Indiscriminate testing raises doctors’ concern
Tumour marker tests are being marketed as an early detector of cancer, but doctors say they are unreliable and sometimes inaccurate.
Incorporated into many health or "wellness" packages, these tests are available at some clinics and clinical laboratories, especially in the Klang Valley. They are even marketed directly to staff at companies. The cost ranges from RM20 to RM65.
Doctors said tumour marker tests can either cause unnecessary concern or give a false sense of security. "These tests are a waste of money," said Dr S.K. Dharmalingam, president of the National Cancer Society.
"The authorities should regulate this indiscriminate testing," said Dr Leslie Lai, who last year helped the Academy of Medicine of Malaysia, an association of specialists, produce guidelines on the use of these tests.
Tumour markers are substances produced by cancer cells, and high levels can be found in the blood and urine of patients with cancer.
However, normal cells also produce these markers, sometimes in large amounts in people who do not have cancer.
Almost everyone has a little of these substances in their blood, said Dr Dharmalingam. "This is why sometimes tumour marker tests are not reliable," he said.
Furthermore, low levels do not mean there is no cancer.
"Sometimes, tumour marker levels rise only when cancer is already advanced." "The marker levels are rarely elevated in patients with early malignancy," said Datuk Dr Abdul Hamid Abdul Kadir who heads the Malaysian Medical Council's ethics committee. Tumour markers are best used to monitor how well a cancer patient is responding to treatment. If marker levels fall after treatment, then the doctor knows he is on the right track, for example. "In the United States and the United Kingdom, the use of these tests is tightly regulated," said Dr Lai.
The Department of Health has approved the guidelines produced by the committee Dr Lai headed and distributed to its doctors and hospitals, he said.
The guidelines do not apply to private doctors, however, except as a recommended standard of practice.
Malaysian Medical News: keeping you up to date with news sourced from various online sites, put in one place for your convenience, with a searchable archive
Sunday, August 01, 2004
Mercy sets up fund for Sudanese
KUALA LUMPUR: Grim images of hollow-eyed, skeletal and dying adults and children in desperate need of help have been beamed across the globe over the past weeks from Darfur in Sudan.
Malaysians can help alleviate what the United Nations has declared as the “worst humanitarian crisis in the world” at present by contributing to a fund set up by the Malaysian Medical Relief Society (Mercy Malaysia).
Named the Sudan Humanitarian Crisis Appeal, the fund will go towards setting up a basic health facility and therapeutic feeding centre in El-Geneina in West Darfur, where about 170,000 displaced Sudanese have fled to following violence mounted by Arab Janjaweed militias, accused of ethnic cleansing and genocide against the black Africans.
A contribution of RM5 can prolong the life of a malnourished child by up to a month while RM10 can address the medical needs of one displaced person for the same period.
Mercy Malaysia president Datuk Dr Jemilah Mahmood said a four-member team would be leaving for Sudan on Monday on board a Qatar Airway-sponsored flight to gather information on the needs before deploying a medical team there in middle of next month.
At least RM1.5mil is needed to set up a medical facility and operate it for six months.
“Our priorities are to provide basic healthcare, prevent the spread of diseases and feed malnourished children.
“We need special food and milk formula as prescribed by the World Health Organisation for these children,” she told a press conference yesterday.
According to United Nations estimates, one million black Sudanese fled their homes since early last year and 50,000 have been killed. Of the displaced, 88% are without shelter, 64% without clean water and 49% without food relief.
Dr Jemilah appealed to Malaysians to donate generously and also called for medical volunteers to come forward.
“Mercy will write to the Malaysian Government requesting support. We hope the Health Ministry will allow doctors from public hospitals who are interested in joining the relief mission to apply for leave,” she said.
For details, call Mercy Malaysia at 03-4256 9999/012-916 2579/019-636 6595.
KUALA LUMPUR: Grim images of hollow-eyed, skeletal and dying adults and children in desperate need of help have been beamed across the globe over the past weeks from Darfur in Sudan.
Malaysians can help alleviate what the United Nations has declared as the “worst humanitarian crisis in the world” at present by contributing to a fund set up by the Malaysian Medical Relief Society (Mercy Malaysia).
Named the Sudan Humanitarian Crisis Appeal, the fund will go towards setting up a basic health facility and therapeutic feeding centre in El-Geneina in West Darfur, where about 170,000 displaced Sudanese have fled to following violence mounted by Arab Janjaweed militias, accused of ethnic cleansing and genocide against the black Africans.
A contribution of RM5 can prolong the life of a malnourished child by up to a month while RM10 can address the medical needs of one displaced person for the same period.
Mercy Malaysia president Datuk Dr Jemilah Mahmood said a four-member team would be leaving for Sudan on Monday on board a Qatar Airway-sponsored flight to gather information on the needs before deploying a medical team there in middle of next month.
At least RM1.5mil is needed to set up a medical facility and operate it for six months.
“Our priorities are to provide basic healthcare, prevent the spread of diseases and feed malnourished children.
“We need special food and milk formula as prescribed by the World Health Organisation for these children,” she told a press conference yesterday.
According to United Nations estimates, one million black Sudanese fled their homes since early last year and 50,000 have been killed. Of the displaced, 88% are without shelter, 64% without clean water and 49% without food relief.
Dr Jemilah appealed to Malaysians to donate generously and also called for medical volunteers to come forward.
“Mercy will write to the Malaysian Government requesting support. We hope the Health Ministry will allow doctors from public hospitals who are interested in joining the relief mission to apply for leave,” she said.
For details, call Mercy Malaysia at 03-4256 9999/012-916 2579/019-636 6595.
Saturday, July 31, 2004
Nurses may get higher allowances
KUALA LUMPUR - Faced with a critical shortage of nurses, Malaysia is considering increasing allowances in a bid to attract more people to the job.
About 4,000 of the country's 27,000 nurses retire annually while only 2,500 new graduates a year are coming through, Deputy Health Minister Abdul Latif Ahmad told a nursing-college audience. The imbalance could cause problems if comprehensive plans are not put in place.
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Besides the option of increasing allowances, the government has allocated RM140 million (S$63.5 million) to upgrade facilities such as hostels and lecture halls at nursing schools.
