognized and registered in Malaysia.

Dr Ahmad said their main strategy was to step up consumer education and increase public awareness against the dangers consuming unregistered products.

“One factor might be their reluctance to consult the doctors of their impotency and the best resort being to approach the illegal peddlers,” he said.

He also disclosed that some RM14 million of unregistered drugs and health products as well as cosmetics in operations conducted since January this year throughout the whole country.

Heart disease still No. 1 killer in S'wak

Heart disease and diseases of pulmonary circulation were collectively the most common causes of death recorded in Sarawak government hospitals from 1998 to 2000.

Such deaths accounted for 1,416 or 13.8 per cent of total deaths, according to heath department statistics.

The higher percentage of heart patients were among people below the age of 45, who suffered from severe coronary heart disease compared to the situation in developed countries.

Meanwhile, the development budget for Sarawak Health Department has increased from RM72.5 million in the Fourth Malaysia Plan (1981-1985) to RM316 million in the current plan.

The manpower had also increased from about 4,000 in 1980 to 11,465 until February this year.

As for the doctor to population ratio, it had also improved from 1:8, 420 in 1980 to 1:2, 476 in 2002.

The number of government hospitals in the State had been increased from 15 in 1980 to 21 this year, whereas health clinics increased from 136 in 1980 to 246 last year.

Reports link Jui Meng's exit to feng shui and political careers

Former Health Minister Datuk Chua Jui Meng's exit from the Cabinet generated a host of reports in the Chinese dailies yesterday, including those touching on the co-relations of “feng shui” and political careers.

Sin Chew Daily, with a front-page headline which read “Chua Soi Lek replaces Chua Jui Meng,” ran a story along the lines that the two men shared the same surname.

The daily also highlighted that MCA ministers who held the post of health minister always saw the end of their political careers.

The daily ran a list of MCA MPs who had been appointed to the post from 1977 and detailed how all of them were “banished politically” after taking up the position.

First on the list was former MCA deputy president Tan Sri Lee Siok Yew, who lost his Cabinet post within 24 hours after having fallen out of favour with then party president Datuk Lee San Choon in 1977.

Subsequent health ministers were dropped after one term in office, sacked following internal party conflicts, not nominated as candidates or defeated during general elections.

The daily named Chua as the latest casualty, adding that his predecessor, Tan Sri Lee Kim Sai, had advised him to consult a “feng shui” master when handing over the post to him.

It is learnt that Chua had indeed consulted a “feng shui” master twice during his two-term tenure as Health Minister from 1995 to 2004. He has been the longest serving Health Minister.

Nanyang Siang Pau reported that friends and relatives of Chua were shocked and saddened that he was dropped from the Cabinet line-up.

In a news analysis, the daily concluded that Chua, who was viewed as the “third force” in the aftermath of the party's two-year power struggle, was sacrificed for the sake of unity in MCA.

Panel formed to promote reproductive healthcare

NEW YORK: Malaysia has taken several initiatives to ensure family planning services are provided under a broader package of reproductive health, the United Nations Commission on Population and Development was told.

Malaysia’s representative to the 37th session of the commission, Fatimah Saad, told the gathering that a co-ordinating committee on reproductive health had been formed to look into policies, strategies and ways of integrating other reproductive health components into the primary health care system and into family planning programmes.

Fatimah said for greater understanding of the concept, scope and operation of reproductive health, training updates had been intensified and standard operating procedures for model reproductive health clinics developed.

There were also efforts to promote greater participation of males in reproductive health and household responsibilities.

An educational module on fatherhood had been developed and implemented.

“Emphasis is now on high risk as well as adolescent reproductive health (ARH) and high parity mothers including those living in poverty,” she said.

Some elements of ARH had been incorporated into the school curriculum to address adolescents’ sexuality issues, while at the same time educational and training programmes were being conducted for adolescents with the aim of instilling greater resilience, positive values and promoting healthy lifestyles.

A technical working group of sexuality education was also incorporated into the National Social Policy last year.

Fatimah also spoke on the great strides made by Malaysian women in all areas of development, stating that 58.8% of undergraduates were females, resulting in almost half the working population being women.

“The female labour force increased from 41.9% in 1991 to 46.7% in 2002,” she said.

New Health Minister

Prime Minister Abdullah Badawi has announced the new Cabinet.
Chua Jui Ming is out and in comes Chua Soi Lek (incidentally also an MCA man, also a Chua and also from Johor!)

Flourishing global herbal mart

There is big money in herbs, and the Malaysian Herbal Corporation is
gearing Malaysia to become a global player by 2010 to capitalise on the
local market expected to be worth RM8 billion by then.

The current value of the local market is RM3.8 billion, while the global market is estimated at US$80 billion (RM304 billion).

Gabungan Wawasan Generasi Felda chairman Tan Sri Rozali Ismail said of the current herb market of RM3.8 billion, RM2 billion went to herbal remedies, RM1.6 billion on flavours and fragrances, and RM1 billion on pharmaceuticals and nutraceuticals.

Annual growth was expected to be 15 to 20 per cent, he said.

The World Bank anticipates that the market will hit US$5 trillion by 2050.

The major herbal products markets are Europe, North America, China and Japan.

In 1996, the World Health Or-ganisation estimated that 3.5 billion people in developing countries relied on plants as key components of their primary health care.

"Besides aquatic animals, medicinal and aromatic plants, Malaysia has 15,000 species of flowering plants besides lower plants and soil microorganisms. Of these, 1,200 species have potential pharmaceutical value," he said at the launch of the four-day Herbal Asia 2004 expo at the Mid Valley exhibition centre, organised by Forest Research Institute Malaysia and Gitex (M) Sdn Bhd.

Herbal Asia 2004 is the first international herbal exhibition and trade show of its kind in Malaysia, bringing together international and local farmers, planters, manufactur-ers, retailers, researchers, agri-scientists and non-governmental or-ganisations.

It showcases the industry's herbal products, technology and services to the latest in alternative medicine, and provides a platform for producers and manufacturers, investors, health and industry-related professionals to meet, exchange ideas and promote this rapidly growing industry.

