A shield for our young

Star: Pneumonia is, in fact, the number one killer of young children in many countries.
IN 2008, an estimated 8.8 million children died before their fifth birthday. One in five of the deaths was due to pneumonia. Pneumonia kills an estimated 1.4 million children under the age of five years annually – more than deaths from AIDS, malaria and tuberculosis combined.
In effect, one child dies from pneumonia every 20 seconds. Most of these pneumonia deaths occur in developing countries.
In Malaysia, the prevalence of pneumonia in children under five is between 28% and 39%. It is the fifth highest cause of death in Malaysian children, contributing 4% of deaths under the age of five years.
This global tragedy becomes even more depressing if you look at the universal finding that only one in five caregivers could recognise the danger signs of pneumonia, and only one in five children with pneumonia actually received lifesaving antibiotics!
Pneumonia often mimics the common cold, starting with a fever and cough, and parents may not realise that the condition may be much more serious.

The World Health Organization (WHO) and UNICEF in their 2008 document outlined the Global Action Plan for Prevention and Control of Pneumonia (GAPP). In summary, this child survival strategy embraced the following three key elements:
·Protection by handwashing, exclusive breastfeeding, improved nutrition, avoidance of indoor pollution (smoking, stove fires) and reducing risk factors (eg HIV).
·Treatment by improving access to healthcare and appropriate management at health facilities.
·Prevention of pneumonia by immunising against germs that are responsible, eg measles, pertussis, Haemophilus influenza B (Hib) and pneumococcus.

The implementation of the GAPP interventions to protect (breastfeeding), prevent (vaccinations) and treat (case management) in the 68 high child mortality countries would potentially avert up to 1.2 million post-neonatal pneumonia deaths annually by 2015.
The prevention strategy with “pneumonia vaccines” have been shown to substantially reduce pneumonia morbidity and mortality in children.
Malaysia introduced the pertussis, measles and Hib vaccines in 1960, 1982 and 2002 respectively. However, the pneumococcal vaccine is still not in the Health Ministry’s (MOH) National Immunisation Programme (NIP).
And unfortunately, the pneumococcus is the number one cause of pneumonia deaths. More than 50% of pneumonia deaths are due to the pneumococcus.
Apart from pneumonia, the pneumococcus can cause other serious diseases, namely meningitis (inflammation of the lining of the spine and brain), bacteraemia (germs in the blood), and other less invasive but nonetheless very burdensome medical conditions in terms of volume of morbidity and complications – otitis media (inflammation of the middle ear) and sinusitis (infection of the sinuses).
For every case of pneumococcal meningitis each year, there are probably 1,000 cases of pneumococcal otitis media. The two cases below illustrate the spectrum of diseases caused by the penumococcus.

Case 1: A three-year-old girl presented with a three week history of coughing and six days of high grade fever. She did not respond to oral antibiotics and was referred to hospital.
On admission she was febrile, breathing rapidly and was grunting. Her chest x-ray showed pneumonia of the entire right lung, with fluid collection. The lung fluid was drained and it grew the pneumococcus.
She required respiratory support in the intensive care unit (ICU) for five days, and oxygen support for another five days. Her repeat chest x-ray showed residual lung damage and she was in hospital for a total of four weeks.
Case 2: The second case a five-month-old girl was less fortunate. She had fever 36 hours prior to admission, was feeding poorly and vomited twice. She was noted to be more sleepy. Both her blood and cerebrospinal fluid grew pneumococcus.
Despite ventilation in the ICU, intravenous antibiotics, and close monitoring, she died within 10 hours.

Thus, vaccination against invasive pneumococcal disease (IPD) is a pivotal life saving strategy and reduces morbidity because:
·It may prevent children from ever being infected.
·It reduces the transmission of the bacteria in the community, thus reducing IPD in other age groups (herd immunity),
·It reduces the need for antibiotics, resulting in lower rates of resistant bacteria.

The pneumococcal vaccine first introduced in the US in 2000 has since been shown to be highly efficacious in a wide variety of populations studied in the US, Gambia and South Africa.
The pneumococcal conjugate vaccine (PCV) is the first vaccine in 20 years to show a significant reduction in all-cause child mortality in a major randomised, controlled clinical trial in Gambia, where seven deaths were prevented for every 1,000 children vaccinated.
The WHO, in a position statement in 2007, declared: “Recognising the heavy burden of pneumococcal disease in children and the safety and efficacy of PCV7 in this age group, WHO considers the inclusion of this vaccine in national immunisation programmes as a priority.”
Looking at the annual world birth cohort in 2008, only 7% have been immunised with the PCV, and most of these were in developed countries. More than 50 countries have incorporated the PCV in their NIP. In Asia, only Singapore, Macau and Hong Kong have included PCV in their NIP.
Since the arrival of the PCV in Malaysia, only a meagre 10% of our birth cohort have been vaccinated against the pneumococcus, and virtually all of these were in the private health sector. The vaccine is not available to the 70-80% of Malaysian children who attend government health centres for their scheduled immunisations since the PCV is not in the nation’s NIP.
The Asian Strategic Alliance for Pneumococcal disease prevention (ASAP) has been at the forefront in the advocacy for the inclusion of PCV in the NIP of countries in the Asia Pacific. With her Malaysian partner, the Malaysian Paediatric Association, they were part of the Global Coalition against Child Pneumonia established in 2009, to advocate for global action to protect against, effectively treat and help prevent pneumonia.