Yet another measure is allowing foreign students to take up nursing courses and to serve here upon graduation, he said at the Seremban Nursing College.
'We will also consider taking in foreign nurses. However, this will only be a last resort.'
The country could be turned into a teaching and training centre for foreign nurses but an in-depth study is needed, he added. -- New Straits Tim
KUALA LUMPUR - Faced with a critical shortage of nurses, Malaysia is considering increasing allowances in a bid to attract more people to the job.
About 4,000 of the country's 27,000 nurses retire annually while only 2,500 new graduates a year are coming through, Deputy Health Minister Abdul Latif Ahmad told a nursing-college audience. The imbalance could cause problems if comprehensive plans are not put in place.
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Besides the option of increasing allowances, the government has allocated RM140 million (S$63.5 million) to upgrade facilities such as hostels and lecture halls at nursing schools.
Yet another measure is allowing foreign students to take up nursing courses and to serve here upon graduation, he said at the Seremban Nursing College.
'We will also consider taking in foreign nurses. However, this will only be a last resort.'
The country could be turned into a teaching and training centre for foreign nurses but an in-depth study is needed, he added. -- New Straits Tim
Friday, July 30, 2004
Mercy Malaysia Needs RM1.5 Million For Relief Mission To Sudan
KUALA LUMPUR, July 30 (Bernama) -- What does a Malaysian get with RM5 today? A plate of nasi lemak and teh tarik perhaps? Or simply the fee for parking in some area of Kuala Lumpur?
In Sudan, with RM5 one can provide a malnourished child with therapeutic feeding for a day which includes milk and nutrients.
This was told to the media by Malaysian Medical Relief Society (Mercy Malaysia) president Datuk Dr Jemilah Mahmood Friday.
She said her organisation had been requested by the United Nations (UN) agencies to lend medical assistance to the country's Internal Displaced People (IDP).
"Basically we need about RM200 monthly to treat one malnourished child, and RM1.5 million to have and run a decent therapeutic feeding centre for six months," she said during a media briefing on Mercy Malaysia's six-month relief mission to the war-torn African country, beginning next month.
She said with that amount of money, Mercy Malaysia could treat at least 180,000 Sudanese at IDP camps in El-Geneina, west Darfur region.
At present the town was populated by 1.2 million of IDPs with 88 percent of them without shelter and 75 percent are children and women.
"According to the United Nations agencies, 10,000 people are expected to die by next month if they still cannot get access to basic medical supply," she said adding that most roads to the region were inaccessible at this time of the year due to the damage caused by rain.
Dr Jemilah said Mercy Malaysia would send a team of four people this Monday, to assess the situation in the city.
"We will make preparations on what is needed based on their report, and where we are actually going because the camps cover a large area, and we need to be where we are needed most," she said.
Six relief missions would be sent to the country from next month till February next year, involving about 60 Mercy Malaysia staff and volunteers, with the first team to be deployed in mid August, said Dr Jemilah.
"We appeal to Malaysian medical staff and practitioners to be our volunteers. This will be a good learning experience for them because we are going to deal with the condition of malnourishment, a condition we don't have here," she said.
These six teams, said Dr Jemilah, were to establish a basic therapeutic feeding centre as well as to provide primary health care.
"If we can, we will continue with the second phase which is to provide mental health care as well as strengthening the basic health care system," she said.
People interested in making donations or who wish to be volunteers can call 03-42569999, 012-9162579 or 019-6366595. Donations are tax exempted.
-- BERNAMA
KUALA LUMPUR, July 30 (Bernama) -- What does a Malaysian get with RM5 today? A plate of nasi lemak and teh tarik perhaps? Or simply the fee for parking in some area of Kuala Lumpur?
In Sudan, with RM5 one can provide a malnourished child with therapeutic feeding for a day which includes milk and nutrients.
This was told to the media by Malaysian Medical Relief Society (Mercy Malaysia) president Datuk Dr Jemilah Mahmood Friday.
She said her organisation had been requested by the United Nations (UN) agencies to lend medical assistance to the country's Internal Displaced People (IDP).
"Basically we need about RM200 monthly to treat one malnourished child, and RM1.5 million to have and run a decent therapeutic feeding centre for six months," she said during a media briefing on Mercy Malaysia's six-month relief mission to the war-torn African country, beginning next month.
She said with that amount of money, Mercy Malaysia could treat at least 180,000 Sudanese at IDP camps in El-Geneina, west Darfur region.
At present the town was populated by 1.2 million of IDPs with 88 percent of them without shelter and 75 percent are children and women.
"According to the United Nations agencies, 10,000 people are expected to die by next month if they still cannot get access to basic medical supply," she said adding that most roads to the region were inaccessible at this time of the year due to the damage caused by rain.
Dr Jemilah said Mercy Malaysia would send a team of four people this Monday, to assess the situation in the city.
"We will make preparations on what is needed based on their report, and where we are actually going because the camps cover a large area, and we need to be where we are needed most," she said.
Six relief missions would be sent to the country from next month till February next year, involving about 60 Mercy Malaysia staff and volunteers, with the first team to be deployed in mid August, said Dr Jemilah.
"We appeal to Malaysian medical staff and practitioners to be our volunteers. This will be a good learning experience for them because we are going to deal with the condition of malnourishment, a condition we don't have here," she said.
These six teams, said Dr Jemilah, were to establish a basic therapeutic feeding centre as well as to provide primary health care.
"If we can, we will continue with the second phase which is to provide mental health care as well as strengthening the basic health care system," she said.
People interested in making donations or who wish to be volunteers can call 03-42569999, 012-9162579 or 019-6366595. Donations are tax exempted.
-- BERNAMA
Health Director Talks On Strategies To Destroy Aedes Mosquitos
Vector surveillance, case surveillance, health education and promotion are the strategies to control and destroy aedes mosquito breeding.
Dr Zainol Ariffin bin Pawanchee, Director of Health in Kuala Lumpur, Malaysia, highlighted this at a session on diseases carried by mosquitoes at the health seminar yesterday.
The vector surveillance is to identify dengue sensitive areas, using mosquito larva trapping devices to decrease mosquito population in residential areas, create special anti-dengue epidemic control team in out-break areas and mobilise members of the community for aedes control.