Rozali said traditional medicine continued to flourish, due also to the failure of modern medicine to treat AIDS and cancer.

"The belief is that herbal medicine is natural and bears less side-effects," he said.

Earlier, MP for Beruas Datuk Seri Dr Lim Keng Yaik said the Malaysian Industry-Government Group for High Technology (MIGHT) had drafted plans to turn Malaysia into one of the biggest global producers of herbal raw materials and products by 2010.

In a speech read by the ministry's secretary-general Datuk Dr Abdullah Mohd Tahir, Dr Lim said the everexpanding market for herbal products had increased demand for raw materials.

The State Forestry Departments have licensed and regulated extraction and movement of medicinal and herbal plants from forests to curb indiscriminate harvesting.

To ensure continuous supply and reduce pressure on natural forest, the Forestry Research Institute of Malaysia has launched a pilot project in Maran, Pahang, to systematically cultivate herbal plants like Tongkat Ali and Kacip Fatimah.

Dr Lim said the use of herbs as alternative medicine was reflected in the increasing sales of herbal products.

To gain a foothold in the global herbal market, Malaysia must compete in terms of quality, efficacy, safety, pricing and even packaging besides meeting the requirements of the European Union, Japan and US.

Revisiting healthcare

IT has been eight years since the Government adopted a national-level strategy to leapfrog the country’s healthcare system to a new e-Health paradigm. With the Multimedia Super Corridor Telehealth Project and MSC Telehealth Blueprint (1997) in place, the Government hopes to transform the healthcare system to a nation of healthy individuals, families and communities via the adoption of information technology (IT).
To support the developments in e-healthcare, the country also went on to define the legal framework with new cyberlaws such Telemedicine Act 1997, Digital Signature Act 1997 and Personal Data Protection Bill.
Even a Telehealth Unit under the Health Ministry was established to oversee the project implementation and play a strategic role in aligning future IT projects undertaken by the Ministry. The unit is also responsible for the development of code sets, policies, health informatics standards and functional specifications of e-Health applications.
Several significant developments have taken place since the launch of the MSC Telehealth project. Among them are the establishment of two hi-tech hospitals with total hospital information systems (Selayang Hospital and Putrajaya Hospital), 37 health centres and two hospitals (Hospital Kajang and Hospital Seremban) with clinical information systems, and 42 health centres with teleconsultation facilities. Another 14 hi-tech hospitals will be rolled out by next year, and another 20 are in the planning process.

Lacking human capacity
Though the e-Health endeavour has come a long way, the country is currently facing a shortage of domain experts or health informaticians in the design, development and deployment of the e-Health projects, says Dr H.M. Goh, secretary for both Malaysian Health Informatics Association and Asia-Pacific Association for Medical Informatics.
He attributes this shortage to the lack of awareness by the stakeholders and healthcare community about health informatics.
The field of health informatics provides the training and research opportunities to develop and implement new technologies that will enhance decision support to healthcare professionals and biomedical scientists.
“While our doctors need to be more IT savvy, so must IT professionals be more medical savvy,” Dr Goh says. “We need a good mix of both type of professionals to exchange ideas and collaborate in research and development.”
“We cannot provide quality, safe and efficient healthcare without IT, so there will be a direct impact to the cost of healthcare. As Malaysia is getting more developed, demographics have changed too and people are living longer. We will be dependent on strategic information to manage our national health and policy-making. We can’t get timely information for planning if we don’t computerise,” he explains.
In addition, he believes that if the country is serious about health tourism to attract international patients, she must be better equipped and IT-ready, otherwise patients will choose to seek healthcare elsewhere.

People development
Dr Goh calls for a more structured national training programme to be established and given high priority. This, he says, is to ensure that Malaysia has sufficient human resource expertise to meet the demand for the e-Health projects.
He suggests that academic institutions look into developing a more structured curriculum to churn out more health informaticians, and that the country emulate some of the successful initiatives undertaken by countries such as Taiwan, South Korea and Japan in human capital development.
Taiwan has started many postgraduate programmes in health informatics while Korea and Japan have recognised professorship in health informatics. These, Dr Goh says, have created a strong research foundation for health informatics development.

Standards development
Apart from people development, standards development in healthcare is equally important, points out Dr Goh.
To meet national objectives, standards must be in place so disparate and fragmented systems can work together, interface and collaborate, he says. This way, health information can be standardised among different healthcare facilities, and a more continuous and seamless care can be achieved.
These standards need not necessarily be created, according to Dr Goh. “Some of the standards have already been developed elsewhere and we can actually evaluate them for possible adoption and integration. Additionally, we can localise some of the international standards for our own use,” he says.

Philips eyes govt sales for iU22



Dutch firm Royal Philips Electronics is scouting for procurement opportunities in Malaysia to supply at least 10 units of its new iU22 Ultrasound Systems machines this year.

The 10 units, which are worth between RM9.5 million and RM11.4 million, would be for government hospitals and private medical establishments, said its senior vice president for medical systems Victor H Reddick at a press conference after the launch of iU22 in Singapore on Friday.

Officials from Universiti Kebangsaan Malaysia Hospital and Kuala Lumpur Hospital were present at the launch.

“Malaysia is an interesting market for us (Philips). Its government adopts a clear direction on the healthcare industry. It has been investing in new hospitals and rehabilitating existing ones,” he said.

iU22, Philips’ latest ultrasound product in the premium market segment, costs between US$250,000 and US$350,000 a unit. The machine’s smart features include intelligent control and advanced ergonomic design, real-time imaging, voice-activated control and automated image optimisation technologies.

Reddick said clinicians would be more confident in their diagnosis due to image clarity and higher patient-handling time instead of equipment-toggling with voice-recognition feature.

The company will demonstrate iU22 to local doctors and physicians at a Magnetic Resonance Imaging event in Kuala Lumpur on April 4.

Philips expects to supply more than 200 units of iU22 to the Asia Pacific region, in which Malaysia, Singapore and Thailand are its lead medical equipment markets.

Philips Electronics Singapore Pte Ltd chairman and chief executive officer Mourad Mankarios said Philips was also planning to work out financing arrangements for its iU22 customers that may involve tie-ups with the local banks and finance companies.