Number Of Mental Patients Increases In Parallel With WHO's Projection

KOTA KINABALU, Nov 12 (Bernama) -- The number of mental patients in Malaysia has been seen to be increased in parallel with the World Health Organisation's (WHO) projection that the global burden of mental disorders would increase by 16 per cent by 2020.
Deputy Health Minister Datuk Rosnah Abdul Rashid Shirlin said 400,227 mental patients had sought treatment at government hospitals last year and the number was an increase of 15.6 per cent from the previous year.
"We have identified depression as the most worrying type of mental disorder and it is expected to be the second largest disease suffered by Malaysians after heart disease," she told reporters after opening the Physical and Mental Health and Fitness Campaign at Queen Elizabeth Hospital here today.
Rosnah also said the ministry was giving extra focus on promoting mental health care, including by organising a six-month stress management activities for students in several schools nationwide.
The schools involved are SMK St Michael in Penampang Sabah, SMK Datuk Haji Ahmad Badawi (Seberang Perai, Penang), SMK Simpang Bekoh (Jasin, Melaka), SM Sains Teluk Intan (Perak), MRSM Gemencheh (Negeri Sembilan) and SMJK Catholic (Petaling Jaya, Selangor).
Rosnah said the activities, which aimed at improving the students' skills and abilities to manage stress, also saw participations of parents and school management.
Hence, she said such activities would be expanded to all schools soon.

Ministry wants an increase in health services for orang asli

Star: PETALING JAYA: The Health Ministry wants to see more orang asli providing health services to their community.
“We would like to encourage orang asli with relevant qualifications to apply to become nurses, medical assistants, radiographers as well as doctors and pharmacists.
“Those who qualify will certainly be given priority for employment to serve their community,” said Deputy Health Minister Datuk Rosnah Shirlin via an email interview.
The ministry will take over health and medical services run by the Orang Asli Development Department (JHEOA) effective Jan 1, next year.
At present, JHEOA operates a hospital in Gombak, Selangor, three family clinics in Pahang, Kelantan and Perak, 16 transit centres for families of hospitalised patients, and 108 halls to provide health services using the department's mobile clinic programme, mobile dental clinics and an airborne doctor service.
“The orang asli will be able to obtain health services at any ministry facility and not just those operated by JHEOA.
“We will also ensure that the traditional practices such as family admission is honoured,” she said.
She added that a dedicated unit under the Public Health programme will be established to monitor the implementation of services and to plan for future development.
A doctor at the orang asli hospital in Gombak had highlighted alleged mistreatment of patients, medical negligence and abuse of power at the facility.
The hospital reportedly underwent some cosmetic changes in June last year to stave off further criticism.
An orang asli hospital staff member, who declined to be named, said that she looked forward to the changes.
“For many years I have longed to see more orang asli employed to serve our people,” she said.

S'pore billionaire to buy 10ha from Johor royal family

Star: PETALING JAYA: Singapore billionaire Peter Lim, dubbed the “Remisier King”, has signed a deal with the Johor royal family to acquire 10ha in Johor for the development of a medical hub and a marina city.
The joint venture company behind the development is Best Blend Sdn Bhd, which Lim owns 70%, and the royal family owns 30%. Lim is ranked by Forbes business magazine as Singapore's eighth wealthiest individual with a fortune of S$1.8bil.
“The cost of the medical hub is estimated at S$200mil and the total development cost could range from S$1bil to S$2bil. The medical hub will be funded through a mixture of debt and equity,” said Koh Kim Huat, a director of Best Blend.
The hospital, when completed, will be managed by Thomson International Health Services, the consultancy and management division of Thomson Medical Pte Ltd.
Singapore-listed Thomson Medical was taken private by Lim last year. It is described as a leading healthcare service provider in Singapore for obstetrics, gynaecology and paediatric service.
The site of this hub is located at Bandar Johor Baru, and is within close proximity to Johor's new royal customs, immigration and quarantine complex as well as Singapore's Woodlands checkpoint.
The first phase of the project will see the construction of a medical hub which will include a private hospital and healthcare-related facilities and also supporting facilities including serviced apartments, a mega shopping mall and a mega fully secured car park. A special feature of the complex is a state-of-the-art security deterrence and detection systems.
The 200-bed general hospital will house centres of excellence for diabetes, orthopaedics, ophthalmology, women's health, and a state-of-the-art day surgery centre.
“The medical hub will provide quality private healthcare at affordable prices to Singaporeans and Malaysians,” said Koh.
When asked whether TMC Life Sciences would be involved in the medical hub, Koh said there were no plans at this point.
Lim made headlines in Malaysia last year when he bought a substantial stake in TMC Life Sciences Bhd, a private healthcare group which is popular for its fertility treatments. Lim is now the largest shareholder of TMC with 32.59% stake.
Koh said fertility would be one of the key focus segments of the hospital. Among others, the focus for the hub will be the treatment of chronic and lifestyle diseases associated with growing affluence and which afflicts increasing numbers of Malaysians. The hub aims to provide a one-stop centre for chronic disease management of diabetic patients. A training school will be set up for nurses and medical technicians.

