Monday, May 31, 2004

Ministry to raise next year's varsity intake for medicine :

The Star, Malaysia - 22 hours ago
... Higher Education Department director Prof Datuk Dr Hassan Said said he would hold discussions with the deans of medical faculties to find ways of increasing the number of places as well as conduct a stock check of what the country needs with the help of the Malaysian Medical Council and the Health Ministry.

“The Government has the money and the infrastructure but the problem is filling the universities with qualified lecturers. There are no takers because many prefer to join the private sector as it pays better. So maybe they have to be put on a different salary scheme to overcome the problem,” he said yesterday.

He was speaking at a briefing for editors of the media on university admission called by the National Economic Action Council (NEAC) and chaired by NEAC special adviser Datuk Rahmah Kassim.

The session was to give the press a clearer picture of the selection process and admission statistics.

Rahmah urged the public to stop looking at the public university admission figures in racial terms as entry was now based on merit.

The Star highlighted on Friday that 128 STPM and matriculation students who obtained the maximum Cumulative Grade Point Average (CGPA) of 4.0 failed to get a place in medicine, their first choice. Only 779 out of 907 top students who applied were successful.

On a long-term plan to train teaching staff for the medical faculties, Prof Hassan said: “We have schemes like the four-year specialist courses to train these people but no one wants to join them, so we cannot solve the problem.”

He said the shortage of places for medicine had been a problem for some years, adding that although land for institutions, infrastructure and teaching hospitals were easily available, hiring good lecturers remained the stumbling block.

To a question, the professor said hiring foreign lecturers would be an option to be considered.

On the salary of lecturers and medical specialists, he said it came under the Public Services Department. However, the matter was discussed at a meeting with medical deans recently but had not been brought to the policymakers.

“By next year, we expect the number of top scorers to increase. So we have to take stock of the situation, see how many doctors we need, look at our strengths and weaknesses.

“We have to look at the complete picture and then bring the recommendations to the Higher Education Minister who will take it to a higher level,” he said.

Prof Hassan said he sympathised with the plight of top students who had the grade but could not get into medicine. The 5% increase in the number of places this year was already the maximum the faculties could absorb without compromising the quality of the course.

“The universities are particular about this. There must be a ratio of one lecturer to six students. You can’t have more students without more lecturers.” he said.

He added that the Government was already subsidising 95% of the fees or RM55,000 per year per student.

He urged top scorers not to give up on their ambition to become doctors but to appeal through the universities as well as explore other means.

Those with a high CGPA who failed to get a course of their choice should apply for scholarships offered by the Public Services Department (PSD) and study loans by the National Higher Education Fund Corporation, he added.

The PSD will advertise its scholarships next month.

When asked to comment on public feedback that it was unfair to equate matriculation with STPM, he said the two were equated based on learning outcomes.

He added that although the matriculation programme was a year-long programme and Form Six a year-and-a-half, they were comparable based on what the students had learned during the course of their study, in terms of teaching hours and assignments.

“Matriculation enrols only the best students, those with a string of As. STPM is open to all,” Prof Hassan said, explaining why there were a high number of top scorers from the matriculation programme.

Of the 1,774 Science students who achieved the 4.0 CGPA, 1,247 were from matriculation.

Among those from matriculation, 789 were bumiputras, 419 Chinese and 39 Indians. Non-bumiputras comprised 10% of the total number of students in matriculation.

... [Google News Search: malaysia medical]
Medical faculties lack lecturers

New Straits Times:
There are simply not enough lecturers at local medical faculties to cope with the demand for more places. And this situation is likely to persist for the foreseeable future. What this means is that straight-A students are still going to face rejection in the future.

Education Ministry Higher Education Department director Datuk Prof Dr Hassan Said said this trend would most probably continue in future, as demand outstripped the availability of medical seats in such institutions every year.

Responding to disappointment this year among top students unable to secure medical seats in local public universities, he said the bar was being raised for entry into specific faculties every year.

A total of 128 of 907 students with 4.0 cumulative grade point averages were unsuccessful in their bid for medical seats, and allocated seats in other faculties.

Of the 779 successful candidates, 439 (56.4 per cent) were Malays, 297 (38.1 per cent) Chinese and 43 (5.5 per cent) Indians.

Hassan said the medical faculty’s lowest CGPA last year was 3.88, adding that it was 3.94 this year compared to 3.83 last year for pharmacy, and 3.50 this year for law year compared to 3.38 last year.

He said the Government was not willing to compromise on the quality of medical students by increasing seats in medical faculties without a corresponding increase in lecturers.

The ministry also wanted to maintain the current 1:6 medical student-lecturer ratio, which was the most equitable for the country, he added.

Hassan said this at a briefing for editors organised by the National Economic Action Council at the Ministry of Higher Education, following complaints today from top non-Malay students over their failure to obtain seats in medical faculties in local public universities.

The general unhappiness with the meritocracy system was a repeat of last year, where a number of non-Malay science students who performed well did not get medical seats.

He said the ministry was taking stock of the nation’s long-term need for doctors, and working with the Health Ministry and the Malaysian Medical Council on incentives for more medical lecturers.

Hassan said unsuccessful candidates, including those who had applied for medical seats, could lodge appeals with the department "as the door is not closed yet, as a few may not accept offers".

Appeals will have to be submitted by June 7.

Another option was to apply for Public Service Department scholarships, to be advertised in local newspapers next month, which also allow study at private medical institutions.

Hassan advised students to be realistic when applying for university courses by providing alternative choices of courses.

On overall entry into universities this year, he said 72,199 of the 85,966 who applied managed to obtain places.

Of this, 73.3 per cent (52,914) were Bumiputeras, 20.7 per cent (14,923) were Chinese and six per cent (4,362) were Indians.

Bumiputera performance improved by 1.2 per cent, Chinese fell by 1.9 per cent and Indians improved by 0.7 per cent, he added.

Successful applicants will have to register at designated universities on June 13... [Google News Search: malaysia medical]

Sunday, May 30, 2004

POISON CONTROL: The tobacco lobby and its tall, tall tales

TOBACCO companies have always insisted that their products contribute to the economic well-being of tobacco-growing countries.

This is not the case. In fact, the opposite is true, for tobacco increases poverty. This will be among the facts and figures that will be released tomorrow, World No-Tobacco Day.

Aptly, the theme this year is "Tobacco and Poverty: A vicious circle."

According to the World Health Organisation (WHO), tobacco is the fourth most common risk factor in diseases worldwide.

It is a leading cause of death in Malaysia, incurring high public health costs in treating tobacco-related diseases.

It deprives families of breadwinners and nations of a healthy workforce.

Moreover, on average, the expenditure of households, especially the poor, on tobacco products (estimated between four and five per cent of all their disposable income) diverts scarce resources away from many basic needs of the families.

These include food and other essential needs such as nutrition and even schooling.

In cases where family members are deprived of schooling, tobacco-induced poverty is perpetuated. It has been observed that individuals with no schooling are more likely (seven times in the case of China, five times in Brazil) to smoke than those with tertiary education.

Thus the vicious cycle of poverty continues.

So too, when family members are deprived of food, leaving them open to malnutrition which causes further "unnecessary" health expenditure.

Malnutrition can be easily averted if money is spent only on food and not wasted on cigarettes.

In Bangladesh, for example, more than 10 million people need not suffer malnutrition if 60 per cent of the money spent on tobacco is spent on food instead.

The situation worsens when tobacco users and families become prone to some form of illnesses, reducing their productivity.

In a 1994 report, WHO estimated that the use of tobacco resulted in an annual global net loss of at least US$200 billion (RM760 billion).

A third of this loss is attributed to developing countries, like Malaysia, one of the countries said to suffer a negative balance of trade in tobacco products of over US$100 million.

Generally, 75 per cent of tobacco users worldwide are in developing countries, spurred by the neglect of tobacco control, and readily exploited by the tobacco industry.

In stark contrast to the decline in tobacco use in many developed countries in recent years, the reverse is the case in developing and under-developed countries.

Of the 5.7 billion cigarettes smoked each year, 60 per cent are lit up in developing countries.

But more and more governments, development agencies and donors are beginning to realise the wide-ranging implications of tobacco use, that they go far beyond health to include poverty.

In addition, as far back as 1999, in a report entitled "Curbing the Epidemic, Governments and the Economics of Tobacco Control", the World Bank "systematically and scientifically demolished doomsday scenarios of economic loss that have deterred policy-makers from taking action".

This effectively rebuts claims by the tobacco industry and its lobbyists that policies directed at reducing the demand for tobacco (such as to increase tobacco taxes) would cause long-term job losses.

All along, the industry has fooled policy makers into believing that implementing policies unfavourable to the industry will harm the economy.

But the fact is that tobacco actually drives the vicious poverty circle as articulated in this year WTND theme. Not to mention other forms of "poverty".

For example, planting tobacco results in nutrients being leached from the soil, and it also poisons the soil because of the high level of pesticides and fertilisers used.

Tobacco growing generally harms the environment as indicated in a recent study that assessed the amount of forest and woodland consumed annually for curing tobacco.