Meanwhile, case surveillance is to determine occurrence of cases according to grid areas and to determine place of transmission such as residential, school, work place and others. Health promotion, on the other hand, is to determine the target groups and information for dissemination.
At the same session, Dr Siti Romlah binti Haji Mohammad Jais, Veterinarian Officer at the Agriculture Department, stressed on the danger of pets and livestock to human health.
She said the factors in preventing all such hazards are cleanliness for the animals and visits to the veterinarian at least once a month for health checkups.
At the session, it was also revealed that houses nowadays cannot guarantee 100 per cent safety to occupants.
Many types of accidents can happen at any time. For example, fire hazards caused by carelessness that can result in loss of properties and a place to stay, injuries and even death.
This was disclosed by Awang Osman Jailani, the Public Relations Officer of the fire services department, in his working paper entitled "Hazards in domestic setting".
He said every house should have a systematic plan to prevent fire and save lives during a fire.
Meanwhile, Dr. Pengiran Haji Khalifah, Acting Senior Medical Officer of the Health Work Practice Section, Ministry of Health, in his talk on "Workplace, health and safety", revealed that according to the 2003 Annual Report from the Occupational Health Division, 139 cases of accidents at work were reported during the period from June to December of last year.
He said the workplace should implement hazard controls. -- Courtesy of Borneo Bulletin
Vector surveillance, case surveillance, health education and promotion are the strategies to control and destroy aedes mosquito breeding.
Dr Zainol Ariffin bin Pawanchee, Director of Health in Kuala Lumpur, Malaysia, highlighted this at a session on diseases carried by mosquitoes at the health seminar yesterday.
The vector surveillance is to identify dengue sensitive areas, using mosquito larva trapping devices to decrease mosquito population in residential areas, create special anti-dengue epidemic control team in out-break areas and mobilise members of the community for aedes control.
Meanwhile, case surveillance is to determine occurrence of cases according to grid areas and to determine place of transmission such as residential, school, work place and others. Health promotion, on the other hand, is to determine the target groups and information for dissemination.
At the same session, Dr Siti Romlah binti Haji Mohammad Jais, Veterinarian Officer at the Agriculture Department, stressed on the danger of pets and livestock to human health.
She said the factors in preventing all such hazards are cleanliness for the animals and visits to the veterinarian at least once a month for health checkups.
At the session, it was also revealed that houses nowadays cannot guarantee 100 per cent safety to occupants.
Many types of accidents can happen at any time. For example, fire hazards caused by carelessness that can result in loss of properties and a place to stay, injuries and even death.
This was disclosed by Awang Osman Jailani, the Public Relations Officer of the fire services department, in his working paper entitled "Hazards in domestic setting".
He said every house should have a systematic plan to prevent fire and save lives during a fire.
Meanwhile, Dr. Pengiran Haji Khalifah, Acting Senior Medical Officer of the Health Work Practice Section, Ministry of Health, in his talk on "Workplace, health and safety", revealed that according to the 2003 Annual Report from the Occupational Health Division, 139 cases of accidents at work were reported during the period from June to December of last year.
He said the workplace should implement hazard controls. -- Courtesy of Borneo Bulletin
Sarawak Housewives Face Increasing Risk Of HIV Infection
KUCHING, July 29 (Bernama) -- Housewives are at an increasing risk of getting HIV infection as heterosexual transmission is now the main cause of AIDS cases reported in Sarawak.
Sarawak General Hospital (SGH) Sexually Transmitted Diseases and AIDS Unit head, Dr Oui Siew Kim said Thursday it was the main mode of HIV infection unlike elsewhere in the country where drug abusers and sex workers were at a higher risk.
"When AIDS cases were first detected in Sarawak in 1989, it was initially reported among foreigners, mostly Thai fishermen but now more and more Sarawakians are contracting HIV infection," she told reporters after the opening of an HIV/AIDS Awareness Campaign For Women by Sarawak Women's Bureau director Norjanah Razali here.
Dr Oui, who is also the State Health Services Assistant Director, said a total of 424 HIV cases had been reported in Sarawak, including 174 AIDS cases and 89 AIDS-related deaths since then.
Up to June this year, she said 34 new HIV cases, 19 AIDS cases and nine deaths were reported in the state compared to 75 HIV cases, 49 AIDS cases and 13 deaths last year and 55 HIV cases, 26 AIDS cases and 14 deaths in 2003.
She advised those with multiple partners or were in doubt of their health status to undergo counselling and medical screening at any of the government health clinics, which were free of charge.
Earlier SGH Obstetrician and gynaecologist Dr Wendy Loh said women constituted 5.5 percent of the estimated 58,000 HIV positive people in the country.
Dr Loh, who is Sarawak Family Planning Association (SFPA) Honorary Treasurer, said the number of women, who were newly infected went up by over 10-fold to 673 cases from 66 new cases in 1993.
On the campaign being funded by the Ministry of Women, Family and Community Development, she said it was to create awareness and understanding among women on HIV/AIDS.
She said it was also aimed at promoting healthy lifestyle that could reduce HIV transmissions and enable women to make responsible choices with regards to the promotion of their general wellbeing.
-- BERNAMA
KUCHING, July 29 (Bernama) -- Housewives are at an increasing risk of getting HIV infection as heterosexual transmission is now the main cause of AIDS cases reported in Sarawak.
Sarawak General Hospital (SGH) Sexually Transmitted Diseases and AIDS Unit head, Dr Oui Siew Kim said Thursday it was the main mode of HIV infection unlike elsewhere in the country where drug abusers and sex workers were at a higher risk.
"When AIDS cases were first detected in Sarawak in 1989, it was initially reported among foreigners, mostly Thai fishermen but now more and more Sarawakians are contracting HIV infection," she told reporters after the opening of an HIV/AIDS Awareness Campaign For Women by Sarawak Women's Bureau director Norjanah Razali here.
Dr Oui, who is also the State Health Services Assistant Director, said a total of 424 HIV cases had been reported in Sarawak, including 174 AIDS cases and 89 AIDS-related deaths since then.
Up to June this year, she said 34 new HIV cases, 19 AIDS cases and nine deaths were reported in the state compared to 75 HIV cases, 49 AIDS cases and 13 deaths last year and 55 HIV cases, 26 AIDS cases and 14 deaths in 2003.