Powertek aids kidney foundation

NST: Every year, more than 4,000 Malaysians are diagnosed with kidney failure. Some 22,000 are on dialysis and the number continues to rise.
Concerned about these alarming statistics, Powertek Bhd (Powertek) recently joined the National Kidney Foundation of Malaysia (NKF) to help save lives through education and early detection of kidney disease.
Powertek presented RM100,000 to NKF in support of its public education outreach programme.
The sponsorship will enable the NKF to conduct free health screenings at Felda settlements, smaller towns and rural areas in Malaysia, especially in the east coast and East Malaysia.
The funding commitment is for one year, till June next year, covering 34 screening sessions.
Powertek executive director and chief executive officer Dr Ong Peng Su said: "As part of our corporate social responsibility initiative, we are pleased to work with NKF to provide free screenings to ensure that needy communities receive the support and assistance required for good health."
NKF chief executive officer Chua Hong Wee said: "There is no cure for kidney disease. The only way to reduce the number of dialysis patients is through regular check-ups and educating the public on how they can prevent kidney disease."
NKF has conducted 10 sessions in rural areas such as Hulu Selangor, Kampung Kundur Tengah in Negri Sembilan, Felda settlements in Terengganu and Kuching, Sarawak.
The NKF LifeCheck Mobile Health screening programme was launched in 2008. It has screened more than 100,000 participants.
NKF has over 1,400 dialysis patients receiving subsidised treatments in 24 dialysis centres nationwide.

Malaysian healthcare shines at Jakarta Hospital Expo

NST: KUALA LUMPUR: Malaysian healthcare companies participating at the Hospital Expo 2011 in Jakarta, last month, received strong interest from Indonesian hospitals and laboratories for medical devices, equipment and services.
The 14 participating companies, led by the Malaysia External Trade Development Corporation (MATRADE), also received numerous trade enquiries for spinal implants, urine bags, hospital beds, health screening services, cancer treatment, fertility treatment and orthopaedic surgery.
MATRADE Deputy Director of Corporate Communications Unit, Khairul Annuar Abdul Halim said the Hospital Expo 2011, is one of the largest health care related trade events in Indonesia.
He said with a population of over 220 million people, 80 per cent of the medical devices utilised in Indonesia, is imported.
Thus, the hospital show was a strategic platform to promote and foster business and networking opportunities between Malaysian healthcare device manufacturers, their potential distributors, agents and end-users throughout Indonesia, he added.

Specialists to learn TCM in China

Star: BEIJING: Specialists from hospitals and medical centres in Malaysia will soon be able to work with Chinese traditional medicine practitioners to develop methods of treating illnesses under a new cooperation agreement between both countries.
Health Minister Datuk Seri Liow Tiong Lai said the cooperation would benefit Malaysia as some of the traditional practices adopted by the Chinese physicians could be good reference for Malaysian doctors.
“This is a very important development in our medical field. There are some cancer conditions in Malaysia that are hard for our specialists to treat,” he said.
“China invited our specialists to visit the country and learn from their practitioners specialising in traditional Chinese medicine (TCM),” he said after signing a memorandum of understanding on policy regulation and promotion of traditional medicine with Chinese deputy health minister Wang Guoqiang here yesterday.
He said both countries had agreed to start developing more software programmes such as training, research and development and clinical management for their doctors while waiting for the construction of a centre of excellence for TCM in Malaysia.
It is learnt that the Malaysian Government had offered a 20.2ha land in Salak Tinggi, Selangor, for the project which is estimated to cost RM200mil to RM300mil. The Chinese side will provide the technical expertise to build the centre.
Federation of Chinese Physicians and Medicine Dealers Associations president Ting Ka Hua said Malaysia was one of the few countries in South-East Asia which had kept the rich TCM tradition from generation to generation.

Scrapping MQE plan will "open floodgates" to foreign doctors

SunDaily: PETALING JAYA (Nov 6, 2011): The government's decision to scrap the plan to make the Medical Qualifying Exam (MQE) compulsory for all foreign medical graduates may have negative consequences come 2014, when Malaysia opens its doors to foreign medical practitioners under the World Trade Organisation agreement.
A source close to the situation said the decision of the Cabinet recently had obviously not taken into account the consequences of the WTO when the floodgates will be open to medical practitioners from the world over.
He said Malaysia had signed the WTO General Agreement on Trade in Services (GATS) in 2005 and the agreement on allowing foreign medical practitioners into Malaysia to practice will come into effect in the next one to two years.
"In two years' time, Malaysia may be flooded with foreign doctors who may not be fit to practise here," said the source, who is a Health Ministry consultant, adding it will exacerbate public fears over the quality of doctors in the country.
He said many of the healthcare professionals who were consulted for the process of amending the Medical Act 1971 had been all for making it compulsory for everyone to pass the MQE before practising medicine here.
Earlier this year, Health Minister Datuk Seri Liow Tiong Lai had announced that the current list of 365 recognised overseas foreign universities may be abolished in favour of making it compulsory to pass the MQE before practising medicine here.
However, the idea was recently quashed by the Cabinet which decided instead that the universities are only to be reviewed more frequently and the list shortened.
The source was however skeptical, saying the move will not resolve fears of poor quality medical graduates and low standards -- both of which are very much the realities of the medical profession now.
"Some of these universities have not been reviewed in 10 years, while some, the ministry is not even sure still exists," he said.
"Some even "put on" a show for the review, because they know the evaluation team is coming," he said, adding that it is a huge burden to review universities regularly, as each visit would take at least a week.
"How is it possible to review 365 universities in a year? Even if you review one university a week it is not possible," he said.
He cautioned that the ministry has yet to have a proper mechanism in place to ensure that local doctors will not lose out, and that foreign doctors would be tested for fitness before allowing to practise here.
"In Indonesia, all medical graduates regardless from which university or country must pass the certificate of fitness of practise before becoming doctors. Indeed, any medical practitioner wishing to be a doctor in indonesia must also sit for this certificate," he said, adding that Malaysia has yet to put in place a system like that.
"All this was brought up to the minister, but it was rejected. Many of those consulted, myself included, was in favour of making the MQE compulsory," he said.
He lamented that as more opportunities to study medicine both locally and overseas emerge, standards to studying medicine is lowered.
"The bar gets lower and lower each time, and so candidates get used to having it easy. By the time they come out to practice as housemen, they find it all too much because they are not used to hard work," he said.
Meanwhile, Malaysian Medical Association president Dr Mary Suma Cardosa described the cabinet decision as "an example of political interference in professional matters."
"The task of monitoring the quality of these universities is a massive task, which is why the Malaysian Medical Council wanted the exam to be compulsory initially," she said.
She nevertheless welcomed with caution the proposal by the Health Ministry to reduce the number of recognised overseas medical universities, though she said existing programmes may become more slipshod due to high demand.
"The emphasis should be on teaching modules, quality and caliber of the lecturers," she added .