It was concluded that nearly five per cent of overall deforestation in tobacco growing countries was due to tobacco cultivation.

It is evident thus that tobacco not only impoverishes the users and their families, but also damages the environment.

It puts undue strains on national financial and human resources, resulting in increased health-care costs, lost productivity due to illness, misery and early death.

It is therefore clear that the Malaysian Government has no choice but to act immediately to change its tobacco policies. The country has been bleeding economically with millions of its citizens senselessly caught up in the addiction.

The industry must be treated with suspicion when it lobbies for favours. Indeed, the World Bank has argued that the claims and data used by the industry thus far "greatly misrepresent the effects of tobacco control policies".

More compelling still, the Government needs to send a very positive signal that it is serious in its efforts to further eradicate poverty.

It would be a most embarrassing contradiction if the "poverty-causing" and "poverty-sustaining" tobacco industry, as WHO has described it, is given "licence" to perpetuate poverty.

To help eliminate poverty is to break the vicious poverty circle which tobacco use helps to perpetuate. This is best done by eliminating tobacco use.

* The writer is the Vice-Chancellor of Universiti Sains Malaysia. He can be reached at

Recommended site:

Saturday, May 29, 2004

Doc: Our blood supply is safe

KUALA LUMPUR: Malaysia has a safe blood supply but risky donors continue to test the system, said National Blood Centre director Dr Yasmin Ayob.

“Malaysia is one of the countries that puts safe blood supply as a priority and it has attained international standards as far as making our donated blood safe,” she said yesterday.

Donated blood is currently screened for four diseases – HIV, Hepatitis B and C, and syphilis.

Safe blood is defined as that which is not contaminated by viruses, parasites, drugs, alcohol or other material that could endanger a recipient.

“Only safe donors should donate blood,” she added.

Contaminated blood, which constituted about 2.5% of donated blood, came from risky blood donors such as injecting drug users or those with multiple sex partners, said Dr Yasmin.

She appealed to such people not to donate blood and not to use the donation process to get a free blood test.

“A few of them who come to donate are actually coming to see if they are infected with hepatitis or HIV. Maybe it's easier than going to a doctor and having to answer uncomfortable questions.

“If a positive reading is found, we send them letters asking them to report to the bank so that we can run another test. But they don't respond. Then they turn up at another place as donors and we send them another letter. This is irritating and uses up a lot of our time. It's a problem throughout the country,” she said.

Speaking at a press conference to announce the World Blood Donor Day set for June 14, Dr Yasmin said that the National Blood Centre's ongoing programmes among the youth appear to have borne fruit as the bulk of donors are aged between 20 and 25. One third of all blood donors are students, she said.

Last year, 98,936 people donated blood at the centre and mobile units, up from 96,673 in 2002.

Dr Yasmin said that the inaugural worldwide celebration was introduced to thank individuals who voluntarily donated blood without reward.

“The focus is on youth because we need a continuous supply of blood. We need healthy people to donate blood,” she said.

The inaugural World Blood Donor Day celebration at the centre will be attended by Health Minister Datuk Dr Chua Soi Lek.
Intake of medical students into IPTAs need to be studied

PENANG May 28 - Every year, about 300 doctors who have completed their housemanship resign from public service because they find themselves not cut out for a medical career, Deputy Health Minister Datuk Dr Abdul Latiff Ahmad said Friday.

He said students' interest, comprehension and exposure to the duties of a doctor should be considered before they are allowed to pursue medical courses at public institutions of higher learning to prevent them from making wrong career choices.

"This profession differs from others because it is based on skill and the ability to combine both the arts and sciences," he told reporters after opening the sixth Malaysian Islamic Medical Association's (PPIM) scientific meeting here.

Therefore, Dr Abdul Latiff said, public universities should re-examine the method of student selection into medical courses because not all students with excellent academic results would make dedicated doctors.

He said another factor encouraging doctors to leave the public service was the salary, which was much lower than that paid by the private sector.

However, he said, the trend was getting less popular because the quality of the public service had improved and private practices no longer promised the high returns it once did a decade ago.

"There are also those (doctors) who resign from the public sector because of the difficulty in getting promotion. Consequently, the government has suggested setting up a Medical Services Commission so that the promotion process for doctors in the public service differs from other civil servants'," he said.

He said the government needed to prepare a long term plan to encourage doctors and specialists to continue serving in the public sector by providing them various facilities.

For the long run, he said, the government must set up many more medical faculties, including in public institutions for higher learning which previously did not offer medical courses, to cater for a ratio of one doctor to every 800 patients (1:800) by the year 2020. The current ratio is 1:1,400.

Dr Abdul Latiff said the number of Malay doctors had also increased and according to the year 2002 statistics, there were now 5,346 Malay doctors or 40 percent compared to 4,151 Chinese doctors or 31 percent and 3,546 Indian doctors or 29 percent.

Friday, May 28, 2004

128 top scorers fail to get into medical school

KUALA LUMPUR: As many as 128 students with top grades for their STPM and matriculation examinations failed to get into medicine in public universities because of the stiff competition and the limited number of places available.

Among the sciences, competition for the 779 places for medicine was the toughest – 14% of applicants with the maximum Cumulative Grade Point Average (CGPA) of 4.0 who put medicine as their first choice did not get a place.

Many students with excellent results also failed to get into other competitive science courses like dentistry and pharmacy because of the higher cut-off points this year, partly due to a spillover of students who missed the cut for medicine.

This year, an amazing number of students – 1,774 – obtained the maximum CGPA, and more than half of them applied to do medicine

Higher Education Department director Prof Datuk Dr Hassan Said attributed the keen competition to the high number of top scorers in last year’s STPM (Sijil Tinggi Persekolahan Malaysia) examination and matriculation programme.

“The cut-off point for medicine is 4.0 this year compared to 3.88 last year. This shows how well students have to do to secure a place,” he told reporters when announcing university admission figures yesterday.

This is despite the fact that the number of places for medicine has increased from 744 last year to 779 this year, or up by almost 5%. Of those offered places to do medicine, 439 are bumiputras, 297 Chinese and 43 Indians.

The cut-off point for pharmacy has also gone up from a CGPA of 3.83 last year to 3.94 this year; dentistry from 3.78 to 3.94; and law from 3.38 to 3.50.

Under the merit system for admission into public universities introduced two years ago, STPM and matriculation students are put on the same master list and students with the best results will gain admission into the respective courses. They have to indicate eight choices in order of preference in their application forms.

Of the 85,966 students who applied for admission into 14 public universities, 84% qualified for entry based on the minimum requirement of 2.0 CGPA but only 45% were offered places. Out of the 38,892 students offered places, 63.8% are bumiputras, 30.3% Chinese and 5.9% Indians.

There were marginal increases in the number of places offered to bumiputras and Indians but a slight decline in the number of places offered to Chinese students.

“We have also achieved our target of obtaining a 60:40 science to arts ratio in public universities,” Prof Hassan said, adding that 60.8% of the enrolment was for courses in the sciences and 39.2% in the arts.

A very high percentage of Chinese students – 84% – who applied for places in the sciences were successful, compared to 58.7% for bumiputras and 60.2% for Indians.

Elaborating on the merit system, Prof Hassan said in cases where students’ CGPAs were tied, their individual component papers would be taken into consideration

“If there is still a tie, we will consider their participation in extra-curricular activities.

“In a scenario where even their extra-curricular activities are equal, then we will look at their SPM grades.”

Commenting on the common complaints from students that they were not offered courses of their choice, he said there were many applicants who applied for courses that required a higher CGPA than what they had.

“If you list medicine as five of your eight choices then you may be offered other courses if your CGPA or papers do not meet the cut-off point,” Prof Hassan said.

He advised students to be wise when selecting a course of study as the cut-off points applied to courses, regardless of universities.

This meant that if a student did not meet the grade for a particular course and had it listed as five of his options, then only the three remaining options would be considered.

Often, he added, students with good results were given a course that they did not apply for if they failed to meet the cut-off point for their choices. Their course would be based on what any of the universities wished to offer them.
Asia food-safety conference addresses avian flu

Seremban, Malaysia-AP -- Countries in Asia are pledging to produce and handle food more carefully to curb diseases such as avian flu.
But delegates at a U-N-backed food safety conference in Malaysia failed to determine how governments can better disclose information about outbreaks.

The renewed spread of bird flu in northern Thailand is underscoring concerns about not only the health consequences of such diseases -- but also their financial impacts and other consequences.

Bird flu is among Asia's biggest recent public health emergencies. The disease originates in chickens. Officials say it's not spread by eating chicken, but by people who handle the birds in production.

Wednesday, May 26, 2004

Compulsory service plan

UTRAJAYA: Allied Health Science graduates like optometrists, dieticians, pharmacists, speech therapists and physiotherapists may have to sign up for compulsory service with the Government to reduce the shortage of professionals in their respective fields.

Higher Education Minister Datuk Dr Shafie Mohd Salleh said serious measures had to be taken as Health Ministry statistics showed that by next year, there would be a shortage of 49,000 health service professionals in 13 fields.