She advised those with multiple partners or were in doubt of their health status to undergo counselling and medical screening at any of the government health clinics, which were free of charge.
Earlier SGH Obstetrician and gynaecologist Dr Wendy Loh said women constituted 5.5 percent of the estimated 58,000 HIV positive people in the country.
Dr Loh, who is Sarawak Family Planning Association (SFPA) Honorary Treasurer, said the number of women, who were newly infected went up by over 10-fold to 673 cases from 66 new cases in 1993.
On the campaign being funded by the Ministry of Women, Family and Community Development, she said it was to create awareness and understanding among women on HIV/AIDS.
She said it was also aimed at promoting healthy lifestyle that could reduce HIV transmissions and enable women to make responsible choices with regards to the promotion of their general wellbeing.
-- BERNAMA
Tuesday, July 27, 2004
Debate on private wings
Having private wings in public hospitals to stop brain drain may leave the poor with inadequate healthcare, reports LOH FOON FONG.
PUBLIC hospitals all over the world have to deal with the problem of brain drain. In Malaysia, it has become more acute in recent years and to discourage doctors from leaving the civil service, private wings in Government hospitals have been opened to improve the incomes of doctors.
However, public interest groups say setting up private wings will overstretch the already limited resources in government hospitals and possibly jeopardise the health of poorer patients.
S.M. Mohamed Idris, president of the Consumers Association of Penang (CAP) says concerns regarding the set-up have been raised to the Health Ministry but they have not been addressed. For instance, there are at least 3,000 vacancies for government doctor positions. As a result of this shortage, medical officers are overworked.
There is concern that patients' healthcare may be compromised for monetary benefits with the advent of private practice in government hospitals.
“If there is an overall manpower shortage, how is the hospital going to deploy staff to the private wing and still cope with the ever increasing number of patients?” he asks.
“There is also a shortage of first-class wards in the general hospitals, so how do we accommodate the influx of private patients into the general hospitals? There is concern that the beds may be converted for the use of private wings,” he says.
In University Malaya Medical Centre (UMMC) which has public and private wings and the corporatised Institut Jantung Negara (IJN), the cost of medicines, procedures and laboratory charges has gone up. The waiting time for heart patients who are unable to afford surgery in private hospitals can be two years or more, he says.
CAP has called on the Health Ministry to scrap the system. “Introducing private practice in government hospitals has the potential to drastically change the face of the present healthcare system. The healthcare of patients should not be compromised for monetary benefits,” says Mohamed Idris.
Citizens’ Health Initiative coordinator Dr Chan Chee Khoon fears that the needs of the poor will be neglected even more under the system.
He cites the case of a janitor at Universiti Sains Malaysia who underwent colorectal cancer surgery at Penang Hospital in 2002. She earned RM500 monthly and received no hospitalisation benefits from her private sector employer. When she was discharged from her third-class ward, she was billed RM1,662 for a stapler device for re-joining 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% of the operational costs of the Health Ministry’s hospitals,” he says.
As part of the Malaysian government’s corporatisation policy, government hospitals were directed to increase the rate of their cost recovery, he says. That is because patients at government hospitals contributed about 5%-10% of the hospitals’ actual operational costs. The government’s medical services were being subsidised up to 95%.
“It is clear that our under-financed public healthcare will become even less effective for the poor when more private wings are set up in government hospitals as human and material resources are re-allocated in line with the market needs rather than the desire to serve the needs of the poor,” he says.
It is predictable that private wings will soon be encouraged to service the regional health tourism market as well, he says.
“The Citizens’ Health Initiative has repeatedly voiced its concern over such developments. We are not against foreigners benefiting from our healthcare capabilities. Indeed we can take pride in this, but we are concerned when more and more of our local health resources are diverted to serving regional and national healthcare priorities as dictated by market demand, rather than on need basis,” he says.
“The proposal to introduce private wings in government hospitals is an unworthy idea which is rife with conflict of interests. It should be definitively scrapped,” he says.
A doctor who does not want to be named says setting up private wings does not guarantee that specialists will not leave the public sector.
“There are specialists who earn a lot of money from the private wing of UMMC but some of them still leave for private practice. One reason is that they have to work long hours. The specialists can only serve in the private wing after 5pm. So they serve in the public hospital during the day and continue to work at night to earn the extra income and find that they have no life,” says the doctor.
Moreover, he says, research work that is commonly carried out in teaching hospitals may be neglected when doctors do not have time or earning incentive to carry out the task, he says.
“In Singapore, this system seems to work better. The Singapore government is more successful at keeping doctors possibly because there are more direct rewards for them. The doctors are paid well.
“The best way to retain doctors in the public sector is to give them a better salary,” he says.
Although the Malaysian government subsidises more than 90% of public healthcare costs, Chan notes that it only spent 2.04% of the Gross Domestic Product (GDP) on public healthcare in 2001. The World Health Organisation recommends that national health expenditures be 4%-8% of GDP.
He urges the Health Ministry to implement the Prime Minister’s call for transparent, accountable healthcare governance, where there is open, competitive tendering to ensure cost-efficient use of public finances for healthcare, and that resources are directed to those areas which can deliver better gains in primary health care.
He adds that the fees schedule in the private sector should also be regulated to reduce the disparity in earnings between the public and private-sector doctors.
Mohamed Idris says charges for specialist and in-patient treatment at government hospitals can be raised slightly to bring in more revenue. “Those who cannot afford to pay full rates should be given discounts or in the worst case, free treatment. Patients in the second and first-class wards should pay a greater percentage of the costs of treatment.”
Raising the current charge of RM1 for outpatients at government facilities to RM5 can bring in another RM100mil which can go towards financing healthcare, he says.
At the same time, the Social Security Organisation’s (Socso) services can be extended to include medical care in general, rather than just restricting it to industrial accidents and occupational diseases. The annual profits of Socso can be transferred to the Health Ministry through hospital payments, thus easing the financial strain of the ministry, he says.
If the contributions are still insufficient, employers and employees can each contribute RM1 a month and that will yield at least an extra RM200mil a year in Socso contributions which can be used to finance medical treatment, he says.