Philips has shipped seven units of iU22 and will deliver 30 more to Singapore by the end of this month. The company has forecast that medical equipment sales in the Asia Pacific market will contribute 30% to the group’s revenue this year from 22% a year earlier. For the financial year ended Dec 31, 2003, it posted a net profit of €695 million.

American dream

Today a respected specialist surgeon in America, a health policy lecturer and an author of medical textbooks, Dr Lee Keat Jin was just a naïve, sheltered schoolboy in Penang half a century ago. ZACK YUSOF speaks to the doc about his struggles and journey to self-realisation

The Star has an interesting write up on a local boy who made good in Malaysia in the filed of medicine.

Excerpt:

In late 1958, Lee was enrolled at Harvard University, after an interminable five-week boat trip. However, when he went to Harvard, he found out that nuclear physics was not his strength and duly made the switch to medicine. After graduation, he proceeded to Columbia University College of Physicians and Surgeons, completing his formal training in otolaryngology surgery at Harvard Medical School.

Fast forward to the present day, Dr Lee is now a successful and widely respected doctor who practises and teaches at Yale. These days, he can also be found travelling around the world lecturing on heath policy. In practice for over 30 years and widely regarded as something of a pioneer in his field, Dr Lee has authored several articles and many books and has also invented about a dozen medical instruments, including a drill for pituitary surgery. In addition, he has also pioneered new surgical procedures to treat disorders of the ear, nose and throat.

Now residing in Cambridge, Massachusetts, Dr Lee was back in Malaysia for six days last month to conduct a series of lectures on various health-related issues. Generously taking time out from his busy schedule, he took a stroll down memory lane back to his childhood days in idyllic Penang during a recent interview.

MOH steps up campaign against measles

About 4.5 million schoolchildren aged between seven and 15 will receive free measles vaccinations in a nationwide campaign due to start in April.

Health Minister Dato’ Chua Jui Meng told reporters that the campaign would cover children below 15 as many would not yet have received a booster vaccination. The current immunization practice for measles, where jabs are given at age one and seven, was only introduced in 2002; previously, booster doses were not given.

The national immunization program successfully reduced the number of cases from almost just over 9,000 in 1982 to about 500 in 1990. In the 1990s, the average number of cases was 300 to 615 per year. However, about a decade later, the rate increased to 6,200 with seven deaths.

These outbreaks began in children who were not immunized or did not obtain adequate protection from the vaccination.

According to Chua, measles remains the biggest killer of children of all the vaccine-preventable diseases.

“Every year for the last 5 years, we have seen a total of 30 million measles cases and 875,000 deaths from measles globally. [It is still] a major threat to mankind even though immunization programs have been launched by the WHO,” said Chua.

The local campaign will run from April to June followed by a “mopping up” campaign from July to September to vaccinate children missed in the initial phase. Trained healthcare staff from the public health department and health clinics will visit schools to ensure all the children are immunized. Parents will also be able to bring children who have missed the campaign or who are not schooling to the nearest health clinic for the free vaccination.

“Children will be immunized irrespective of whether they had been immunized in the past or had measles in the past,” Chua said.

He urged parents to fully cooperate with the Health Ministry, reminding them that measles can be fatal due to accompanying complications, such as pneumonia and severe diarrhea.

Korean vaccine-maker drawn to BioValley



A Korean biotech company is planning to set up Southeast Asia’s largest human vaccine plant in Malaysia’s BioValley, sources say.

Sources say the company, Glovax, will produce the Japanese encephalitis (JE) vaccine and plans to develop a vaccine for dengue as well at the Malaysian plant.

A source familiar with the plan says Glovax is looking to raise up to US$100 million (RM380 million) for this venture, with one of the main financiers being Malaysian Debt Ventures (MDV) Bhd.

The funds raised will be used to build the factory, for equipment purchase and hiring of scientists.

Glovax, a privately owned company, is renowned for its patents and production of the JE vaccine.

It has outsourced the production of the JE vaccine to a Chinese company in Chengdu, China. The Chinese plant is the only one producing the vaccine at the moment, catering only to the domestic market. Glovax is, therefore, looking for a location for a new plant and has decided on Malaysia, drawn to the BioValley initiative.

Glovax is believed to have been attracted to the BioValley because of its incentives such as a 10-year rent-free offer — an incentive expected to be one of the attractions to lure investments into BioValley.

“They are also attracted to Malaysia because of the availability of funds here, mainly MDV,” says a source close to the proposed plan.

Malaysia’s BioValley is situated on an 800ha site in Dengkil, Selangor, south of Cyberjaya and Putrajaya. It is within the larger Multimedia Super Corridor.

The RM2 billion BioValley, which will include research, commercial, educational, recreational and residential facilities, is expected to be fully completed by 2009.

Sources say that Glovax’s plan may also involve a number of financial backers apart from MDV, including government grants and private venture capitalists, due to the large amount of funds needed.

It is learnt that MDV is likely to ask for permission from the Japanese government to allow it to invest more than the current cap of 10% of its total funds.

MDV uses the money loaned from the Japanese government to provide loans to deserving technology and non-technology ventures in Malaysia and abroad, which traditional financial institutions will not fund.

Based on MDV’s total funds of RM1.6 billion, the 10% cap would mean that MDV could lend only up to RM160 million per company.

WoMan: A precious gift of health

THREE years ago, Datuk Seri Endon Mahmood expressed a dream — of a clinic that will provide health screenings as well as educate women in preventive diseases. Specialists would provide the services free of charge, or at a very affordable cost. "We need to keep women informed about their health and educate them on proper measures against all kinds of diseases. We need a wellness centre which provides information as well as services that are accessible to women and their families," said Endon. Last Thursday, her dream came true. The First Lady launched the Kelinik Nur Sejahtera at the National Population And Family Planning Board (LPPKN), in Jalan Raja Laut, Kuala Lumpur, with Woman and Family Development Minister Datuk Seri Shahrizat Abdul Jalil.