“As research in this area of health and allied sciences continues to intensify, so does the demand for human resource.

However, it is estimated that by 2005, the country will see a deficit of 49,000 health science professionals that are integral for our health services sector,” he told reporters after opening the fifth Symposium on Health Sciences, organised by Universiti Kebangsaan Malaysia, yesterday.

“Local university dons have come up with a list of proposals which my ministry is scrutinising. Among the main propositions are that graduates in these areas do a compulsory service stint and be offered a better pay scheme and incentives. There is a suggestion for the creation of a professional body for health service professionals,” said Dr Shafie at the Marriott Hotel here yesterday.

Courses in allied health sciences include Biomedicine, Optometry, Food Science, Dietetics, Pharmacy, Audiology, Speech Therapy, Diagnostic Imaging and Radiotherapy, Physiotherapy, Environmental Health, Occupational Therapy and Psychology.

Dr Shafie said that although allied health sciences were relatively new in Malaysia, it was becoming increasingly popular and relevant not just locally but internationally.

“Health delivery now is not dependent on the doctor alone but is very much a team effort. We do not want Malaysia to be left behind in this area; we have to intensify our research in allied health sciences. Public universities must also offer courses that are relevant and build partnerships with private companies and agencies,” he said.

The minister also urged universities to use traditional plants and herbs in their research in the health and allied health sciences.

“Researchers should make use of our traditional herbs and plants which have a lot of natural healing properties. We should use them and patent them before they either become extinct or are used by foreign researchers,” he said.

Tuesday, May 25, 2004

Private Hospital Wings Won't Ease Health Woes - Critics

PENANG, Malaysia, May 24 (IPS) - The Malaysian government's plan to set up private commercial wings in government-run hospitals to stem the brain drain of doctors to the private sector has come under fire.

Health Minister Dr Chua Soi Lek said a committee, tasked to look into the idea, would come up with a working model within two months. Patients would pay ''reasonable charges'' for better facilities at the private wings, such as private rooms with attached bathrooms and television.

The reaction to the plan was swift. ''It is clear that our under-financed government health care will become even less available to the poor,'' said Dr Chan Chee Khoon, coordinator of the Citizens' Health Initiative.

He warned that private wings in state hospitals would lead to human and material resources being reallocated to serve the dictates of the health care market - including ''health tourism'' - rather than the needs of the poor

At present, a nominal fee is imposed for treatment in crowded open wards while a higher, though still subsidised, charge is billed for more spacious rooms in general hospitals. Some 80 to 85 percent of Malaysian in-patients obtain treatment in general hospitals.

The proposal for private wings in general hospitals first came in 1997 from the Section Concerning House Officers, Medical Officers and Specialists of the Malaysian Medical Association (SCHOMOS MMA), the body representing government medical doctors.

The aim was to allow government doctors to do private practice to supplement their relatively low salaries. The health ministry however deemed the plan not practical.

The MMA kept the issue alive, believing that limited private practice would help to retain senior and trained staff in the public sector. It felt that doctors, the government and patients would all benefit from this scheme.

In 1999, the MMA brought the matter up with then Prime Minister Mahathir Mohamad and senior health officials were said to be keen on having the proposal implemented by June 2004.

Chua pointed out that 40 percent of the 1,200 positions for specialists and 25 percent of the 10,000 medical-specialist posts had not been filled - a critical shortage. The public-private mix has already been introduced in a few hospitals such as the University Hospital (UH) and the National Heart Institute (IJN) to plug the brain drain to the private sector.

''It has been a disaster so far,'' said Dr T Jayabalan, advisor on health care issues to the Consumers Association of Penang.

Drug, procedure, and laboratory charges at the UH has soared, he said. What's more, ''the IJN is probably the costliest place for heart surgery'', he noted. ''The waiting time for heart patients who are unable to afford surgery could be two years or more.''

Some government doctors who once supported the private wings proposal are having reservations. ''We know among ourselves that there are guys who will abuse it,'' said a senior doctor at a government hospital who declined to be named, citing the fear of repercussions.

He said the proposal appears to be targeted at patients who would otherwise go to private hospitals. But in practice, he pointed out that the private wings could end up siphoning patients from the public section of the general hospitals by baiting them with shorter waiting times and superior care.

The key issue is underfunding of public health care, a subject rarely discussed openly in Malaysia.

Expenditure on public health care as a percentage of Gross Domestic Product has traditionally hovered at around 3 percent - well short of the five to six percent proposed by the World Health Organisation. Underfunding is responsible for inadequate facilities, long waiting lists and low salaries.

In the Penang General Hospital, for example, the waiting time for patients needing a Magnetic Resonance Imaging (MRI) brain scan can be up to five months.

Underfunding also means that government doctors remain underpaid -- despite their heavy workload. Medical officers routinely see some 150 outpatients a day, when the ideal should be not more than 50.

Such conditions have led to an exodus of staff, prompting the government to hire expatriate Asian and Middle Eastern doctors - and this in turn creates resentment among local government physicians.

The declining standard of nursing care also plagues the health system. ''It is quite common to enter a ward and see patients with soiled clothes and (intravenous) drips running dry,'' said Cecilia, an experienced health care worker. ''It is also common to see groups of nurses chit-chatting merrily away while the sick yearn for help.''

At the Penang Hospital for instance, nurses expect visiting family members to change the soiled clothes of bedridden patients and feed them during mealtimes. Services like cleaning, facilities maintenance and the catering of meals for patients have been privatised - leading in some cases to lack of accountability and conflicting responsibilities.

At mealtimes at the hospital, attendants from the private catering firm merely leaves the meal trays at patients' bedside. An hour later, they come around to collect the trays - whether the patient has touched the food or not.

In one incident, Xavier, an elderly bedridden patient, was unable to sit up and reach for his tray. When the attendant returned and collected the untouched food, it was pointed out to him that the patient had not yet eaten.

The worker merely shrugged his shoulders and said: ''It's the nurse's job to see that he is fed. Mine is just to serve the food and collect the utensils after mealtimes. I have to account for each and every item of cutlery - anything missing gets deducted from my wages.''

But one of the more diligent nurses flitting around from patient to patient is Siti. Asked about the indifferent attitude of some of her colleagues, she sighed: ''You have to be like a Florence Nightingale. You have to think about how you would like to be treated if you were in their (the patients') position.''

Said Siti: ''Many of my colleagues - they are here because they can't find jobs elsewhere. Their hearts are not in it - it's just a means of earning a living for them.'' (END/2004)

Monday, May 24, 2004

Cleric refuses to bar AIDS victims from marrying

KUALA LUMPUR (AFP) - An Islamic religious leader has refused to bar some 3,000 Muslims suffering from HIV/AIDS from marrying despite fears that the disease could spread to their offspring, a report said Sunday.

The Malay-language Berita Minggu said a health department officer in central Perak state had approached chief cleric Harussani Zakaria to block the state's AIDS victims from tying the knot by the end of this year.

But Zakaria told the newspaper that the Islamic department would not reject their marriages because this could encourage the couples to have illicit sex.

"We don't have the power to stop anyone from marrying even though they could endanger the health of another person," he said, adding that only the father of a woman who is still a virgin could block the wedding.

State health department officials declined to comment, saying they had to verify reports that 3,000 AIDS sufferers were getting married.

In southern Johor state, the Islamic religious department had in November 2001 introduced pre-nuptial HIV testing for Muslim men before marriage to check the spread of infection, the newspaper said.

Malaysian AIDS Council President Marina Mahathir was quoted by the Sunday Star as saying the AIDS problem was getting more serious, and that Malaysia had 51,256 reported HIV/AIDS victims, including 6,978 new cases.

Activists have cited deep-rooted reticence about discussing sex and a reluctance to admit the existence of a problem as obstacles to Malaysia's fight against HIV/AIDS.

Sunday, May 23, 2004

FDA issues alert on tainted raw almonds

PETALING JAYA: The Health Ministry will look into a report that California raw almonds contaminated with salmonella bacteria have been shipped to Malaysia among other countries.

The ministry's Food Quality Control Division director, Dr Abd Rahim Mohamad, said they were not aware of this and would investigate.

The US Food and Drug Administration (FDA) issued an alert on their website on Friday advising distributors, wholesalers and consumers that a recall of raw almonds from California's Paramount Farms due to reports of Salmonella Enteriditis had been extended. The almonds were shipped to Malaysia, Mexico, Japan, Korea, Taiwan, France, Britain and Italy.

“Before eating any raw almonds having a “best before” date of August 21 or later, consumers are advised to check with the store where they purchased the product to see if the almonds came from Paramount Farms,” the FDA said.

“The FDA has learned that Paramount Farms distributed the recalled almonds in bulk or packaged nationwide to brokers, distributors and grocery store chains which in turn sold the almonds to consumers in a variety of package sizes under a variety of brand names,” it said.

Dr Abd Rahim said it was not common for nuts to be contaminated with salmonella.

“It's very seldom one finds salmonella in nuts as it's more common for nuts to be contaminated with afla toxin, a type of fungus which is very carcinogenic (cancerous). Salmonella is more common in meat and poultry products,” he said.