The United Kingdom experience has shown that the private wing system is detrimental to the rights of poorer patients. In 2002, The Observer discovered that of the more than 10,000 private patients treated in Britain’s National Health Services’ hospitals, around half came from overseas and were treated in preference to local patients, who were left on waiting lists. The private patients were treated by the same NHS doctors and nurses and often slept on the same beds and used the same equipment.
Having private wings in public hospitals to stop brain drain may leave the poor with inadequate healthcare, reports LOH FOON FONG.
PUBLIC hospitals all over the world have to deal with the problem of brain drain. In Malaysia, it has become more acute in recent years and to discourage doctors from leaving the civil service, private wings in Government hospitals have been opened to improve the incomes of doctors.
However, public interest groups say setting up private wings will overstretch the already limited resources in government hospitals and possibly jeopardise the health of poorer patients.
S.M. Mohamed Idris, president of the Consumers Association of Penang (CAP) says concerns regarding the set-up have been raised to the Health Ministry but they have not been addressed. For instance, there are at least 3,000 vacancies for government doctor positions. As a result of this shortage, medical officers are overworked.
There is concern that patients' healthcare may be compromised for monetary benefits with the advent of private practice in government hospitals.
“If there is an overall manpower shortage, how is the hospital going to deploy staff to the private wing and still cope with the ever increasing number of patients?” he asks.
“There is also a shortage of first-class wards in the general hospitals, so how do we accommodate the influx of private patients into the general hospitals? There is concern that the beds may be converted for the use of private wings,” he says.
In University Malaya Medical Centre (UMMC) which has public and private wings and the corporatised Institut Jantung Negara (IJN), the cost of medicines, procedures and laboratory charges has gone up. The waiting time for heart patients who are unable to afford surgery in private hospitals can be two years or more, he says.
CAP has called on the Health Ministry to scrap the system. “Introducing private practice in government hospitals has the potential to drastically change the face of the present healthcare system. The healthcare of patients should not be compromised for monetary benefits,” says Mohamed Idris.
Citizens’ Health Initiative coordinator Dr Chan Chee Khoon fears that the needs of the poor will be neglected even more under the system.
He cites the case of a janitor at Universiti Sains Malaysia who underwent colorectal cancer surgery at Penang Hospital in 2002. She earned RM500 monthly and received no hospitalisation benefits from her private sector employer. When she was discharged from her third-class ward, she was billed RM1,662 for a stapler device for re-joining 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% of the operational costs of the Health Ministry’s hospitals,” he says.
As part of the Malaysian government’s corporatisation policy, government hospitals were directed to increase the rate of their cost recovery, he says. That is because patients at government hospitals contributed about 5%-10% of the hospitals’ actual operational costs. The government’s medical services were being subsidised up to 95%.
“It is clear that our under-financed public healthcare will become even less effective for the poor when more private wings are set up in government hospitals as human and material resources are re-allocated in line with the market needs rather than the desire to serve the needs of the poor,” he says.
It is predictable that private wings will soon be encouraged to service the regional health tourism market as well, he says.
“The Citizens’ Health Initiative has repeatedly voiced its concern over such developments. We are not against foreigners benefiting from our healthcare capabilities. Indeed we can take pride in this, but we are concerned when more and more of our local health resources are diverted to serving regional and national healthcare priorities as dictated by market demand, rather than on need basis,” he says.
“The proposal to introduce private wings in government hospitals is an unworthy idea which is rife with conflict of interests. It should be definitively scrapped,” he says.
A doctor who does not want to be named says setting up private wings does not guarantee that specialists will not leave the public sector.
“There are specialists who earn a lot of money from the private wing of UMMC but some of them still leave for private practice. One reason is that they have to work long hours. The specialists can only serve in the private wing after 5pm. So they serve in the public hospital during the day and continue to work at night to earn the extra income and find that they have no life,” says the doctor.
Moreover, he says, research work that is commonly carried out in teaching hospitals may be neglected when doctors do not have time or earning incentive to carry out the task, he says.
“In Singapore, this system seems to work better. The Singapore government is more successful at keeping doctors possibly because there are more direct rewards for them. The doctors are paid well.
“The best way to retain doctors in the public sector is to give them a better salary,” he says.
Although the Malaysian government subsidises more than 90% of public healthcare costs, Chan notes that it only spent 2.04% of the Gross Domestic Product (GDP) on public healthcare in 2001. The World Health Organisation recommends that national health expenditures be 4%-8% of GDP.
He urges the Health Ministry to implement the Prime Minister’s call for transparent, accountable healthcare governance, where there is open, competitive tendering to ensure cost-efficient use of public finances for healthcare, and that resources are directed to those areas which can deliver better gains in primary health care.
He adds that the fees schedule in the private sector should also be regulated to reduce the disparity in earnings between the public and private-sector doctors.
Mohamed Idris says charges for specialist and in-patient treatment at government hospitals can be raised slightly to bring in more revenue. “Those who cannot afford to pay full rates should be given discounts or in the worst case, free treatment. Patients in the second and first-class wards should pay a greater percentage of the costs of treatment.”
Raising the current charge of RM1 for outpatients at government facilities to RM5 can bring in another RM100mil which can go towards financing healthcare, he says.
At the same time, the Social Security Organisation’s (Socso) services can be extended to include medical care in general, rather than just restricting it to industrial accidents and occupational diseases. The annual profits of Socso can be transferred to the Health Ministry through hospital payments, thus easing the financial strain of the ministry, he says.
If the contributions are still insufficient, employers and employees can each contribute RM1 a month and that will yield at least an extra RM200mil a year in Socso contributions which can be used to finance medical treatment, he says.
The United Kingdom experience has shown that the private wing system is detrimental to the rights of poorer patients. In 2002, The Observer discovered that of the more than 10,000 private patients treated in Britain’s National Health Services’ hospitals, around half came from overseas and were treated in preference to local patients, who were left on waiting lists. The private patients were treated by the same NHS doctors and nurses and often slept on the same beds and used the same equipment.
Docs: CCTVs no help during robberies
The safety of patients and staff is more important than security mechanisms, said doctors who are not in favour of opening their clinics round the clock.