"This is our gift from us to you," said Shahrizat at the opening. The clinic focuses on prevention of diseases through periodical health screenings for diseases. Nur Sejahtera will also organise talks, seminars and workshops to raise public awareness and also educate people on health care and medicines on the prevention of diseases. It will also advocate maintaining a healthy lifestyle. Shahrizat said there are six packages available for screening — general women's health, cancer, treatment for menopause, family planning, weight management and general health for men. She said the packages came either with free consultation or a low fee, and would be handled by seven specialist doctors who have offered their services on a part-time basis. These doctors are prominent specialists in the country and experts in various in various disciplines. They are Dr Nor Ashikin Ahmad Mokhtar (obstetrics and gynaecology), Prof Madya Dr Aminuddin Ahmad (gastroenterology), Prof Dr Raman Subramaniam (obstetrics and gynaecology), Datuk Dr Tan Hui Meng (urology), Prof Dr Yip Cheng Har (surgery), Dr Tee E Siong (nutrition) and Dr Salina Low Abdullah (psychology).

Besides these doctors, there are also a few specialists who are willing to offer their services in cardiology, endocrinology and other fields of medicine. "I want to make sure cost concerns don't keep a woman from getting these life-saving screenings," said Shahrizat. "We have asked other private clinics to offer their expertise as well. Right now, Pantai Medical Centre has agreed to set a minimum price of RM90 a year for mammograms for women with lower incomes. "We will try to get the services at even lower rates, hopefully," she added.

Urging the people to make use of the facilities, Shahrizat said: "The preventive concept is suitable and timely, especially these days when cancer is becoming a common occurrence. We should use this opportunity to enhance our health.

She was also concerned about women neglecting their health after menopause. Regular medical exams are just as important to a woman's health after menopause as they are before. Some women still mistakenly believe that because they no longer menstruate, some of the screenings they used to take — mammograms and pap smears — are no longer needed. "With education and the right information, it will be possible for us to prevent these diseases as well as to cure them at the early stages. Hence, free health talks will also be held at the clinic every month," she said. Similar programmes all over the world have screened hundreds of thousands of women for early detection and successful treatment of both breast and cervical cancers. Breast cancer is most curable when detected in its earliest stages and cervical cancer is nearly 100 per cent preventable with regular Pap smears. A Pap smear can find cervical cancer long before signs and symptoms show up.

But why do significant numbers of women still die of one of the most preventable and best-understood malignancies? This is definitely because of the lack of effective screening programmes, especially for those medically underserved, explained Shahrizat. Women's health is a matter of global concern. Women are becoming increasingly affected by cancer, HIV/AIDS, and heart diseases. The Malaysian health care system has achieved some degree of success, and it is reputed to be among the best in the Asia-Pacific region. And yet there are still so many out there who have not had a Pap smear or breast check even once. "Before you take the woman you love shopping for a gift, before you take her anywhere at all to celebrate her birthday, take her to the clinic. That would be the best gift you can give the woman you love — the gift of health," Endon said.

Realising a dream to prevent a nightmare

The recent launch of the first Nur Sejahtera clinic is, as Datuk Seri Endon Mahmood says, the result of "hard work and determination of the Ministry of Women and Family Development (KPWK), in demonstrating its awareness towards a crucial basic need of women and family." "I am honoured to officiate another realisation of the KPWK's dream," she continued, having been there three years ago to launch the ministry's budding vision.

Begun in 2001, Nur Sejahtera's primary aim was to create and increase health awareness among women and family. In almost 15 years of experience in women's health, programme co-chairman Dr Nor Ashikin Mokhtar has seen much ignorance shown by even professional women as regards women's health.

Targeted principally at the poor, Dr Nor Ashikin says the three years of Nur Sejahtera road shows, lectures and seminars have reached "hundreds of thousands of women all over the nation." According to her, after each event, LPPKN would get requests for more like programmes, "and that's when we knew that we needed somewhere for them to keep coming back to for more information." The Nur Sejahtera wellness clinic and information centre, situated in the LPPKN building in Kuala Lumpur, will now serve as the first permanent base of the Nur Sejahtera programme.

Chief among the parties responsible for the materialising of the clinic, says Dr Nor Ashikin, is Datuk Seri Shahrizat Abdul Jalil, the Minister of Women and Family Development.

"She actually stayed the whole day and sat through the seminar I gave," says Dr Nor Ashikin of the minister, in reference to the inaugural seminar held after the 2001 launch of the Nur Sejahtera: Sihat dan Segak programme.

"She keeps her promises," Dr Nor Ashikin added, explaining that when the idea was first proposed to Shahrizat, the minister saw it as a "value programme." Since then, Dr Nor Ashikin has seen all plans approved and efficiently implemented.

Shahrizat in turn expresses gratitude to the Prime Minister's wife for being the inspiration in her ministry's project.

"Datin Seri's strength and bravery in facing her own predicament inspired me to push the project through," says the minister. "We talked about how important health is and how important doctors are," adding also that from experience, Endon couldn't emphasise enough how important the surrounding is for a patient's well-being.

This aspect motivated Shahrizat to press for clinic aesthetics, on top of equipment and staffing, making Klinik Nur Sejahtera truly a one-of-a-kind, one-stop family wellness and information centre.

LPPKN director-general Fatimah Saad calls Shahrizat, "a breath of fresh air," as the latter has introduced new approaches to the concept of wellness, which includes making the clinic premises as beautiful as the limited budget allows.

Now LPPKN is able to narrow healthcare inequalities between the rich and the poor from all angles.

"This clinic is the ministry's gift to Datin Seri and the nation's women," says Shahrizat. Based on the concept of prevention and early intervention, Nur Sejahtera clinic provides comprehensive health screening and laboratory testing services. It is well equipped in terms of both facilities and expertise.

Apart from permanent staff of trained clinical personnel and doctors, Nur Sejahtera canvassed for, and got, the volunteer services of specialists in various fields from various establishments.

The list of prominent doctors includes Dr Nor Ashikin herself, a gynaecologist with Pantai Medical Centre. Not content with serving on Nur Sejahtera's Perubatan dan Saintifik advisory panel, Dr Nor Ahsikin is one of about 15 volunteer specialists who will be working at least once a month on a rotational basis.