“We will look into this matter further,” he said, adding that they have a good food integration monitoring system with the Port Klang authorities to screen food at entry points.

The FDA said those infected with salmonella often experience fever, diarrhoea (which may be bloody), nausea, vomiting and abdominal pain.

“In rare circumstances, infection with salmonella can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections (infected aneurysms) and arthritis,” it said.

On Tuesday, Paramount Farms announced a limited recall of whole natural raw almonds sold under the Kirkland Signature, Trader Joe's and Sunkist brands, Reuters reported on Friday.

The company recalled five million pounds of raw almonds on Tuesday after FDA received seven reports of food poisoning, reported.

The FDA said they have received 18 reports of people infected with Salmonella Enteriditis possibly linked to the consumption of the recalled raw almonds.

Saturday, May 22, 2004

Mental health checks for employers?

The mental health of prospective employers of domestic maids may be screened under a proposal to prevent the recurrence of abuse cases such as the one suffered by 19-year-old Nirmala Bonat of Indonesia.

This is one of the suggestions mooted to the Human Resources Ministry, which is drawing up a Memorandum of Understanding (MoU) with Indonesia on the recruitment of domestic maids.

"It is a suggestion that we need to look into in our efforts to regulate the intake of Indonesian maids as well as put a stop to such cases of abuse,' said Human Resources Minister Datuk Dr Fong Chan Onn, after visiting Nirmala at the Indonesian Embassy here yesterday.

"We need to take into account the background of the prospective employers because if they have a record of being abusive or abusing their children, then they should not be allowed to take one," he said.

If the proposal is accepted, the domestic maid recruitment agencies would have to do the background checks.

Fong said the Government viewed this incident seriously and his Ministry would investigate how the abuse could have gone on for so long.

He said the Ministry would also look into amending the Employment Act to cover domestic maids as well to give them more protection in the event of injuries or accidents.

At present, the Act only covers foreign workers in the mercantile industry.

Other proposals include compulsory insurance coverage for the domestic maids. Fong said there should also be guidelines in place where domestic maid agencies are given regular access to the maids, for the first six months of employment at least to monitor their performance and the working conditions.

He hoped the details of the MoU could be finalised within the next two or three months.

He said although there were only two or three cases of domestic maid abuse which were reported to the Ministry over the last one year, they are "two or three cases too many." Fong said the Ministry would soon be calling all domestic maid recruitment agencies for a meeting soon to put in place better guidelines to safeguard domestic maids and ensure that employers are aware of their responsibilities.

Indonesian Ambassador to Malaysia Drs K.P.H. Rusdihardjo said over the last four years, the embassy had received 26 cases of abused maids but he acknowledged that the majority of employers here took good care of their foreign workers.

At the function, Fong later handed over a cheque for RM2,000 from the Malaysian Association of Foreign Maid Agencies (Papa) to Nirmala. Also present was Papa vice-president Jeffrey Foo and Maggie Phong, managing director of Agensi Pekerjaan AZ Sdn Bhd, Nirmala's recruiting agency.

Friday, May 21, 2004

More mental illness cases recorded

The Ministry's statistics recorded 11,120 mental health outpatients throughout the country last year compared to 5,687 in 1998.

Lee said 10 to 15 per cent of these cases were classified as “suicidal” or “could bring harm to the people around them”.

"It is estimated that one in four families has at least one member currently suffering from a mental or behavioural disorder.

"These families are required not only to provide physical and emotional support, but also to bear the negative impact of stigma and discrimination against them," he said.
Bid to list medical institutions

THE Federation of Chinese Physicians and Acupuncturists Associations of Malaysia hopes to register Chinese medical schools and practitioners from next month so that they will be recognised by the Government.

China Press quoted Federation president Ng Seow Hooi as saying the aim was also to find out the number of Chinese medical schools that would register with the Government.

He said that eight schools were registered with the associations, of which four were in Kuala Lumpur, three in Johor and one in Malacca.

Ng said the federation would sign a memorandum of understanding with the Chinese medical schools if they agreed with the federation’s policy.

This would ensure that graduates from the schools would be registered as traditional physicians with the Health Ministry, he added.

He said that more than 1,000 Chinese physicians in the country were not registered although many practised under various business registrations.

Teamwork a must to fight outbreaks

KUALA LUMPUR: The emergence of health problems that transcend national boundaries has become a major challenge to many countries, especially within the Asia Pacific region, where tourism plays a big role in bringing in foreign exchange, said Health Minister Datuk Dr Chua Soi Lek.

“Thus, the strengthening of collaboration among countries, especially in the surveillance, prevention and control of communicable diseases, has become a priority in order to address the challenges posed by emerging and resurging infections.

“The SARS (severe acute respiratory syndrome) outbreak last year elicited an unprecedented level of regional and global co-operation among countries,” he said in his speech at the 57th World Health Assembly in Geneva.

Dr Chua said the world today had no real boundaries. Just as computer viruses could spread through the Internet, so too can the viruses of infectious disease spread across nations.

He said although there had been several meetings during the SARS outbreak to deal with the problem within the Asean region, it had not been enough to eradicate the transmission of other deadly diseases.

The minister also said that Malaysia was committed to the global eradication of poliomyelitis, initiated by the World Health Organisation (WHO).

During the Leaders of the Organisation of the Islamic Conference Summit held in Kuala Lumpur in October last year, member countries were urged to assist WHO in the “final push” to eradicate poliomyelitis and to finance the funding gap.

“To this effort, Malaysia is contributing US$1mil (RM3.8mil),” he said.

Dr Chua said the upcoming revision of the International Health Regulations (IHR), would also be more challenging to member countries especially in their implementation.

He said capacity building and ensuring that the necessary infrastructure and national legislations were in alignment with the IHR, again required co-operation and collaboration among countries, as it would not be possible for all countries with different levels of development to be able to implement all provisions of the IHR.

There was also the issue of non-compliance and its consequences, which might need to be addressed, he said.

Dr Chua said that the revision of the IHR should also explore the possibility of including provisions for strengthening control over the movement of infectious materials, as these can be sources of outbreaks.

“The stakes are high and the challenges are many, but I am sure with the strengthening of co-operation and collaboration among countries and among regions, and with the leadership and support of WHO, we can make this world a healthier place to live in,” he added. – Bernama
Pyongyang in need of medical aid, says MERCY

The Malaysian Medical Relief Society (MERCY Malaysia) medical relief and humanitarian assessment team to the Democratic People’s Republic of Korea (DPRK) returned from their seven-day expedition to Pyongyang, North Korea last Saturday.

The non-profit, non-governmental organisation had established a three-man team comprising team head executive council member Dr Heng Aik Cheng, relief manager Aris Oziar and team photo coordinator Tengku Bahar Idris.

They left Kuala Lumpur on May 7 in response to North Korea’s appeal for international aid following the train explosion at Ryongchon on April 22 of last month.

Some 161 people were killed, 1,300 injured and about 8,000 people rendered homeless.

The MERCY team visited several county, provincial and village hospitals in Ryongchon and Sinuiju in the north-west, and Sunchon just north of Pyongyang, to assess the medical needs in the area.

They were studying the possibility of establishing a longer term humanitarian presence in the country.

Also, RM50,000 worth of medical supplies were sent to aid victims of the explosion which had affected a 10-kilometre radius of Ryongchon.

“From the blast site we saw some 2km worth of flattened land. Buildings from as far as 5km away were destroyed,” said Dr Heng.

Dr Heng also noted that many people at the hospitals suffered from malnutrition and lack of basic health facilities and clean water.

“The hospitals have only minimal medical supplies, much of which are in need of upgrade. In fact, most of the patients in the hospitals suffer greatly from basic health problems like diarrhoea and gastroenteritis due to the lack of clean water supply,” he said.

Some of the blast victims had to have their limbs amputated as there was a lack of medication to treat their infected wounds.

“The medical staff really do their best to keep the hospitals as clean as possible and to provide for their patients. But without the facilities and supplies, there is only so much they can do,” said Dr Heng.

In their quest to establish trust with the DPRK Government, the team met with the DPRK Government officials, United Nations agencies, international NGOs, directors from the Ministry of Public Health and the Flood Disaster Relief Committee.

“We want their trust. With that, we can proceed to working together with the DPRK Government to upgrade their medical facilities and providing for the people of North Korea,” said MERCY Malaysia president Datuk Dr Jemilah Mahmood.

“As the only Asian NGO to give aid in North Korea, we are seeking to open as many doors as possible to help in the health sector. We hope to share our knowledge and work with them in building their capacities, providing basic medical equipment and drugs, infrastructure rehabilitation as well as training of their medical staff,” she said.

MERCY Malaysia appeals to the Malaysian Government, other NGOs and the general public to join hands in their endeavour to provide basic food and health needs to the people of North Korea.

Wednesday, May 19, 2004

AIA to spend RM5mil on ad campaign

AMERICAN International Assurance Co Ltd (AIA) will spend up to RM5mil in an aggressive advertising campaign called Protecting Your Future.