Malaysia to host talks on female health

Star: KUALA LUMPUR: Every year, about 350,000 girls and women die from pregnancy-related causes and almost all of these deaths occur in developing countries.
But there is some good news; the numbers are decreasing across Asia, and Malaysia is helping to lead the way, making huge strides in reducing maternal deaths.
Between 2000 and 2011, Malaysia reduced maternal mortality rates from 63.6 per 100,000 live births to 48.2 per 100,000. That is one of the lowest maternal mortality ratios in Asia.
But that is not saying much, for Asia-Pacific still bears the brunt of birth-related deaths; 44% of maternal deaths and 56% of newborn deaths worldwide occur in the region.
This information was shared by Women Deliver, an international organisation that brings together voices from around the world to call for improved health and well-being for girls and women.
Launched in 2007, it works globally to generate political commitment and financial investment for fulfilling Millennium Development Goal 5 — to reduce maternal mortality and achieve universal access to reproductive health.
The organisation’s founder, Jill Sheffield, said Malaysia managed to reduce maternal deaths through simple interventions, such as improvement in access to maternal health services and investment in obstetric care in district hospitals.
This is one of the reasons that Women Deliver has chosen Malaysia as host for its third conference, scheduled for May 2013. The first conference was held in London in 2007 and the second in Washington (2010).
“This global conference will draw advocates, activists, civil society leaders from around the world to Asia to discuss the most pressing issues facing women and girls,” Sheffield said.
“A joint report will be released by Women Deliver and the World Bank that shows data on why investing in women is a smart thing to do.
“In 2010, more than 3,400 people came together at the Women Deliver conference to stand behind one message: invest in women – it pays.
“Women Deliver 2013 will build on these commitments, and it will launch a new era of engagement among all partners working together to improve maternal health and deliver for girls and women everywhere.”
The 2013 conference will focus on accelerating progress towards Millennium Development Goal 5 (MDG5) so that it can be achieved by 2015.
“Women Deliver 2013 will be an opportunity for the world to reassess our progress on MDG5 and set ambitious but realistic goals for impacting maternal mortality and reproductive health access for 2015 and beyond,” Sheffield said.
Women Deliver 2013 aims to build on the commitments and investments made in 2010, including the Muskoka Initiative launched by the leaders of the G8, the resigning of the Maputo Plan of Action by the African Union, and the United Nations’ Global Strategy for Women’s and Children’s Health.

4.8 Million Malaysians Suffer From NCD

KUALA TERENGGANU, Oct 28 (Bernama) -- Almost 4.8 million Malaysians are suffering from non-communicable diseases (NCD), which include hypertension and heart-related illnesses, according to Health deputy minister Datuk Rosnah Abdul Rashid Shirlin.
Launching the 1Malaysia East Zone University Students Programme 2011 at Universiti Malaysia Terengganu here today, she said studies done at government health clinics in the country found 70 per cent of patients receiving treatment were at risk of NCD.
"The percentage is very worrying for the ministry as NCD is a predisposing factor to mortality, debilities and lifelong agony.
"In this respect the ministry wants to encourage the younger generation especially university students to make healthy living a culture," she said.
Also present at the function was UMT Assistant Vice Chancellor (Research and Innovation) Prof Dr Norhayati Mohd Tahir.
The joint programme between the Health Ministry and UMT is the third after Universiti Utara Malaysia (UUM) and Universiti Kebangsaan Malaysia (UKM) respectively, since it was launched on Sept 23.
Rosnah cited the practice of walking 10,000 steps a day and reducing the intake of fats in the daily diet as among the initiatives to ward off NCD.
In another development, Rosnah said the ministry planned to hold a convention for university students who participated in the 'Kumpulan M10' programme after the completion of its last edition at Universiti Malaysia Sabah (UMS) before the end of this year.
She said the convention would deliberate on the results of the 'Cabaran Siswa Sihat' an intervention project carried out by students at the four universities.