Some of the specialists confirmed so far are Dr Zain Al Rashid of Pantai Medical Centre, Professor S.P. Chan of Universiti Malaya, Professor Dr Muhammad Abdul Jamil Mohd Yassin of Universiti Kebangsaan Malaysia, Datuk Dr Haron Ahmad of Damansara Specialist Hospital, Dr Suniza Sufian of Universiti Kebangsaan Malaysia and Dr Norlaila Mustafa of Universiti Kebangsaan Malaysia.

For Institut Jantung Negara consultant cardiologist Dr Azhari Rosman, it is a small service to offer in view of Dr Nor Ashikin and Shahrizat's dedication to promoting family health.

"I have worked with Dr Nor Ashikin on many projects before on men's health," and in the name of common interest, he volunteered his expertise. "Datuk Seri Shahrizat has also worked with us on health programmes," Dr Azhari gave another good reason for joining the panel, "and for Nur Sejahtera, I felt honoured that she took the trouble to write me a personal invitation." Dr Azhari finds Shahrizat "easy to work with and she prioritises family health as an important asset." He therefore considers one day a month "not too much", even with his tight regular schedule at IJN. Pantai Hospital as a group has also offered a much appreciated discount programme for mammograms conducted on patients referred to them by Klinik Nur Sejahtera. For one year, Pantai CEO Datuk Dr Ridzwan Bakar has agreed to reduce mammogram charges from RM150 to RM90 for Nur Sejahtera referrals.

Q is for quit

Want to say tak nak and quit smoking? There are 300 quit-smoking clinics based in hospitals and government health clinics all over Malaysia. All you need to do is make the effort, writes TEE SHIAO EEK.

RAMESH Muniandy has lit up more than 10,000 cigarettes in his lifetime. When he started smoking at the age of 13, he only had three or four cigarettes a day. By the time he entered university, he had graduated to at least 30 cigarettes a day.

Today, he doesn’t smoke anymore, and urges other smokers to quit as well.

Dr Sallehudin bin Abu Bakar...'Tobacco dependence is a disease.'
“Quitting smoking improves symptoms of bronchitis, asthma, emphysema and other chronic obstructive pulmonary diseases (COPD). If a smoker stops before middle age, his health risks are reduced to the level of a non-smoker,” says Dr Sallehudin bin Abu Bakar, Deputy Director of the Wilayah Persekutuan Health Department.

“Approximately 15 to 20 years after a smoker quits, the risk of lung disease and coronary heart disease will be almost as low as that of a non-smoker. The risks take a long time to reduce (because) the damage to your organs is almost permanent,” he adds.

Two decades may seem impossibly long, but one cannot expect the toxic effect of cigarettes to disappear overnight. There are, after all, more than 4,000 chemicals in cigarette smoke, including hydrogen cyanide, butane, acetone, ammonia and cadmium. It is these chemicals that cause smoking to be a risk factor for 25 types of diseases.

“Smoking causes 90% of all cancers. It is a major cause of throat cancer, stroke, coronary heart disease and erectile dysfunction,” says Dr Kuppusamy Iyawoo, Head of the Institute of Respiratory Medicine.

“Smoking is also dangerous to family and friends. About 75% of cigarette smoke is released into the environment as second-hand smoke, which increases the risk of lung cancer,” he adds.

It was a picture of blackened, diseased lungs that finally drove the point home for Muniandy. The shocking revelation that he was putting himself and his loved ones in danger made him decide to quit.

In this day and age, it’s safe to say that only a few people do not know about the consequences of smoking. Despite that, the nicotine addiction is still strong, with five million adult smokers in Malaysia.

[abbreviated - read more at the link above]

There are 300 quit-smoking clinics based in general hospitals and government health clinics all over Malaysia. Klinik Q is situated in the Institute of Respiratory Medicine (before Hospital Tawakal), Jalan Pahang. It is open on Tuesdays (2.30-4.00pm) and Saturdays (8.30am-12.00pm). If you wish to register, you can walk in or call 03-4023 2966 to make an appointment. Treatment is absolutely free.