The campaign is aimed at reminding customers of the real-life costs and implications of inadequate insurance protection.

Executive vice-president and general manager Richard Bender said in a statement that studies had shown that modern lifestyle had contributed to health risks and was increasingly becoming a major concern.

“The studies cautioned that more people are being hospitalised in their most productive economic year with heart disease as No. 1 killer in Malaysia, while more and more are being afflicted with serious illnesses such as cancer and stroke at young age.

“In total, 40,000 new cancer cases are diagnosed annually in Malaysia. In fact, between 2000 and 2003, 60% of critical illness claims made with AIA were for cancer-related,” he said.

He said AIA hoped to drive home the message that insurance was about protection and not just financial growth and investment. – Bernama

Tuesday, May 18, 2004

Private wings can make doctors stay back

KUALA LUMPUR: One reason for setting up private wings in public hospitals is to get doctors to continue their service with the Government, said deputy Health Minister Datuk Dr Abdul Latiff Ahmad.

He said many health professionals had found jobs in the private sector more lucrative.

“By letting our government specialists become legalised locums, we can be sure they will not leave government hospitals as they will be able to earn extra income by seeing patients in the private wings,” he told reporters after launching World Nurses Day at Hospital Kuala Lumpur here, yesterday.

Dr Abdul Latiff said the ministry welcomed the suggestion for government doctors to use facilities at private hospitals, adding that this created a ‘free-flow’ of skills where government specialists could earn extra and still work for public hospitals.

He said the public health system here was facing problems similar to the British National Health Service. He added, however, “only a Malaysian solution should be found for a Malaysian problem”.

To an opinion voiced by Association of Private Hospitals president Datuk Dr Ridzwan Bakar that the private wings in public hospitals would not necessarily be cheaper than the private hospitals, Dr Abdul Latif said the association had the right to voice its views.

“Of course there will be problems,” he said.

He added: “We are trying to establish the best system for the Malaysian public health establishment as no other country has a system where the public gets excellent health care for as low as RM1.”
Hepatitis B herbal cure under testing

PENANG: The Institute for Medical Research (IMR) is conducting interim tests on the effects of herbal treatment of Hepatitis B on humans, Health Ministry deputy director-general Datuk Dr Mohd Ismail Merican said.

He said preliminary tests, using the extract from a certain type of plant, were carried out by the IMR on animals successfully.

“The tests on animals have been carried out for the past two years,” he told reporters after the launching of Penang Hepatitis Day by Chief Minister Tan Sri Dr Koh Tsu Koon at the Prangin Mall Atrium A.

Dr Mohd Ismail, who is also the Malaysian Liver Foundation (MLF) president, said that it would take about five years before the herbal treatment could be commercialised.

“However, if the trial run is good, then we can even look into commercialising the product much earlier,” he added.

He said India, which had conducted tests using a different type of herb, had approached Malaysia to collaborate on the matter but “we have very stringent standard to be complied with”.

Earlier, in his speech, Dr Koh said there was a need for more concrete action to ensure Hepatitis B was contained and the rate of incidence reduced.

He said although the number of Hepatitis B cases had declined over the years, there were still one million Hepatitis B carriers in Malaysia, which was 4% of the population.

He added that although most people were aware of the disease, very few acted to take preventive measures as they would procrastinate until it was too late.

The one-day campaign, jointly organised by the MLF and the state Health Department, saw visitors having their blood tested for Hepatitis A, B and C.

Vaccinations for Hepatitis A, B and AB were carried out for a special fee.

A public forum was held at the Atrium’s foyer area.

A public exhibition, membership drive, quiz and an organ donation campaign were also held in conjunction with the campaign.

Sunday, May 16, 2004

Doc: Private wings do not mean cheaper fees

PETALING JAYA: The setting up of private wings in government hospitals will not mean that medical fees would be cheaper compared to private hospitals, said Association of Private Hospitals of Malaysia president Datuk Dr Ridzwan Bakar.

He said fees charged would depend on the tests needed by the patients.

He said private wing charges would be different from those at private hospitals due to the cost of machines and efficiency of usage.

“Private hospitals are possibly more efficient in using the machines as the machines are used for more hours compared to those at private wings,” he said.

Dr Ridzwan was commenting on the recent statement by Health Minister Datuk Dr Chua Soi Lek that his ministry was looking into the feasibility of setting up private wings in government hospitals to halt the brain drain of doctors and specialists and follow-up reports that private hospitals were worried about competition from the private wings.

Private wings are available at the Universiti Malaya Medical Centre (UMMC) and Hospital Universiti Kebangsaan Malaysia.

Dr Ridzwan, who said the association was not in favour of private wings, said a quick check with the UMMC showed that charges for an abdomen ultrasound scan cost RM110 while a private hospital nearby charged RM10 less.

“This private hospital can give the report within two hours while the quickest UMMC can give the results is overnight,” he said.

Dr Ridzwan said private hospitals welcomed competition from private wings but said a level playing field should be given to all players.

“This means all players must be exposed to the same subsidies and business risks,” he said.

He said the theory private wings would help to retain specialists had yet to be proven as some might use the private wings as a “testing ground” before leaving for the private sector.

He also said the association would propose that specialists in government hospitals be allowed to have limited private practice.
Russian medical options

WHEN it comes to studying medicine, Russia is probably not the first destination that comes to mind. Most students would cite the United Kingdom or even Australia as their top choice.

But before you dismiss Russia on grounds that you simply couldn't possibly master the Russian language or withstand those absolutely freezing temperatures, think again! Studying medicine in Russia might just turn out to be the best option for you if your financial resources are limited.

More and more Malaysians today are looking at Russia for a medical degree. Abdullah Mohd Salleh will tell you that studying medicine in Russia is not without its advantages His daughter, a fourth year medical student in Moscow Medical Academy, is not only under the tutelage of some of the finest doctors in the world but has also picked up the Russian language and is actively involved in student life.

''My daughter Nor Azimimah or Azie as I call her, has always wanted to be a doctor. I checked out a few countries such as India and the United Kingdom but the costs were prohibitive. Then I discovered that studying medicine in Russia over a period of six years only costs about US$25,000 (RM95,000), including accommodation. The fees could also be paid in affordable instalments, so I decided to send her there,'' shares the proud father.

Abdullah says Azie was among the pioneer batch of eight Malaysian students who went to Russia in 2000.

''I have no regrets sending her there as she picked up the Russian language and is now very fluent. When my wife and I visited her last December, she impressed us with her command of the language when she took us around.

''She is also the president of the Moscow Malaysian Students' Association and rents an apartment near the metro (Moscow subway system) with two friends,” he adds.

Russia is an interesting option for Malaysian students.
Marik Singh, whose daughter Jaspal Kaur is a third year medical student in Moscow Medical Academy, also has no hesitation in recommending Russia as a study destination to anyone.

''Jaspal was doing her 'A' levels in one of the private colleges here in Kuala Lumpur when we found out about Russia. We were impressed by what we were told. The fees were also very affordable. I think we are fortunate that Russia accepts Malaysian students to study medicine there.

''She adapted very well and is very happy,'' he says, adding that he and his wife are planning to visit her soon.

Marik says his daughter needs about RM300 for rental, food, travel and other personal expenses per month.

''Jaspal has learnt to be a good cook and we are very proud of her,'' he adds.

Numbers growing annually

The figures on the popularity of Russia as a destination for medical studies speak for themselves. From a mere 100 students in 2001, the figure has grown six-fold to over 650 students studying medicine in various universities throughout the country.

Although Russia is a relatively new destination for Malaysians wishing to pursue higher education courses, it has long been popular with Asian countries such as India, China, Bangladesh and Sri Lanka. Ambassador of the Russian Federation to Malaysia and Brunei Darussalam Vladimir Morozov says Russia has been opening the doors of its universities to youths from many countries for many years.

''Students have the opportunity to use state-of-the-art training and research facilities. The latest laboratories, teaching aids, instruments, simulators and specialised libraries combined with your lectures will help you achieve your dream of becoming a specialist in your chosen field,'' he says when he attended the high tea reception marking the opening of the Kuala Lumpur office of Russian Resources Sdn Bhd last Wednesday.

''We hope that the knowledge and skills our students acquire will help provide high quality medical services to the people in Malaysia,'' he says.

Besides receiving an education of international standing, students will also enjoy the enriching experience of living in a country steeped in culture, history and beauty.

''I hope the students will make new friends and help foster ties to promote better understanding between Russians and Malaysians,” he says.

Studying in Russia

The Public Services Department in Malaysia recognises medical degrees from the Moscow Medical Academy, Russian State Medical University, Nizhny Novgorod State Medical University, Volgograd State Medical University and Kursk State Medical University. The six-year medical degree in Russia includes clinical experience.

Both the World Health Organisation (WHO) and United Nations Educational, Scientific and Cultural Organisation (Unesco) has ranked Moscow Medical Academy and Russian State Medical University as second and third in the world.

Honorary consul of the Russian Federation Teoh Seng Lee says Russian medical universities offer highly affordable medical degrees compared with other countries, without compromising on quality.