Breast cancer the top threat

Star: PETALING JAYA: Breast cancer continues to be the most common type of ailment among women.
The latest Health Ministry report, which gave statistics up to 2007, said 29 out of every 100,000 Malaysian women had breast cancer.
In comparison, eight out of 100,000 suffered cervical cancer, the third most common cancer affecting women.
The other most frequent cancers among women were colorectal cancer (10%), ovary (6.5%) and lung (5.4%).
Worldwide, breast cancer was also the most frequent among women.
Nineteen to 86 cases per 100,000 women were diagnosed with the ailment in various countries, corresponding to 10.9% of all cancer cases.
Deputy Health Minister Datuk Rosnah Abdul Rashid Shirlin, who revealed this at a press conference after the official launch of the Softlan Breast Cancer Charity Campaign here yesterday, said this type of cancer accounted for six to 19 out of every 100,000 deaths worldwide.
She said the latest statistics showed that breast cancer represented almost a third (32%) of all new cancers affecting women.
“Women tend to put their family first, rather than themselves.
“But, they must put a priority on their health too and examine their breasts monthly as well as go for screenings.
“It would be difficult for women to take care of their family if they are suffering themselves,” she said, urging all women, especially those aged 40 and above, to go for annual clinical breast examinations.
Rosnah said while more women were coming forward with early Stage 1 and Stage 2 breast cancers, there were still patients turning up at the later Stage 3 and Stage 4 phases.
“Most breast cancer cases are detected at age 45 and above,” she said, adding that early detection provided higher chances of survival.
Giving a racial breakdown of cancer sufferers, Rosnah said the incidence among the Chinese was 38.1% per 100,000; while among the Indians it was 33.7% and the Malays at 25.4%.
Among men, the most frequent cancers were lung (16.3%), colorectal (14.6%) nasopharynx (8.3%), prostate (6.2%) and lymphoma (5.5%).
Rosnah said the most frequent cancers for both genders combined were breast (18.1%), colorectal (12.3%), lung (10.2%), nasopharynx (5.2%) and cervix (4.6%).

Rosnah: We have highest number of obese people in region

Star: HULU TERENGGANU: Malaysians are the fattest in Southeast Asia and the Health Ministry is determined to lose that “honour”.
Deputy Health Minister Datuk Rosnah Abdul Rashid said Malaysia had the highest number of obese citizens in the region.
“This is very worrying as the country is also ranked sixth among Asian countries,” she said after launching the Cakna Kesihatan programme at Kampung Pasir Nering here yesterday.
“One of the main contributors is our inactive lifestyle, whereby 43.7% of those above 18 years of age are not exercising.”
Rosnah said her ministry had set a target to reduce 30% of the weight for those classified as obese nationwide.
“We'll do this through efforts such as introducing a calorie guideline in schools as well as instilling healthy lifestyle habits among university students.
“Studies conducted have revealed obesity is common among urban people, given the high number of fast food outlets located in towns and cities.
“We are also organising various health checkups through the respective health departments nationwide to ensure that the people can gauge their health levels,” she said.
Rosnah said 60% of deaths worldwide were due to non-communicable disease and obesity was a type of NCD.
“Such deaths can be prevented if only people would take charge of their lives,” she said.
“It is not hard to exercise, thus the ministry has introduced the 10,000 steps a day programme.”

Ambulance crash sends more patients to hospital

Star: GEORGE TOWN: It took two ambulances to send an asthma patient to the Penang Hospital as the first one had crashed in an accident, injuring the patient and six others.
A 47-year-old man, who had suffered a heart attack at around 5am yesterday, was picked up by an ambulance from the Penang Hospital. Half an hour later, at a junction in Jalan Sg Pinang, the ambulance collided with an oncoming car.
The man and two female relatives, who had accompanied him, as well as the driver of the car, in his 30s, suffered light injuries.
The ambulance driver and two att­en­dants were also hurt.
All seven were later picked up by two ambulances and admitted to the Penang Hospital.
There have been several accidents involving ambulances in just under four months.
On Sept 10, an ambulance heading to an accident scene collided with a car, injuring four people near Kuantan.
On Sept 5, a woman accompanying her husband died when the ambulance skidded into a ditch in Sabah.
On Aug 31, Norizah Bujang, 62, was accompanying her daughter Moriem Tam Suhana Ahmah, 30, when the ambulance crashed into a ditch in Gemencheh, Negri Sembilan. Norizah was killed in the crash.