RM75 mil biogenerics plan

Two years ago, the Malaysian government quietly invested RM75 million in a biotech venture to make "biogenerics" or off-patent biotech drugs. The company, a wholly owned subsidiary of the Ministry of Finance, is Inno Biologics Sdn Bhd. However, up until now, the government has still not made a formal announcement on the investment.
This lack of information on Inno Biologics has drawn much criticism. Some believe the company failed in its first attempt at making insulin. Others reckon that Inno Biologics spent too much money paying hefty licence fees for access to certain process technologies.
Yet others question the appropriateness of the deal - how did the Science Adviser (Tan Sri Datuk Dr Ahmad Zaharudin Idrus) to the Prime Minister end up as Inno Biologics' chairman?
But in an interview with netv@lue2.0, Ahmad Zaharudin explains that the main reason for the low-key nature of Inno Biologics' formation is purely strategic. "We didn't want our neighbouring countries to know early on what we were planning as many are getting into the biotech space as well."
He also denies failed attempts at making insulin, saying that since the company was set up in December 2002, it has been busy designing its plant and enhancing and pilot-testing the process technologies involved in the making of biogenerics.
Ahmad Zaharudin says there is no conflict of interest in his position as both Science Adviser and chairman of Inno Biologics. Apart from being a government representative to oversee the development of the company, he says there is so much to be done in science and technology that conflict of interest is not relevant in this case.
He adds that he does not earn any money from Inno Biologics or ask for special favours from the government to help the company. "We could have asked the Ministry of Health for an exclusive contract to buy insulin from us but we did not," he stresses.
The raison d'ztre for Inno Biologics is to kick-start the country's manufacturing foray into the biotech arena, Ahmad Zaharudin says. "This company represents the business content aspect of the country's plans to embrace biotechnology while the three institutions in the BioValley are focused on research."
(The three institutions are the Agro-Biotechnology Institute, the Pharmaceutical and Nutraceutical Institute and the Genomic and Molecular Biology Institute.)
The bulk of the RM75 million investment will go towards the design and building of a plant, which includes a bioreactor - a container in which a biological reaction or biological activity takes place for the production of biotech drugs. A Europe-based consulting firm designed the plant according to European standards at a cost of RM1 million. At the time of writing, Inno Biologics was preparing to open a tender for the building of the plant, likely to be done in Europe. The plant will be shipped to Malaysia after passing necessary tests for such certification as GMP (good manufacturing practice) and US FDA (Food and Drug Administration) approval, explains Ahmad Zaharudin. However, he declined to reveal the estimated cost of the plant, which is expected to start operations in 2006 at the Nilai Science and Technology Park. It will have the capacity to produce 1,000 litres of mammalian cell culture, which will be used to produce biogenerics. (The large-scale culturing of mammalian cells allows for the production of biogenerics such as proteins that are otherwise difficult or expensive to extract from living organisms.)
Although Ahmad Zaharudin specified that the plant will be producing insulin and erythropoietin (a hormone normally produced by the kidney that stimulates red blood cell production), Inno Biologics' chief executive Dr Mohd Nazlee Kamal says those are just examples of the kind of biogeneric drugs that the company can produce.
The plant will also be able to produce monoclonal antibodies and be used as a facility to make drugs for companies that are conducting clinical trials for their drugs, adds Nazlee.
Inno Biologics has hired five Malaysian PhDs, including Nazlee, a qualified engineer in bio processing who was previously with Amersham Biosciences (as business area manager), Sartorius (business development manager) and B.braun biotech (sales manager). Prior to that, he had spent 10 years as a lecturer in bio processing engineering at Universiti Teknologi Malaysia. Inno Biologics' chief technology officer is Professor Dr Mohd Sanusi Jangi, a microbiologist who was a professor at Open University Malaysia and Universiti Kebangsaan Malaysia before that.
Apart from making biogenerics, the company also plans to offer contract research and manufacturing services. In the pipeline for Inno Biologics is a much larger plant, with the capacity to produce 10,000 litres of mammalian cells. It is unclear how much Phase 2 will cost and how Inno Biologics will raise the additional funding. What is clear is that Inno Biologics has started work on the design of the plant in Phase 2 and that it will be located within the BioValley.
Ahmad Zaharudin does not rule out more funding from the government (for Phase 2) but adds that they will look at other options too, such as the capital market.

Will Inno Biologics survive?
Large government-funded projects like Inno Biologics typically face criticism that they are not viable. Otherwise, why wouldn't private investors fund the project? And the typical response to such criticism is that a project like Inno Biologics is driven by national interest, not the profit motive.
In this case, the rationale for the investment is not only capacity-building (an oft-used justification these days in government-funded science and technology projects) but also that it is an opportunity that promises good returns in the long run, according to Ahmad Zaharudin.
"The government was pleased because there was a bunch of competent people who were gung-ho enough to take the risk and propose the project. There is no profit motivation from the people and we cut all costs to a minimum," he says.
Nevertheless, Ahmad Zaharudin is confident the company will break even in five years and become a RM100 million company in terms of revenue by then. It will first target the domestic market and then venture into regional markets such as Thailand and the Philippines to sell its drugs.
The competitive edge that Ahmad Zaharudin hopes will spur its success is the simple, high-quality, low-priced model. "We are doing things very cheaply yet we have the necessary scientific brain power to ensure our products are of high quality."
But it can be argued that this is the same model that others in the region are toying with. Even at home, Inno Biologics will possibly face competition from an insulin plant being built in Penang. In June last year, it was announced that a US$34-million (RM129.2 million) human insulin plant will come onstream by mid-2005 in that state. The project is a joint venture between the Penang Development Corporation and London-based GeneMedix plc. The latter was founded by well-known Malaysian biotechnologist Dr Kim Tan. GeneMedix will license its insulin-making technology to the Penang plant, which will then manufacture and commercialise human insulin.
Inno Biologics would have passed its final test when it is able to market enough of its biogenerics and other services to see it break even in its fifth year, and report the RM100-million turnover its chairman is confident of.

New therapy for dadah addicts

PUTRAJAYA, Mar 09:

The Government is turning to drug substitution therapy, using methadone on
dadah addicts, under a plan to overhaul the conventional drug
rehabilitation system.

Deputy Home Minister Datuk Chor Chee Heung said a pilot study would begin next month involving 50 ex-Pusat Serenti inmates from the Klang Valley, who would be given methadone for three to six months.

Methadone suppresses the craving for the "high" obtained from drugs such as heroin, morphine and codeine.

The treatment works on the medical premise that some people may be predisposed to drug addiction because of biological deficiencies, such as their body's inability to produce natural endorphins as a response to pain.

Notably, drug substitution therapy has also helped to curb the spread of HIV/AIDS, hepatitis and other diseases spread through needle sharing.

In Malaysia, about 80 per cent of persons with HIV/AIDS contracted the disease through needle-sharing.

The treatment could change the way drug addicts were viewed here; no longer as people with social and psychological problems but as medical patients, said Chor.

"The addict will be like a patient who can take his medication and go about living a normal life.

"He will be just like a person who requires medication for diabetes or high blood pressure," he said. The pilot study is jointly conducted by the National Drug Agency, Universiti Malaya Medical Centre (UMMC), Universiti Sains Malaysia (USM) and Duopharma (M) Sdn Bhd, the maker and sponsor of the drug.

The Government is to decide whether the drug therapy will be adopted in its Pusat Serenti rehabilitation programmes after the pilot study.

The project is focused on ex-inmates because 75 to 80 per cent of them relapse upon release from rehabi-litation centres.

Conducted voluntarily, ex-inmates must obtain the consent of their families and moral support from their local communities or non-governmental organisations.

The idea is to make drug substitution therapy a community-based treatment, whereby an ex-addict can be treated while being an active member of society.

The Government hopes to determine the cost of treatment per person through the pilot study.

The non-monetary benefits and positive effect on society as a whole would be tremendous, said Prof Dr Muhamad Hussein Habil, UMMC's consultant on drug addiction and a Universiti Malaya professor. "It helps the ex-addict return to a normal life by stabilising his relationships with others, thus reducing crime and allowing him to work and contribute to society," said Hussein.