A Russian university medical degree costs between RM130,000 to RM180, 000 compared to between M500,000 and RM800,000 in other countries.

''This estimate covers tuition fees, hostel accommodation, use of university facilities, annual return air fare and living expenses,'' he says, adding that costs may vary depending on the city.

Living in Moscow for instance, would be more costly than living in smaller cities like Volgograd and Nizhny Novgorod

Although the medium of instruction for medical degree programmes in several Russian universities is English, students need to be able to speak Russian by their fourth year.

Nizhny Novgorod State Medical Academy surgery department head and vice dean of overseas admissions Dr Vladimir Zagainov explains that students need to speak Russian in order to communicate with patients and clinical staff.

''Besides anatomy and physiology classes in the first year, students will also be taking Russian language classes. They will be meeting patients in hospitals in their fourth year so they should be able to speak the language by then.''

Dr Zagainov says the academy currently has students from 26 countries, with some 80 Malaysian undergraduates.

''Some have difficulty in pronouncing certain words in Russian but Malaysians in general are able to pick up the language,'' he says.

He says the academy is expecting 55 more Malaysians to join the university in September.

Describing Malaysian students as hardworking, Moscow Medical Academy vice-rector for international affairs Prof Renad Alyautdin says they usually obtain good results.

''Although the minimum entry requirement into medicine in Russia are Bs in Science subjects or a CGPA of 3.0, most of the students have As in all subjects,'' he adds.

Prof Alyautdin says the academy has opened a new hostel this year and is currently renovating older hostels.

Volgograd State Medical University vice chancellor Prof Alexander Spasov says there are 170 Malaysians at his university.

''Most stay in the hostels although some have opted to rent apartments in the city with friends,'' he says.

Teoh, who is also the director of Russian Resources Sdn Bhd, explains that the company assists Malaysian students in their applications to Russian universities and institutes.

To date, the company, founded in 1996, has successfully assisted over 300 Malaysian students in pursuing tertiary education in Russia.

''We act as a liaison between the Russian institutions and students.

''Russian Resources ensures that applications to institutions, visas, initial travel arrangements and housing arrangements are properly coordinated,'' he says.

He adds that students leaving for the first time to Russia will be accompanied by a company representative and met at the airport, and will also be brought to the university for registration.

Presently, the company represents Moscow Medical Academy, Russian State Medical University, Volgograd State Medical University, Nizhny Novgorod State Medical Academy and Moscow State Aviation Institute.

For more information about studying medicine in Russia, contact Roline Ong at Russian Resources Sdn Bhd, Suite 3.05, 3rd Floor North Block, The Ampwalk, 218 Jalan Ampang, 50450 Kuala Lumpur, or tel 03-2171 1226, or fax 03-2171 2329. You may also contact Ng Ting Ah at The Registrar, Education Russia, Russian Resources Sdn Bhd, 37 Green Hall, 10200 Penang, or tel 04-262 2944, or fax 04-262 4926.

Saturday, May 15, 2004

Hospitals to raise charges for foreigners

JOHOR BARU: Foreigners seeking treatment in government hospitals will soon have to pay more.

Health Minister Datuk Dr Chua Soi Lek said the revised fee would reflect that charged by private hospitals, as the RM2 currently imposed on foreigners was “way too low.”

“We have yet to decide on the amount, but some parties have suggested that they should be charged RM5 or RM10.

“We will have to study the matter and look at what the market is charging before finalising the new fee,” he told reporters after opening the third biennial cardiopulmonary bypass conference yesterday.

Dr Chua declined to comment when asked if the fee imposed on locals seeking treatment at government hospitals and clinics would also be raised but admitted that the RM1 fee was “unreasonably low.”

“Even in Beijing, China, one has to pay the equivalent of RM15 when one seeks treatment from a government hospital whereas in Malaysia, it is only RM1.

“This shows how heavily subsidised the public health sector is, “ he added.

Dr Chua said the ministry received RM6.3bil in allocation last year, which was a four-fold increase compared with the RM1.6bil it was allocated in 1990.

He said the previous time the fee was increased was from 50 sen to RM1 in the 1980s.

On vacancies, Dr Chua said 620 foreign doctors had been recruited recently and another 520 foreign doctors would be recruited to fill current vacancies.

“However, this is only a short-term measure as employing foreign doctors will not solve the problem of shortage,” he said.

On another matter, Dr Chua said the ministry would concentrate on advocating “preventive medicine” under the 9th Malaysia Plan, where promotional programmes on healthy living and lifestyle would be conducted.

He said this was to prevent the public from indulging in sedentary and unhealthy lifestyles and to check the ministry’s budget from escalating

Friday, May 14, 2004

Chua: Give out funds quicke

BANTING: Health Minister Datuk Dr Chua Soi Lek wants subsidies and funds to be disbursed faster to kidney patients and non-governmental organisations (NGOs) running haemodialysis centres.

He said it was unacceptable that the subsidies and funds took up to eight months to be approved.

“The patients and the NGOs need the funds urgently because treatment must be administered fast.

“There have been complaints by patients that they needed to wait up to eight months before they received the funding,” he said when opening the Banting Haemodialysis Centre here.

Chua said there was a need to review the entire process of remitting the funds which was presently channelled to the National Kidney Foundation before being dispersed to the approved parties.

“The whole process should be relooked to find out why we need the middleman,” said Chua.

He, however, said he was not questioning the role of NKF in the fund dispensing system.

Chua said presently deserving kidney patients were given a RM50 subsidy for each treatment at an approved NGO centre while the non-profit NGO centres running haemodialysis centres also received grants.

About 2,000 patients are receiving the subsidy from the ministry, which has dispensed close to RM34mil at the end of last year. Eleven NGOs are receiving funds totalling RM2.5mil.

The ministry also has a ringgit-for-ringgit matching scheme given to NGOs to set up haemodialysis centres.

Chua thanked the NGOs for their effort to help make haemodialysis treatments cheaper and more comfortable for patients.

He said the facility provided by the NGOs complemented the 70 treatment centres under the ministry, which is treating 2,500 patients.

“This year, we will be spending about RM30mil to set up such centres in the remaining 45 hospitals that do not have such facilities yet.”

Chua said about 2,400 new patients nationwide were added to the pool of people needing treatment every year, increasing the need for more haemodialysis centres.

Also present were Teluk Datuk assemblyman Datuk Ei Kim Hock; Nanyang Press Foundation trustee Tan Sri Dr Yeoh Tiong Lay and foundation chairman Datuk Wong See Wah as well as St John Ambulance Malaysia president Datuk Dr Law Bin Tick.

The centre is the success story of a tripartite partnership. Nanyang Foundation provided the capital cost for the centre; Ei and the Persatuan Penyayang Kuala Langat will sponsor the monthly rentals for the centre for the next three years and St John Ambulance will manage the centre.
Nursing profession no longer an attraction - Health Minister

BANTING May 13 - Nursing is no longer an attractive profession among girls as the noble values of Malaysian society have changed with priority given to materialism, Health Minister Datuk Dr Chua Soi Lek said Thursday.

In the past there was stiff competition to become nurses but not so now, he said after opening a Hemodialysis Centre here.

"Thirty years ago Malaysian girls in large numbers went as far as England for nurses training. Now there is no such enthusiasm."

"Nursing is no longer the profession of the first choice. It is not easy to look after and care for patients, they say and look for work instead in factories and offices."

Dr Chua said the shortage of nurses was acute.

"The shortage will remain a permanent feature as long as Malaysian women and men do not change their attitude towards nursing as a profession," he said.

IN KOTA BHARU, Deputy Minister Datuk Dr Abdul Latif Ahmad said the Health Ministry has set up a special committee to review qualifications and allowances for government doctors, nurses and medical workers in efforts to ensure they received commensurate renumeration based on their qualifications and duties.

He said the committee, formed last week, was headed by the ministry's newly appointed Secretary-General Datuk Ismail Adam. The committee will conduct a study on the matter and recommend proposals to the Public Service Department (JPA).

"We support more allowances for medical personnel but they depend on the agreement and approval of the JPA," he told reporters after launching the national-level TB Day at the Universiti Sains Malaysia campus, here.

He said this when asked to comment on the reluctance of the younger generation to choose nursing as their career as the ministry did not have a salary grade for nurses with degrees and they were lumped together with diploma holders.

On Wednesday, the Malaysian Nursing Association president, Dayang Annie Abang Narudin said there was now a shortage of 20,000 specialised nurses and the situation became more acute with at least 1,000 nurses either leaving the profession or going on retirement each year.

MEANWHILE in KOTA KINABALU, FOMCA urged the nursing profession in the country to strive to get not only nurses with the right qualification but also those with the right attitude.

Its President of Federation of Malaysian Consumer Associations (FOMCA) Prof Datuk Hamdan Adnan said that this could be done right at the outset when they turn up for the interview to take up nursing courses.

Nurses with the right attitude must be indentified and shortlisted from the beginning... from the interviewing stage. The interviewer should not only look at the aptitude of the candidates concerned but also their attitude as well, Hamdan told Bernama here.