MMC to review and shorten list of recognised foreign medical schools

Star: PETALING JAYA: The current list of recognised foreign medical schools is expected to be reviewed and shortened to ensure that Malaysian medical students who graduate from these schools are of a satisfactory standard.
The Malaysian Medical Council (MMC) is planning on shortening the list of recognised foreign medical schools and carrying out re-accreditation exercises every three to five years.
A source who revealed this said since the proposed amendment to the Medical Act 1971 that compelled all foreign medical graduates to sit for a medical qualifying was rejected by the Government in June, the MMC was now looking at other ways to ensure that medical graduates were of satisfactory standard.
“Colleges that fall short of the standards will be reviewed,” he told The Star.
According to the health deputy director-general (medical) Datuk Dr Noor Hisham Abdullah, there are currently 366 recognised medical degrees in 14 countries.
“We are trying to reduce that figure,” he said, citing quality concerns.
“The recognition (for foreign degrees) was given years ago and we don’t know if the quality has gone up or down.
“If the quality has gone down, we obviously have to ask if they still comply to our standard of nurses, doctors and allied health professionals,” he said.
After rejecting the qualifying exam for all foreign medical graduates, the Government imposed a five-year moratorium on new medical courses and decided to increase the housemanship period.
Meanwhile, Dr Noor Hisham witnessed a signing of a memorandum of understanding between the ministry and several private colleges and universities here yesterday.
With the memorandum, the ministry will allow the higher learning institutions to train their medical, pharmaceutical, nursing and allied health sciences students in various government hospitals.
The source said MMC had discussed steps be taken to identify the number of foreign universities in the Second Schedule of the Medical Act that were still actively teaching Malaysian students so they could be retained.
Currently, only graduates from unrecognised universities are required to sit for a medical qualifying examination.
Last November, The Star carried a front page and subsequent reports on the lack of training hospitals to meet the influx of housemen and doctors’ concern over housemen from some countries who lacked core medical knowledge.
Since the re-accreditation would be an extensive undertaking, the source said they hoped to negotiate with the medical schools concerned to bear the cost of the accreditation process.

Malaysia promotes healthcare travel with a bang in China

Borneopost: NANNING: Malaysia has gone into promoting healthcare travel with a bang in China, a market with about a 1.4 billion population.
Malaysia Healthcare Travel Council (MHTC) Deputy chief executive officer Wong Toon Keng said the campaign was launched in Hong Kong by Health Minister Datuk Seri Liow Tiong Lai two months ago.
“Hong Kong was selected because it’s a trend-setter,” he said at the ongoing 8th China-Asean Expo (CAEXPO 2011) here.
Last week, he said, MHTC chief executive officer Dr Mary Wong Lai Lin attended a forum in Shanghai, where she spoke on the Malaysian healthcare travel industry.
The MHTC has also received approval to bring media practitioners from five Chinese provinces to visit the various healthcare facilities in Malaysia next month.
The main objective of the publicity drive is create awareness among the Chinese public, as the number of healthcare travelers from China to Malaysia, has not seen a significant increase over the years, Wong said.
“Malaysia is a late starter, unlike Singapore.
“At present, about 70 per cent of healthcare travelers in Malaysia are Indonesians, with their main destinations being Penang and Melaka,” he added.
For the six-day CAEXPO 2011 that ends on Wednesday, the MHTC has a cluster alongside KPJ Healthcare Bhd (KPJ) and Sunway Medical Centre Bhd (Sunway), in the Malaysia Pavilion hosted by the Malaysia External Trade Development Corporation (Matrade).
“We have received a lot of enquiries,” Wong said.
The MHTC was established under the Health Ministry in 2009 as the primary agency to develop and promote the healthcare travel industry.
It also serves to position Malaysia as the healthcare destination of choice in the region.
On October 8 this year, Prime Minister Datuk Seri Najib Tun Razak announced in his 2012 Budget speech that the Council would be corporatised.

A strain on the pocket

Star: Healthcare cost is expected to escalate in line with the rising cost of living and the Health Ministry is taking steps to raise public awareness on non-communicable diseases.
OF late, the Health Ministry has been raising public awareness on non-communicable diseases (NCD) chronic respiratory diseases, heart diseases, cancer and diabetes.
According to Health Minister Datuk Seri Liow Tiong Lai, the recent United Nations' high-level meeting on NCD in New York revealed that there would be a 17% rise in global prevalence of NCDs by 2025 if nothing is done to control it.
Recent statistics already show that 60% of premature deaths (below 60 years) in Malaysia were caused by NCD, he has said.
The focus is warranted not only because of the need to keep the population healthy and productive but also to keep healthcare cost, which is expected to escalate in line with the rising cost of living, manageable.
A World Economic Forum (WEF) study carried out with the Harvard School of Public Health shows that the cumulative costs of treating NCDs are expected to be US$7tril (RM21.9tril) from this year to 2025.
Mental health (which is not included in the list of NCDs but which the study found, along with heart diseases, to be responsible for nearly 70% of lost output) will account for US$16tril (RM50tril).

In Malaysia, the Government currently provides highly subsidised healthcare services to the general population while the poor are exempted from paying.
Liow says the current healthcare system offers a safety net from “catastrophic health expenditure” for those seeking treatment at government hospitals.
But Malaysia, like many other countries, is apprehensive that the present system of financing may not be sustainable in the long term due to rising health expenditure and the high out-of-pocket spending by the population, he reveals.
To ensure that people continue to get access and coverage to healthcare, the ministry is planning the 1Care programme, which seeks to address the issues and challenges of the current system.
“In 1Care, it is proposed that the health financing mechanism will keep healthcare inflation under control and reduce out-of-pocket expenditure at the point of seeking care,” Liow explains.
Under 1Care, it is envisaged that the population would have greater choice to seek care either at public or private health facilities. This could happen through mandatory contributions into a consolidated fund managed by the Government, Liow says.
“Healthcare providers will also be better motivated to practise in more rural areas, thus improving access and coverage of the population,” he adds.
“Primary healthcare providers will become family doctors responsible for providing long-term personalised services to their registered patients.”
1Care also envisages the use of a prepayment mechanism, implemented through enrolment in a Social Health Insurance (SHI) scheme, which will reduce high out-of-pocket payments at the point of seeking care when a person is already seriously ill.
SHI premiums, Liow explains, are community-rated and contributions will be based on a percentage of income. The Government will pay the premiums for the poor and vulnerable.
“SHI promotes equity in financing and access, where the amount contributed is based on the level of income and no one is denied access to healthcare due to their inability to pay. The scheme will deploy continuous monitoring and evaluation to ensure the goals of the health system transformation are achieved,” he says.
But there are challenges in implementing the scheme, he admits, citing as examples the recruitment of those in the informal job sector and determination of those eligible for government funding.
“Defining the benefits package and estimating the true cost of health services will also be challenging. Drawbacks include additional administrative costs compared to a public healthcare system funded adequately by general taxes, but the administrative cost is still lower than for privately managed systems,” he says.
Looking at private health insurance (PHI) companies, Liow says premium rates will increase if there are pre-existing conditions such as NCDs and mental illness. Those who buy PHI will have the option to purchase insurance packages specifically tailored to them but they need to be willing to pay higher premiums, he adds.
He assures that when the SHI is introduced, such issues will not arise as people cannot be excluded from joining the scheme because of any pre-existing conditions, age or ability to pay.