Jactim’s donation for haemoglobin meters

Expectant mothers in rural areas can look forward to their nearest health
clinic having a haemoglobin meter, which is used to detect anaemia, thanks to a donation from the Japanese Chamber of Trade and Industry, Malaysia (Jactim) Foundation.

Jactim vice-president Datuk Masatoshi Fujiki handed over a mock cheque for RM120,000 to Deputy Health Minister Datuk Seri Dr Suleiman Mohamed today for the purchase of 44 meters. The ceremony was held at the Health Education and Communication Centre in Bangsar.

Fujiki said the donation came under Jactim Foundation's Medical Support in Remote Areas project for 2003. "We decided to undertake this project when we heard the Health Ministry's request for assistance.

"The foundation hopes the contribution will help promote better health management, especially among those who live in remote areas where medical facilities may be less sophisticated than those available to the urban population." He said the haemoglobin meters were particularly effective for early detection of anaemia among expectant and nursing mothers.

Expressing his gratitude to the Jactim Foundation, Suleiman said the donation was timely as 20 per cent of health clinics in Malaysia lacked the meters.

"Anaemia, one of the leading causes of morbidity among antenatal mothers, can be easily treated if detected early. To date only 686 clinics out of the 858 health clinics in Malaysia are equipped with the meter." The Jactim Foundation was established in 1994 to assist cultural, social and educational development in Malaysia and in the process help strengthen the mutual understanding and friendship between Malaysia and Japan.

Welfare fund to get RM20m more

THE Government has approved an additional RM20mil – over the earlier RM5mil – to help chronic patients.

The extra allocation would also be used to set up a one-stop centre to help patients in need of aid to apply from the National Health Welfare Fund, reported Utusan Malaysia.

Health Minister Datuk Chua Jui Meng said the centre would help to speed up the application process and reduce red tape, as applicants no longer required approvals from various departments. It would be located at the ground floor of the ministry’s Block C in Jalan Cenderasari, Kuala Lumpur.

Doctor found drowned in car

PETALING JAYA: One of the country’s most prominent gastroenterologist was killed when the car he was driving plunged into the Klang River in PJS 7/15 here yesterday.

The body of 55-year-old Dr M. Panir Chelvam, who specialised in digestive diseases, was recovered at noon and sent to the University Malaya Medical Centre (UMMC) for a post-mortem.

Petaling Jaya Selatan Deputy OCPD Asst Comm Osman Abu Bakar said Dr Panir was believed to have lost his way in Bandar Sunway while heading home towards Bangsar Baru when the accident occurred at 2.30am.

“Post-mortem results indicated that Dr Panir had drowned and we have ruled out foul play,” he said.

ACP Osman said although the accident occurred at 2.30am, the authorities were only informed of the accident at 9.30am, when a member of the public contacted the police.

A team of policemen from the Petaling Jaya Selatan police headquarters and Sungai Way police station rushed to the scene together with a search and rescue team.

When the rescue team failed to open the car door to pull out the driver, a tow truck was called to help at about 11.30am.

Dr Panir's black-coloured Mercedes Benz was finally pulled out of the river some 30 minutes later.

It is learnt that Dr Panir was wearing his seat belt during the incident and his car doors were locked. His cash and valuables were found intact.

Dr Panir was awarded the Kesatria Mangku Negara by the Yang di-Pertuan Agong in 1998.

He leaves behind his wife Dr Sheila Pillay and two daughters P. Alisha, 18, and P. Kavita, 16.



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Condolences to the family.

TH Group Bhd buys Nilai Cancer Centre

TH Group Bhd said it has received approval from the Securities Commission for its proposed acquisition of Asiaprise Biotech Sdn Bhd, which owns the Nilai Cancer Institute (NCI), Malaysia’s first private oncology specialist hospital.

TH Group said it was buying Asiaprise for RM43mil to be satisfied by RM9.7mil in cash and the issuance of 30.2 million new TH Group shares at RM1.10 each.

“The acquisition of NCI marks TH Group’s entrance into the healthcare industry, making it our fourth core business,” said group managing director Lei Lin Thai in a statement. The group’s other core activities are plantation, contracting and timber extraction.

Merged funds make aid more accessible

THE Health Ministry’s Special Chronic Diseases Fund has been merged with the National Health Welfare Fund to make it easier for the low-income group to get medical aid, Utusan Malaysia reported.

The Government decided to merge the two funds because those seeking aid were confused by the two funds, Minister Datuk Chua Jui Meng said.

“The applicants did not know which one to apply to,” he said.

The Chronic Diseases Fund is headed by the ministry’s secretary-general and the Welfare Fund by the minister.

Chua said that with only one fund to manage, the ministry hoped to assist eligible applicants by lessening red tape.

The report said the Cabinet also agreed to do away with several conditions on applying for aid, including one that specified that applicants should not have a household income of more than RM600 and that they had to match each ringgit provided by the fund.

Chua said there was a special RM100mil fund announced in last year’s Budget and RM2mil of it was allocated to the Chronic Diseases Fund.

“However, not a sen (of the Chronic Diseases Fund) was used since the application requirements were too tight,” said Chua, adding that the allocation was withdrawn at the end of the year and not carried forward to the following year.

“A new condition agreed upon by the Cabinet is that the grant (for chronic diseases) absorbed by the Welfare Fund be not withdrawn at the end of the year,” said Chua.

He added that the Cabinet was informed that 49 applications involving RM1.677mil were approved under the Welfare Fund in 18 months

MEDICAL care is not a privilege but the right of every citizen.

If a person cannot pay, the Government should step in and help. But welfare would be better served if people volunteered to augment the efforts of a caring state. And non-governmental organisations have done exemplary work in assisting the Government to treat patients suffering from severe kidney ailments.

Haemodialysis can help a kidney patient lead a normal life, but it requires regular weekly treatments on a dialysis machine. Ideally, all those suffering from end-stage renal failure should be able to receive dialysis in government hospitals. But they are already stretched to the limit and treatment in private clinics is expensive.