Hamdan said careful selection of candidates for the nursing profession was possible because there was now a large pool of people to select from.

"Today if you called for an interview, there will surely be a large number of people turning up for it...we can shortlist them properly and train them accordingly," he said.

He concurred on the complaints against arrogant civil servants, including nurses and doctors, saying that it was nothing new.

There are those who shout at patients and did not care at all for the sick, he said.

ON the issue of usage of public funds for treatment, the MMA urged the Health Ministry to periodically publish the number and type of cases of needy patients that have been treated with public donations and the outcomes.

This would ensure that the collecting agencies and donating public were aware of the statistics, its president, Datuk Dr. N. Arumugan, said Thursday.

"We feel that this audit is essential information to enable the potential patient and the donating public to make an informed choice," he said in a statement here Thursday.

He said this in welcoming the government's move to allow the National Heath Welfare Fund to be used by all needy patients instead of only the hardcore poor and the media to collect public donations for deserving patients.

He said the media too "must take into consideration that incessant publicity and collection of funds for treatment and procedures available in government hospitals will perpetuate a negative impression and undermine public hospital confidence in the services provided."

"The undue publicity given to doctors and hospitals who are involved in these cases often contravene the Code of Medical Ethics and we feel that the MMA and the Health Ministry can assist and clarify whenever necessary," he said.

Thursday, May 13, 2004

Chua: RM2.6m given to needy

UALA LUMPUR: The National Health Welfare Fund has given out RM2.6mil to 76 patients since its inception at the end of 2002.

The fund, which started off with RM5.5mil followed by a RM500,000 dividend, is now down to RM3.4mil.

Health Minister Datuk Dr Chua Soi Lek said the ministry must handle the limited amount of money “very properly and professionally” for the benefit of deserving patients.

“There were cases of people who sought treatment in private hospitals and they sent their bills to the ministry to settle from the fund, including one bill amounting to RM100,000.

“We (ministry) cannot simply relax the criteria as this will set a precedent.

“Duly completed applications will be processed within 10 days,” he told a press conference yesterday.

Asked to comment on the case of Saffiyah Khadijah Iskandar, two, who needed another RM65,000 to undergo a liver transplant at the Subang Jaya Medical Centre (SJMC), Dr Chua said the operation could be done at the Selayang Hospital at a lower cost.

At the Selayang Hospital the patient need only pay RM500 because the government subsidises healthcare compared with RM380,000 in SJMC, he said.

He said Saffiyah had been treated at the Kuala Lumpur Paediatric Hospital since September 2002.

The transplant was delayed because Saffiyah’s mother, Nurulhaida Rabu, who was to donate her liver, was found to be pregnant in March last year.

She gave birth in October and was fit to donate her liver beginning March, Dr Chua explained.

As such, he said, claims that the Selayang Hospital did not have the expertise, equipment and facilities for the transplant were baseless.

He said the Selayang Hospital’s liver transplant team had also obtained help from Prof Dr Rusell Strong, who pioneered liver transplants in Australia 15 years ago.

He said the Selayang Hospital could do 12 liver transplants a year now and this would be doubled next year.

Dr Chua also said the Cabinet had agreed to the Health Ministry’s proposal to allow the media to publicise appeals by needy patients and collect funds for them without having to obtain prior approval from the ministry, effective yesterday.

He said the patients must produce their doctors’ confirmation of their illnesses, the type of treatment needed and cost.

The media must get the patients’ approval to raise funds on their behalf, he said.

The money must be placed in a special account set up for the purpose and any excess money upon the patient’s recovery or demise would be passed on to the next deserving patient, he added.

“The fund must be audited by certified auditors, including a representative from the ministry,” said Dr Chua.

Wednesday, May 12, 2004

BIM supports MMA's call to review doctors' salary package

KUALA LUMPUR May 11 - The Balai Ikhtisas Malaysia (BIM) supports the call by the Malaysian Medical Association (MMA) for a review of the salary package for the doctors in government service, said its Chairman Dr Vellayan Subramaniam.

"This review has to take into consideration the skills, expertise and the professionalism of services provided by the doctors. The condition of the workplace like the government clinics and hospitals, its locality and the number of patients treated daily are vital factors to be emphasised," he said in a press statement here Tuesday.

Health Minister Datuk Dr Chua Soi Lek had recently said that the government was considering a new salary scale for government doctors and specialists while MMA president Datuk Dr N. Arumugam said the government doctors' salaries were tied to the salary scale of civil servants and could not be changed without approval from the cabinet.

According to Dr Vellayan, the basic salary now was incremental but the allowances were fixed at predetermined rates and the salary package was rather outdated because the increased number of patients and longer hours taken for treating or attending to them had not been taken into consideration.

"More doctors are doing overtime work to treat their patients. They put in more than 24 hours of work ... the longer time spent in hospitals and clinics had reduced valuable hours for their family members especially in developing good parenting and families," he added.

He said the doctors were committed to their code of ethics to serve the public professionally and the government should treat them fairly and justifiably.

Looking at the position of the government doctors, he said other government professional staff should also be given the opportunity to enjoy a review of their salary package.

"A proper perspective has to be given on professionalism in line with the government policy to encourage the development of science and technology in this country. Professional services are closely related to science and technology that play a pivotal role in developing Malaysia," he said.

According to him, the review proposed should also avoid the long delay in the promotion exercise of doctors in government service by considering the scale of promotion in the profession based on the years of service and expertise acquired.

"BIM hopes that the current Minister of Health (Chua) will be more passionate to listen to their grievances. Medical services in Malaysia cannot be effective and efficient with the equipment alone without the welfare of the doctors and specialists heightened accordingly," he added. - Bernama
Nursing college hit by resignations

SITIAWAN: For over a year, students of a nursing college near here have had their classes disrupted by a series of resignations by lecturers when the college management failed to pay their salaries.

The college's chief executive officer Aminuddin Mohd Nafis Shukri said six lecturers have resigned since the college, which accords government-recognised certificates, was set up by Uji Maju Properties Sdn Bhd in January 2002.

He said the company also delayed in paying the salaries of the administrative staff, adding that he had not been paid his September salary nor for the last three months.

“This has been going on since early last year. There are now three lecturers remaining when there should be seven to 10 at any one time,” he said.

The college now has 148 students, 65 of whom were sponsored by the Health Ministry.

Perak Education, Human Resources and Multimedia Committee chairman Datuk Dr Zambry Abd Kadir advised the company to act quickly in resolving the problems.

He said he would discuss the technical aspects of the matter with the education department and the Health Ministry before the Government takes action.

He said several alternatives would also be discussed, including bringing in lecturers or sending the students to nursing colleges nearby.

“We do not want the students to fail due to reasons beyond their control.

“Institutes of higher learning must ensure students are not victimised or neglected,” he said.

Dr Zambry said this after making a surprise inspection at the college and talking to disgruntled students and staff members yesterday.

The students also complained of poor library resources, lack of adequate security at their hostel and the failure of the management to provide the promised recreational facilities.

One student, Norfazilawati Abd Rani, 21, from Pahang, said her coursemates have seen lecturers teaching for only two or three months before leaving.

Other students said the management had threatened to bar private students who failed to pay their fees from sitting for the semester-end examination.

Dr Zambry said the company owner, who was currently in Indonesia, could not be contact
Chua: Private hospitals fear potential competition

KUALA BERANG: Private hospitals fear the competition that may arise from the proposed setting up of private wings in government hospitals, said Health Minister Datuk Dr Chua Soi Lek.

He said some people were worried the move would affect the quality of service in government hospitals.

“We have to strike a balance between the profit-oriented private sector and the Government’s responsibility of providing services at minimal rates.

“These matters would be looked into by the special Health Ministry committee studying the proposal,” he said, after visiting the Hulu Terengganu Hospital here yesterday.

He said the private sector “will always come out with lots of reasons.”

He declined to elaborate.

He had said on Thursday that his ministry was looking into the feasibility of setting up private wings in government hospitals to halt the brain drain of specialists and doctors.

He said a special committee headed by his deputy Datuk Dr Abdul Latiff Ahmad had been formed to look into all aspects of the proposal such as legislation, human resources and fees.

Dr Chua also said no cases of Severe Acute Respiratory Syndrome (SARS) had been reported in the country following the latest outbreak in China last month.

If there were any cases, the ministry would inform the public, he said.

Dr Chua urged the media not to play up the issue.

He was responding to a report in a Malay daily yesterday that said a 61-year-old man who had returned from China recently was being treated in a special SARS ward at Hospital Sultanah Aminah in Johor Baru.

Tuesday, May 11, 2004

Third anti-impotence drug on sale in Malaysia to tap 'silent sufferers"

KUALA LUMPUR (AFP) - A third anti-impotence drug, Levitra, is now on sale in Malaysia where some 90 percent of men affected by erectile dysfunction (ED) are "silent sufferers," health experts said.

The new orange pill, marketed by pharmaceutical giants GlaxoSmithKline of Britain and Germany's Bayer and launched in US and European markets last year, competes with Viagra, manufactured by Pfizer Pharmaceuticals, and Cialis by US giant Eli Lilly.