Universal coverage
Prof Dr Daniel Reidpath, professor of population health at the Jeffrey Cheah School of Medicine and Health Sciences, Monash University Sunway campus, says managing the future burden of NCDs requires both a prevention strategy and a care and disease management strategy.
“Both strategies need to target the whole population and should be seen as part of universal coverage. People sometimes, mistakenly, think about direct healthcare as the only concern of universal coverage,” he adds.
“The financial and health savings from successful prevention strategies, however, are so substantial that the two arms of prevention and care need to be considered simultaneously. The focus is healthcare, not sick' care.”
Universal coverage, he explains, is a concept based on “the need for all individuals to be able to access adequate healthcare with a focus on efficiency, which is the equitable delivery of relevant, high quality care at the lowest cost”.
Malaysia, he says, would need to consider not only types of preventive services to implement but how they are financed.
He adds that besides prevention delivered through clinical practice, there are also “enormous” opportunities to engage in prevention work through community-based programmes that encourage health and wellness, and structural and policy reform around policies on tobacco, transportation, food and agriculture.
Managing NCDs requires regular monitoring and ongoing treatment, which translates into clear guidance on what is considered “essential” healthcare and the types of services provided under universal coverage such as entitlement for regular kidney dialysis, chemotherapy or statins, he says.
Dr Reidpath says there is always a cost associated with universal coverage.
“The danger here is that knee-jerk responses to possible increases in healthcare costs may ignore the much greater economic cost associated with a loss of economic productivity.”

On Malaysia's healthcare system, he says there is a need to restructure the system, which previously focused on primary healthcare, to one which can deal with current health priorities such as NCDs.
“The great advantage for Malaysia is its network of primary healthcare centres. Appropriately restructured, the centres could become an integral part of any universal healthcare scheme delivering prevention and direct care for NCDs,” he says.
He also points out the misconception that Malaysians are over-dependent on the Government. Governments of the 10 nearest gross domestic product (GDP), including Turkey, Argentina, Mauritius and Mexico, spend on average twice as much, he says.
Dr Reidpath says that if universal coverage is to be seriously considered for Malaysia, especially for strategies to manage NCDs, the Government would have a significant role.
The role could also include direct financing, legislative and regulatory management of healthcare financing to ensure appropriate risk-pooling mechanisms that will protect the health of Malaysians.
He adds that the Government is also “well-placed” to support prevention strategies.
“Lack of good prevention and adequate healthcare cover for the whole population will ultimately be a far greater burden on Malaysia than any modest economic burdens that could occur now in order to ensure universal coverage,” he says.
On healthcare cover for employees, the Malaysian Employers Federation (MEF) executive director Shamsuddin Bardan says most major organisations have a cap on medical entitlement for their employees.
“It is according to the capability of the company to do this,” he says.

Government hospitals and clinics to issue itemised receipts by next year

Star: MUAR: Government hospitals and clinics will issue itemised bills to patients to show the cost of treatment and medicine from next year.
“Although patients only pay RM1, they should know the cost of their treatment and medicine,” Health Minister Datuk Seri Liow Tiong Lai said.
He said he would submit the proposal for itemised bills to the Cabinet soon.
“After the Cabinet approves it, we will issue itemised bills to patients at hospitals as well as clinics.
“We want the people to know how much the Government is spending to subsidise medical treatment for them,” Liow said at the launch of the National Oral Health Clinical Information System (OHCIS) at Klinik Maharani here yesterday.
Liow said the Government had also provided huge subsidies in offering dental care.
The ministry, he said, wanted to reduce the waiting time for denture replacement from the present three to four months to two weeks.
One way to achieve this was to increase the number of dental technologists at dental clinics, he said, adding that in Muar, for example, there was only one dental technologist.
He said the ministry wanted water treatment plants in the states to carry out water fluoridation to reduce tooth decay among the people.
This, he said, was important to ensure healthy teeth.
On the OHCIS, he said the system was aimed at speeding up efforts in providing dental care services.
He said the target was to reduce the waiting time for patients seeking dental treatment at the clinics from two hours at present to 30 minutes.