Dr Koh Geok Leong said that CCTVs could not help in stopping robberies. "What's the use of fixing CCTV when robbers can ask you to climb up to remove the recorder and your life is probably at stake?" he asked.
Dr Koh, whose 24-hour-clinic in USJ, Subang Jaya, was robbed on two occasions two to three years ago, stopped operating after midnight since January this year.
"The nurses are scared to work at such hours and the risk of falling prey to criminals is much higher after midnight," he said.
"We tried installing a peephole through which staff could 'check out' patients before letting them in but it did not work."
Echoing his views was a doctor in Bangsar who shortened his operating hours after an attempted robbery.
"Our clinic used to run 24 hours but two months ago we cut down on the operating hours because the security guard quit and our staff felt it was not safe. CCTV will not help because even banks get robbed," said the doctor, who did not want to be named.
The clinic, which opened some 18 years ago, is currently operating from 7am to llpm to minimise the risk of getting robbed.
"We learnt from the experience of other clinics and try to prevent it from happening here," he said.
However, a clinic manager at Jalan Pudu said that her clinic continues to operate 24 hours daily, as they did not want to disappoint those who came for treatment. "We have not faced any problems so far," she said.
Criminals, who are only slightly deterred by safety measures taken by clinics, also target those operating normal hours, said Malaysian Medical Association (MMA) president Datuk Dr N. Arumugam.
"It is widespread at clinics located in Damansara, Petaling Jaya or Klang. Sometimes, the incidents happen at clinics which close at 10pm or midnight."
Bernama had reported Dr Arumugam as saying on Saturday that 30% of 2,000 licensed 24-hour clinics in the Klang Valley were closing at midnight for fear of being robbed.
When asked to comment on a media report last week that the Internal Security Ministry was prepared to study the possibility of setting a special force to curb robberies at 24-hour clinics, Dr Arumugam said that while MMA welcomed the move, details would have to be worked out. He also said that installing CCTVs or employing private security firms was too expensive.
"If someone takes out a knife and points it at a doctor or nurse, how would they react? We welcome the idea but we need to know what help they can give to combat criminals," he said.
He added that more 24-hour clinics were closing by midnight because it was getting increasingly difficult to get staff who were willing to work late hours.
"Females make up about 90% of clinic staff and it is getting more difficult to get staff to work," he said.
The safety of patients and staff is more important than security mechanisms, said doctors who are not in favour of opening their clinics round the clock.
Dr Koh Geok Leong said that CCTVs could not help in stopping robberies. "What's the use of fixing CCTV when robbers can ask you to climb up to remove the recorder and your life is probably at stake?" he asked.
Dr Koh, whose 24-hour-clinic in USJ, Subang Jaya, was robbed on two occasions two to three years ago, stopped operating after midnight since January this year.
"The nurses are scared to work at such hours and the risk of falling prey to criminals is much higher after midnight," he said.
"We tried installing a peephole through which staff could 'check out' patients before letting them in but it did not work."
Echoing his views was a doctor in Bangsar who shortened his operating hours after an attempted robbery.
"Our clinic used to run 24 hours but two months ago we cut down on the operating hours because the security guard quit and our staff felt it was not safe. CCTV will not help because even banks get robbed," said the doctor, who did not want to be named.
The clinic, which opened some 18 years ago, is currently operating from 7am to llpm to minimise the risk of getting robbed.
"We learnt from the experience of other clinics and try to prevent it from happening here," he said.
However, a clinic manager at Jalan Pudu said that her clinic continues to operate 24 hours daily, as they did not want to disappoint those who came for treatment. "We have not faced any problems so far," she said.
Criminals, who are only slightly deterred by safety measures taken by clinics, also target those operating normal hours, said Malaysian Medical Association (MMA) president Datuk Dr N. Arumugam.
"It is widespread at clinics located in Damansara, Petaling Jaya or Klang. Sometimes, the incidents happen at clinics which close at 10pm or midnight."
Bernama had reported Dr Arumugam as saying on Saturday that 30% of 2,000 licensed 24-hour clinics in the Klang Valley were closing at midnight for fear of being robbed.
When asked to comment on a media report last week that the Internal Security Ministry was prepared to study the possibility of setting a special force to curb robberies at 24-hour clinics, Dr Arumugam said that while MMA welcomed the move, details would have to be worked out. He also said that installing CCTVs or employing private security firms was too expensive.
"If someone takes out a knife and points it at a doctor or nurse, how would they react? We welcome the idea but we need to know what help they can give to combat criminals," he said.
He added that more 24-hour clinics were closing by midnight because it was getting increasingly difficult to get staff who were willing to work late hours.
"Females make up about 90% of clinic staff and it is getting more difficult to get staff to work," he said.
New policies on treatment of mental patients soon
Kuala Lumpur: Policies on the treatment of mental patients and those who suffer from mental health problems are being revamped.
Health Minister Datuk Dr Chua Soi Lek said there were certain components that were neglected in the existing policies such as education, curative, rehabilitation and after-care.
“There has been a neglect of mental health and as we progress I can foresee more and more people with mental health problems,” he said.
A committee headed by Director-General of Health Tan Sri Dr Mohammad Taha Arif will prepare a working paper on mental health problem.
The Ministry’s finding showed that mental illness cases have doubled in six years - from 11,120 outpatients last year compared with 5,687 in 1998.
Also, it was found that 10 to 15 per cent of these patients are suicidal or could harm other people and that 20 per cent of the population have mental health problems, but many are reluctant to seek treatment.
It was also revealed that one in four families has at least one member suffering from a mental or behavioural disorder.
Working Malaysians, increasingly prone to job-related stress, risk developing personal problems, anxiety, psychosis, schizophrenia and multiple personality disorders. In fact, 10 per cent of mental health problems are related to work and social life.
Dr Chua said people who did not know how to channel their emotions, pent-up frustrations, anxiety and depression often end up turning to drugs and psychotropic pills.
He added that gambling was also a part of manifestation of anxiety.
“People who suffer mental health also turn to Ecstasy pills, drug addiction, rape, incest and even commit crimes,” he added.
Dr Chua said depression leading to suicide topped the list worldwide with more people being killed than all the wars combined in any one year.
“It is estimated that 65 per cent of non-communicable disease in the world can be prevented, including mental health.”