In a statement, GlaxoSmithKline and Bayer said the entry of Levitra into the Malaysian market was aimed at meeting the needs of ED sufferers who "are still silent and untreated."

"In Malaysia, it is estimated that over 90 percent of ED sufferers are silent. This means there is still a huge untapped market of untreated ED sufferers in Malaysia," said local consultant urologist Tan Hui Meng.

Based on research conducted on 351 Malaysian men aged 50 and above, he said 69 percent suffered mild to severe ED and only 7.2 percent had tried a prescription medicine.

Reports previously said there were an estimated 2.2 million men in Malaysia affected by ED.

The statement said some 150 million men worldwide were suffering from ED but this figure was expected to double to 322 million by 2025, of which about 65 percent would be in Asia.
Time to tackle obesity

MALAYSIA is fast becoming a fat nation. At last count, three million Malaysians were overweight or obese, according to the Health Ministry. The figure is likely to increase because efforts to create awareness have not been successful.

Professor Mohd Ismail Noor, president of the Malaysian Association for the Study of Obesity, says a sedentary lifestyle and unhealthy eating habits are contributing to Malaysia having the highest prevalence of obesity in Asia. "Malaysians are eating too much but not getting enough exercise. In urban areas, food outlets are open 24 hours, and this, combined with the sedentary lifestyle of most Malaysians, is a recipe for disaster," he says. "Obesity will escalate unless we get our act together now." People with a body mass index of between 25 and 29.9 are considered to be overweight and those with a BMI of more than 30 are obese. Unfortunately, according to Mohd Ismail, Malaysians are not serious in tackling the issue. Obesity is associated with five of the 10 leading causes of death and disability in Malaysia, such as heart disease, Type 2 diabetes, stroke, some forms of cancer as well as hypertension.

It also substantially raises the risk of illness from high cholesterol, gallbladder diseases and arthritis.

More children are also becoming overweight or obese.

In 1990, the prevalence of obesity among children between 13 and 17 was only 0.7 per cent, but in 1997 it had increased to 5.7 per cent.

Mohd Ismail says a UKM/Nestle study of some 11,264 schoolchildren aged between seven and 12 years in four regions of Peninsular Malaysia — north, south, east and central — showed that 10.8 per cent boys and 10.3 per cent girls were overweight. Studies have shown that children who are overweight tend to be overweight adults.

Being an overweight child can have psychological effects such as low self-esteem and a sense of isolation.

Overweight children are also at risk of developing serious health problems in later life, including heart attack and stroke, Type 2 diabetes, bowel cancer, and high blood pressure. Mohd Ismail says a critical period for the development of obesity is during childhood, a period referred to as the time of adiposity rebound. The body mass index of an infant increases in the first year of life and decreases subsequently, he says.

At about five years of age, the BMI increases again. Adolescence is another critical period particularly for girls, since 30 per cent of adult obesity among women begins in early adolescence.

This is a period when patterns of fat deposition are determined by hormonal influences besides changes in eating behaviour.

"Childhood obesity is the prelude to a public health disaster that we will have to deal with. The time to act on this problem is now." "Prevention at an early age is important. Children now are eating junk food and are not involved in physical activities. Fifteen per cent of 12,000 Malaysian children are eating fast food every day." Awareness education should not only be for parents but also for teachers. "Parents and teachers should monitor what the children eat and get them to be active," he adds.

Mohd Ismail says that given the magnitude and the complexity of the problem there is an urgent need to enhance the professional understanding of prevention principles and practices.

"This can only be achieved through shared responsibility among the Government, industries and other units.

Mohd Ismail says that the association is drafting guidelines on prevention of obesity in collaboration with the Health Ministry. These will include recommendations to help prevent individuals of normal weight from becoming overweight or obese.

"The guidelines will propose strategies focusing on relevant settings such as individuals, families and communities, schools, health care, media and communication, and even the workplace." The ministry is collaborating with relevant ministries, academia and professional bodies, including the association, on the second national plan of action for nutrition.

One of the objectives of the plan is to enhance and maintain the nutritional well being for all, says Mohd Ismail.

"This includes preventing and controlling nutritional deficiencies and excesses which can cause obesity, as well as diet-related non-communicable chronic diseases."
Move for thalassaemia register

A National Thalassaemia Registry will be set up to keep track of Malaysians who are carriers of this blood disorder so that marriages among them can be prevented.

Health Minister Datuk Dr Chua Soi Lek said today a task force was in charge of looking into setting up the registry.

"We expect a report to be ready in two months' time and it will then be tabled to the Cabinet to be reviewed.

"Thalassaemia cases can be significantly reduced if we are able to identify the carriers and prevent one from marrying another," he said, adding that such couples have a 25 per cent chance of having a child born with this disease.

"If they insist on getting married, they have to be warned about the risk they are taking," he said.

Dr Chua said premarital screenings were necessary to reduce the number of new cases.

Those targeted for thalassaemia carrier screening include university students, couples planning to get married and pre-natal mothers.

Thalassaemia patients not only suffer the painful effects of the disease their whole lives, they also have to bear the high cost of treatment.

Dr Chua said on average, patients spend RM270 to RM1,080 per month on treatment.

"With an estimated 2,500 transfusion-dependent thalassaemic patients in Malaysia, it will cost the Health Ministry more than RM20 million a year to provide free or subsidised treatment for all of them, and the cost will recur.

"By screening the target groups, we can advise carriers not to get married to each other and lessen the chances of thalassaemic children being born," he said.

Dr Chua cited Iran's experience where proper counselling for couples, who were carriers, resulted in 90 per cent of them opting not to get married for fear of bearing thalassaemic children.

He was speaking at a Press conference after launching the First National Thalassaemia Seminar and International Thalassaemia Day at Corus Hotel.

In his speech earlier, Dr Chua said he was pleased that such an event was held to provide updates on the management of thalassaemia.

Dr Chua also called on the media to play a more active role in highlighting cases of patients seeking public donations to undergo treatment or surgery.
Private hospital wings idea won’t fly

Some years back, as part of the government's corporatisation policy, government hospitals were directed to increase the rate of their cost recovery (at the time, patient charges at government hospitals contributed in toto to about 5-10 percent of the hospitals' actual operational costs, i.e. government medical services were being subsidised to the extent of 90-95 percent).

In preparation for corporatisation, government hospitals were instructed to increase their cost recovery, so that the government could reduce its health outlays which would be preferentially allocated to the low-income, while ‘those who could afford to pay more should become less dependent on government subsidies’, or better yet, look to the private sector for their healthcare needs.

(This is the World Bank's favoured ‘targeted approach’ for a rump public sector in healthcare, as privatisation proceeds to create markets for healthcare entrepreneurs, and more generally, a generic template for the privatisation of social services).

Well, in June 2002, the janitor responsible for my building at the Universiti Sains Malaysia in Penang underwent colorectal cancer surgery at the Penang General Hospital. She earns RM500 monthly (no overtime) and receives no hospitalisation benefits from her private concessionaire employer (outpatient treatment expenses are split 50:50 between her and her employer).

When she was discharged from her third-class ward, she was presented with a bill for RM1,662 (for a stapler device to re-join her colon after surgery), and RM141 in ward charges.

Some months later, I brought this up with the hospital director, who in turn replied that this was in line with a government directive to increase cost recovery to about 20 percent of the operational costs of the Health Ministry's hospitals.

It is clear that our underfinanced government healthcare will become even less available to the poor when private wings are set up in government hospitals as human and material resources are reallocated to serve the dictates of the healthcare market rather than the needs of the poor.

Any expectations that private wings will generate revenue for government hospitals for cross subsidies to poorer patients, have been disabused by the same article: "On MMA's complaints of ‘fee splitting’ (where doctors pass on part of their fees to the hospitals they serve), (Health Minister) Dr Chua asked doctors attached to private hospitals to lodge reports with the ministry if this happened. "It is regarded as unethical," he said.

Would it also be unethical for government hospitals to retain a substantial portion of the professional fees earned in private wings?

It is furthermore predictable that private wings will soon be encouraged to service the regional health tourism market as well.

Indeed, this is already the case. At a management conference organised by the Health Ministry in 2002 in Penang, Chow Sang Hoe, a consultant with Ernst & Young, reported on a survey of health tourism prospects commissioned by a group of private hospitals in conjunction with the ministry.

One of the salient points in his talk was that cardiological and cardiothoracic services constituted the largest clinical category (38 percent) of inpatient procedures performed for foreign nationals at the 28 hospitals surveyed (five public, 23 private), and that the Institut Jantung Negara (a corporatised government referral heart hospital) figured prominently in this.

The Citizens' Health Initiative has repeatedly voiced its concern over such developments. We are not against foreign nationals benefitting from our national healthcare capabilities, indeed we can take pride in this.

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

The proposal to introduce private wings in government hospitals is an unworthy idea which should be definitively scrapped.

The writer is co-ordinator of the non-governmental organisation Citizens' Health Initiative.