Increase in families consenting to donate organs of dead relatives

Star: KUALA LUMPUR: More than half of families approached by doctors to donate organs of their deceased loved ones consented.
National Transplant Resource Centre chief national donor coordinator and procurement manager Datin Dr Lela Yasmin Mansor told The Star that this was a two-fold increase from 2000, when only about 25% families said yes.
“Last year, we had 151 cases (of potential donors) referred to us, and out of that, there were discussions with the family in 113 cases. 58 families (51.3%) consented to organ donation,” said Dr Lela.
“Almost one-third of these discussions are also initiated by the family,” she added.
Dr Lela noted that this indicated an increase in awareness about organ donation.
“The problem is that we are not approaching (potential donors’ families) enough,” she said.
Dr Lela also explained that doctors and medical staff often found it difficult to bring up the subject.
“That is why we need to give them training,” she said.
If the potential donor is already brain dead, doctors could also maintain his or her organs so that they will be in good condition for donation, Dr Lela added.
Last year, 22,835 people had pledged their organs, bringing the total number of organ dona-tion pledges recorded in the National Transplant Registry to 181,534.
Currently there are 14,013 people waiting for kidneys, 17 waiting for livers, two waiting for hearts, three waiting for lungs, and two waiting for both a heart and lung.
“The reason why there are so many people on the waiting list for kidneys is that there is an alternative treatment, which is dialysis,” Dr Lela said.
People who are waiting for other organs may not survive if they do not receive their organs in time, she added.

No meds for unapproved ops

Star: BANGI: Malaysians who travel abroad for organ transplants provided on commercial basis will not be allowed to get free supply of immunosuppressant drugs from Government hospitals, which costs between RM800 and RM1,000 per patient per month.
These drugs are used to inhibit or prevent activity of the immune system and to prevent the rejection of transplanted organs and tissues.
Health Minister Datuk Seri Liow Tiong Lai said the move, which takes effect from January, is to stop people from going overseas to get such treatment from unrecognised hospitals without the ministry's approval or knowledge.
He said many patients go for organ transplants at hospitals in foreign countries that are not recognised.
“They end up with complications while the Government still provides them with free medication for life,” he said here yesterday.
He had earlier launched the National Organ Donation Awareness Week at the Universiti Kebangsaan Malaysia stadium here yesterday.
“We have many experts and hospitals with advanced medical technology that are able to perform successful operations.
“We do not condone organ trafficking. So we have decided to stop supporting these illegal operations by discouraging Malaysians from going abroad to gain organs commercially without the knowledge of the ministry,” said Liow.

According to the Malaysian Trans-plant Registry, between 2001 and last year, transplantations mainly involving the kidney, were largely done in China (834) and India (57).
Fifty-three surgeries were also carried out in countries like Australia, Spain and Russia while 10 were performed in unidentified countries.
Asked about patients who prefer to seek experts from abroad to perform the operation, he said: “They would have to first consult with the ministry, which will allow the operation if it is suitable.”
On an allegation that a local hospital was involved in commercial organ transplants, Liow said the Government does not support any international organ trafficking syndicate.
“The Government views the allegations seriously and would leave it to the police to investigate since police reports have been lodged,” he said, adding that there has been no evidence of this so far.
He said that Malaysia was committed to abiding by the WHO Guiding Principles on Human Cell Tissue and Organ Transplantation.
Public Awareness Action Commit-tee on Organ Donation chairman Tan Sri Lee Lam Thye has proposed for the Road Transport Department to include in its driving licence application forms, a column to indicate whether the applicant was interested to sign up as an organ donor.
He added donors must inform family members to avoid complications.

Malaysia is part of UN health body’s executive wing after 26 years

Star: BENTONG: Malaysia has been elected as a member in the World Health Organisation (WHO) executive board after a lapse of 26 years, Health Minister Datuk Seri Liow Tiong Lai said.
“All of us from the ministry are elated over this great news.
“Being selected to the WHO executive board will enable Malaysia to enhance its image globally.
“At the same time, Malaysia can play an active role in health diplomacy and ensure efficient health policies are implemented,” he said at the “10,000 Langkah Sehari” event here yesterday.
Malaysia was last elected to the WHO executive board for the 1983-1985 term and had also previously served from 1963 to 1965.
Together with Australia, Malaysia was elected at the 62nd session of the WHO Regional Committee for the Western Pacific, which was held from Oct 10-14 in Manila, the Philippines.
This was to fill the two vacant seats representing the WHO Western Pacific region at the board for the 2012-2014 term.
Liow said there were only five seats allocated for WHO Western Pacific Region in the board.
The WHO Regional Committee for the Western Pacific is an annual meeting attended by health ministers from the Western Pacific region, where public health issues and challenges are deliberated.
There are 37 countries and areas in the region.
Liow said the WHO executive board comprised 34 members.
“The main functions of the board are to give effect to the decisions and policies of the World Health Assembly, to advise it and to facilitate its work,” he said.

On another matter, Liow said it was important to raise awareness on non-communicable diseases such as high blood pressure, high cholesterol, diabetes and heart problems.
“Not only do we need to observe healthy eating habits, we also need to exercise regularly to prevent ourselves from becoming overweight or obese,” he said.
He added that according to the ministry's survey in 2006, 14.2% of Malaysians were obese while another 29.1% were overweight.
Liow said school programmes such as measuring students' body mass index, teaching students how to count their calories and promoting healthy diets were some of the initiatives taken by the Government to prevent non-communicable diseases.
He said many Malaysians were still not aware of the danger of being diagnosed with these diseases as they were silent killers that did not show many symptoms.