To meet the increasing number of mental health cases, the Ministry would build two new mental hospitals, one costing RM300 million to replace the Permai Hospital in Tampoi, Johor, and another costing RM400 million to be constructed in Aman Jaya, Kedah.
Besides Tampoi, the other mental hospitals are the Bahagia Hospital in Tanjung Rambutan, Perak, and one each in Sabah and Sarawak. There are 108 family medicine specialists (FMS) under the Ministry trained to diagnose, treat and manage patients with mental disorder.
Until April, 52 FMS were trained in the diagnosis and treatment of depression.
Dr Chua said the Ministry would be working closely with the media, Education Ministry, NGOs, publications and politicians to make health promotion one of their activities.
“When we conducted a survey, it came as a surprise to us that 76 per cent of Malaysians were concerned about their health but did not know how to maintain their health.
“They did not know much about healthy eating and living, stress management and, most of all, where to get health-related information,” he added.
He said the survey also revealed that many did not read and that was why the Ministry has decided to give emphasis to promotion of health and on preventive aspects of health under the Ninth Malaysia Plan.
Kuala Lumpur: Policies on the treatment of mental patients and those who suffer from mental health problems are being revamped.
Health Minister Datuk Dr Chua Soi Lek said there were certain components that were neglected in the existing policies such as education, curative, rehabilitation and after-care.
“There has been a neglect of mental health and as we progress I can foresee more and more people with mental health problems,” he said.
A committee headed by Director-General of Health Tan Sri Dr Mohammad Taha Arif will prepare a working paper on mental health problem.
The Ministry’s finding showed that mental illness cases have doubled in six years - from 11,120 outpatients last year compared with 5,687 in 1998.
Also, it was found that 10 to 15 per cent of these patients are suicidal or could harm other people and that 20 per cent of the population have mental health problems, but many are reluctant to seek treatment.
It was also revealed that one in four families has at least one member suffering from a mental or behavioural disorder.
Working Malaysians, increasingly prone to job-related stress, risk developing personal problems, anxiety, psychosis, schizophrenia and multiple personality disorders. In fact, 10 per cent of mental health problems are related to work and social life.
Dr Chua said people who did not know how to channel their emotions, pent-up frustrations, anxiety and depression often end up turning to drugs and psychotropic pills.
He added that gambling was also a part of manifestation of anxiety.
“People who suffer mental health also turn to Ecstasy pills, drug addiction, rape, incest and even commit crimes,” he added.
Dr Chua said depression leading to suicide topped the list worldwide with more people being killed than all the wars combined in any one year.
“It is estimated that 65 per cent of non-communicable disease in the world can be prevented, including mental health.”
To meet the increasing number of mental health cases, the Ministry would build two new mental hospitals, one costing RM300 million to replace the Permai Hospital in Tampoi, Johor, and another costing RM400 million to be constructed in Aman Jaya, Kedah.
Besides Tampoi, the other mental hospitals are the Bahagia Hospital in Tanjung Rambutan, Perak, and one each in Sabah and Sarawak. There are 108 family medicine specialists (FMS) under the Ministry trained to diagnose, treat and manage patients with mental disorder.
Until April, 52 FMS were trained in the diagnosis and treatment of depression.
Dr Chua said the Ministry would be working closely with the media, Education Ministry, NGOs, publications and politicians to make health promotion one of their activities.
“When we conducted a survey, it came as a surprise to us that 76 per cent of Malaysians were concerned about their health but did not know how to maintain their health.
“They did not know much about healthy eating and living, stress management and, most of all, where to get health-related information,” he added.
He said the survey also revealed that many did not read and that was why the Ministry has decided to give emphasis to promotion of health and on preventive aspects of health under the Ninth Malaysia Plan.
UKM researchers: High levels of bacteria in Tasik Chini
PEKAN: Tasik Chini, the country’s second-largest freshwater lake, is contaminated with high levels of e-coli, the bacteria that may have caused rashes and diarrhoea among the orang asli living near it.
This has prompted the state government to warn the 400 villagers, including 100 children aged six and under, not to drink water from the lake and wells.
Universiti Kebangsaan Malaysia (UKM) researchers in their recent expedition to the lake found high levels of e-coli, salmonella and other bacteria, collectively known as coliform, in the 202ha lake and ground water.
There are five settlements – Kampung Gumum, Tanjung Puput, Chendahan, Melai and Ulu Gumum – on the shores of the lake, which is famous for legends of lost kingdoms and dragons.
PEKAN: Tasik Chini, the country’s second-largest freshwater lake, is contaminated with high levels of e-coli, the bacteria that may have caused rashes and diarrhoea among the orang asli living near it.
This has prompted the state government to warn the 400 villagers, including 100 children aged six and under, not to drink water from the lake and wells.
Universiti Kebangsaan Malaysia (UKM) researchers in their recent expedition to the lake found high levels of e-coli, salmonella and other bacteria, collectively known as coliform, in the 202ha lake and ground water.
There are five settlements – Kampung Gumum, Tanjung Puput, Chendahan, Melai and Ulu Gumum – on the shores of the lake, which is famous for legends of lost kingdoms and dragons.
51 health projects completed
Kota Kinabalu: Fifty-one projects or 31 per cent of the 164 health-related projects identified for Sabah under the Eighth Malaysia Plan (8MP) have been completed, Health Minister Datuk Dr Chua Soi Lek said.
The projects included two hospitals in Keningau and Lahad Datu besides rural clinics and other facilities, he said.
He said 26 other facilities scheduled for implementation were under construction, including hospitals in Pitas, Kuala Penyu and Kunak while 87 other projects were still at the planning stage.
“Overall, Sabah received RM1.2 billion from a total of RM9.5 billion under the 8MP allocations to the Ministry, which is the biggest compared to other states,” said Dr Chua.
On Queen Elizabeth Hospital’s re-development projects, Dr Chua said it had begun since 1992 over a period of 18 years.
As of now, RM51 million had been spent for various facilities including a post-graduate centre, a car park complex, renovations to the surgical hall, the intensive care unit, as well as upgrading infrastructure such as the sewerage system.
A RM74 million specialist clinic on a four-storey block would also be part of the re-development project.