The NGOs have extended a life-saving service by setting up centres to provide subsidised treatment to patients. The Health Ministry has rightly given them financial aid. The amount is not small, totalling RM33.4 million for the 52 centres run by NGOs since 2001. This works out to an average of some RM11 million per year. But it is money worth spending because there is nothing more precious than saving lives and easing the suffering of patients and their families. The NGOs should continue to build more dialysis centres by raising funds on their own. This is a worthwhile cause to which we should all contribute.

Promotion for more Health Ministry staff in the pipeline

The Health Ministry will continue to appeal to the Public Services Department (PSD) for additional allocation to provide an opportunity for more staff and officers from all categories to gain promotions.

Health Minister Datuk Chua Jui Meng said his Ministry was always concerned with the development and welfare of its staff, especially those who deserved promotions.

"The Ministry works closely with central agencies like the PSD, Finance Ministry and the Public Services Commission to speed up the process. It is important that recognition be given where due to enhance the commitment and dedication of staff," he said.

He said about 5,511 staff from the Ministry were promoted in various schemes and job grades last year.

"The number promoted last year was better compared to 2002, and was a 257 percent increase. To my knowledge, I have not come across such a big number of promotions in a year. It is a good sign for the health sector in the country," said Chua.

Meanwhile, Chua said the Cabinet would meet to initiate only one special fund called Tabung Kebajikan Kesihatan Kebangsaan (TKKK).

"The Finance Ministry would introduce RM20 million warrants to TKKK for the purpose," he said.

Chua said the fund would ease the burden of the lower income group to seek medical treatment.

Najib names free clinic after father

Deputy Prime Minister Datuk Seri Najib Razak has had a free clinic named after his late father, former Prime Minister Tun Abdul Razak Hussein.
The clinic, to be run by doctors serving in the armed forces and other volunteers, will offer treatment to those suffering from diabetes, high blood pressure and kidney-related problems.

Najib, who is also Defence Minister and Member of Parliament for Pekan, said many people in the constituency had approached him about their health problems.

"I think it is appropriate to start a clinic that offers free treatment and medicine to those in need," he said at the launch of the clinic yesterday.

The clinic is housed in the former residence of the nation's second Prime Minister, Najib's father.

Najib also paid tribute to Yayasan Sinar Malaysia and its chairman Hashim Tan Abdullah for their role in realising the project.

Later, he launched a mobile clinic to provide medical services to areas within the Pekan constituency.

Resorts World ventures into health tourism

Genting Bhd subsidiary Resorts World Bhd yesterday launched its health holiday package via a tie-up with HSC Medical Centre.

Resorts World executive vice president Lee Choong Yan said the move marked the group’s commitment in promoting health tourism to foreigners worldwide.”The packages will be offered in all our sales offices throughout Asia and sales agents in other regions,”he told reporters at the launching ceremony.

Their “Check-in Check-up” packages priced at RM2,068 onwards offer customers five-star hotel accommoda-tion at the resorts and medical check-ups at HSC Medical Centre.

“Visitors can get their medical report on the same day the check-up is performed,” said HSC Medical Centre executive director Dr YC Lim.

Medical centres in Kuala Lumpur, Penang, Malacca and Johor have been actively promoting health tourism to residents in neighbouring countries.

Medical treatment cost in Malaysia is between 20% and 50% lower than that of Singapore and Thailand.

Culture, Arts, and Tourism deputy minister Datuk Fu Ah Kiow said health tourism in the country raked in RM41 million during the Jan-Sept period last year.

Health tourism rakes in RM41 million

The health tourism industry which was introduced six years ago brought in a revenue of RM41 million in the first nine months of last year.
The revenue was contributed by 75,213 foreign patients who had sought treatment in local private hospitals between January and September last year, Minister of Culture, Arts and Tourism Datuk Paduka Abdul Kadir Sheikh Fadzir.

The amount was RM5.1 million more than 2002 which saw 84,585 health tourists seeking treatment.

Of the total number of health tourists last year, 52,649 were from Indonesia, 5,264 from Japan, about 1,000 from United States and about 400 from West Asia.

Abdul Kadir was speaking at the launching of Genting & HSC Check-in Check-up Holiday Package at the HSC Medical Centre here. His speech was delivered by his deputy Datuk Fu Ah Kiow.

He said when health tourism was introduced in 1998, the number of tourists seeking treatment was only 39,114.

"In 2001, from a survey of 10 private hospitals, the number of foreign patients who sought treatment were 75,210 generating a total revenue of RM44.28 million...a 92 per cent increase from 1998," he said.

Abdul Kadir said the statistics showed that medical health facilities in Malaysia was as good but at much cheaper rate compared with in other neighbouring countries such as Singapore and Thailand.

"The costs of most medical treatments in our country are in fact 20 per cent to 50 per cent cheaper than in Singapore and Thailand," he added.

In a Press conference later, Fu said although the amount of revenue last year indicated that on an average, a foreign patient only spent about RM500 for their hospital bills, Fu said the amount was good enough.

"The figure is considered high because not all of them came here to seek treatment. Some of them only did medical check-ups," he said.

Fu also said that the Ministry was targeting more West Asia tourists to come to seek medical treatment apart from spending their holidays here.

He said the Ministry did not have a projection on the number of health tourists this year because "it is a unique industry and it is rather difficult to set a target."

However, he said the Ministry had been promoting health tourism overseas through its offices and publications, apart from organising familiarisation trips for foreign journalists.

The Genting & HSC Check-in Check-up holiday package offers a three-day/two-night stay at Genting Hotel or Awana Genting with three types of medical check-up - heart, heart and cancer and comprehensive - at HSC Medical Centre.

Resorts World Bhd executive vice president Lee Choong Yan said guests would be provided with limousine service from Kuala Lumpur or the Kuala Lumpur International Airport to Genting Highlands Resort and then to HSC Medical Centre at a minimum rate of RM2,068.

HSC Medical Centre executive director Dr Y.C Lim said the medical centre which was one of the world's most advanced medical centres excelling in achieving a one-stop diagnostic centre, had about 20 per cent international visitors from Southeast Asia, Hong Kong, China, US, Britain and Australia.

"With this package, we hope to increase the number by another 20 or 30 per cent," he said.