“Piling works for the block had been completed but construction has not started yet. There has been a delay...it is not true that the project has been halted due to lack of funds. The construction will start either end of the year or early next year,” he said.
Kota Kinabalu: Fifty-one projects or 31 per cent of the 164 health-related projects identified for Sabah under the Eighth Malaysia Plan (8MP) have been completed, Health Minister Datuk Dr Chua Soi Lek said.
The projects included two hospitals in Keningau and Lahad Datu besides rural clinics and other facilities, he said.
He said 26 other facilities scheduled for implementation were under construction, including hospitals in Pitas, Kuala Penyu and Kunak while 87 other projects were still at the planning stage.
“Overall, Sabah received RM1.2 billion from a total of RM9.5 billion under the 8MP allocations to the Ministry, which is the biggest compared to other states,” said Dr Chua.
On Queen Elizabeth Hospital’s re-development projects, Dr Chua said it had begun since 1992 over a period of 18 years.
As of now, RM51 million had been spent for various facilities including a post-graduate centre, a car park complex, renovations to the surgical hall, the intensive care unit, as well as upgrading infrastructure such as the sewerage system.
A RM74 million specialist clinic on a four-storey block would also be part of the re-development project.
“Piling works for the block had been completed but construction has not started yet. There has been a delay...it is not true that the project has been halted due to lack of funds. The construction will start either end of the year or early next year,” he said.
Specialist complex project ‘not abandoned’
THE Health Ministry on Saturday denied that the proposed specialist complex at the Queen Elizabeth Hospital had been abandoned because the Federal Government has run out of funds.
Health Minister Datuk Dr Chua Soi Lek said the development that will cost RM74 million was a little delayed as some changes had been made to the scope of work. The changes are to ensure optimal utilisation, especially in terms of flow of patients, he said.
“We want to make it more efficientÖthere are also changes in the IT component,” he said.
In this respect, he hoped the project, the foundation phase of which has already been completed, would take off by the end of this year or the latest by early next year.
According to Dr Chua, the Health Ministry was also trying to get allocation for the development of the 9-storey two tower blocks and a 5-storey podium.
When completed, the complex, located just adjacent to the QEH’s Post-Graduate Medical Centre (PGMC), would house all the government specialists under one roof.
Meanwhile, Dr Chua said Sabah was the largest recipient of healthcare allocations under the Eighth Malaysia Plan (8MP), getting about RM1.2 billion from the RM9.5 billion allocated to the Ministry.
He said the funds were for 164 projects in Sabah of which 31 per cent had been completed, while 26 projects were ongoing and another 87 planned, including the building of health clinics.
As for the QEH, he said from 1999 up to now, about RM51 million had been spent, namely for the PGMC, renovation of operation wards, ICU and ICCU (among others).
Asked on the development of Sabah Medical Centre (SMC), which was taken over by the Federal Government to be turned into a Women and Children Hospital, he said: “It would be operating once the renovation is completedÖhopefully by another year’s time.”
THE Health Ministry on Saturday denied that the proposed specialist complex at the Queen Elizabeth Hospital had been abandoned because the Federal Government has run out of funds.
Health Minister Datuk Dr Chua Soi Lek said the development that will cost RM74 million was a little delayed as some changes had been made to the scope of work. The changes are to ensure optimal utilisation, especially in terms of flow of patients, he said.
“We want to make it more efficientÖthere are also changes in the IT component,” he said.
In this respect, he hoped the project, the foundation phase of which has already been completed, would take off by the end of this year or the latest by early next year.
According to Dr Chua, the Health Ministry was also trying to get allocation for the development of the 9-storey two tower blocks and a 5-storey podium.
When completed, the complex, located just adjacent to the QEH’s Post-Graduate Medical Centre (PGMC), would house all the government specialists under one roof.
Meanwhile, Dr Chua said Sabah was the largest recipient of healthcare allocations under the Eighth Malaysia Plan (8MP), getting about RM1.2 billion from the RM9.5 billion allocated to the Ministry.
He said the funds were for 164 projects in Sabah of which 31 per cent had been completed, while 26 projects were ongoing and another 87 planned, including the building of health clinics.
As for the QEH, he said from 1999 up to now, about RM51 million had been spent, namely for the PGMC, renovation of operation wards, ICU and ICCU (among others).
Asked on the development of Sabah Medical Centre (SMC), which was taken over by the Federal Government to be turned into a Women and Children Hospital, he said: “It would be operating once the renovation is completedÖhopefully by another year’s time.”
Monday, July 26, 2004
Govt may ban cigarettes in small packs
KOTA KINABALU - The government is considering banning the sale of cigarettes in small packs to discourage smoking, especially among youths, said Health Minister Chua Soi Lek.
Dr Chua said the move was appropriate as it would make it harder for youths to buy cigarettes.
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'We are also considering banning the sale of loose cigarettes in public places,' he said after opening the 32nd Malaysia Youth Movement annual meeting at the Sabah Trade Centre in Likas near here yesterday.
Dr Chua also slammed cigarette agents who used youngsters, especially primary schoolgirls, to sell cigarettes.
This practice is currently prevalent in certain states in Malaysia.
However, he said that in a recent dialogue with cigarette companies, the corporations had promised to look into the matter and stop their agents from continuing the practice.
The minister said the amendment to the Tobacco Act would also include more public areas as no-smoking zones.
'As soon as it is passed, we will ensure each pack of cigarette includes a note on the dangers of smoking. When smokers open the pack, they can read all about the harmful things related to the habit,' he said. -- Bernama
KOTA KINABALU - The government is considering banning the sale of cigarettes in small packs to discourage smoking, especially among youths, said Health Minister Chua Soi Lek.
Dr Chua said the move was appropriate as it would make it harder for youths to buy cigarettes.
Advertisement
'We are also considering banning the sale of loose cigarettes in public places,' he said after opening the 32nd Malaysia Youth Movement annual meeting at the Sabah Trade Centre in Likas near here yesterday.
Dr Chua also slammed cigarette agents who used youngsters, especially primary schoolgirls, to sell cigarettes.
This practice is currently prevalent in certain states in Malaysia.
However, he said that in a recent dialogue with cigarette companies, the corporations had promised to look into the matter and stop their agents from continuing the practice.
The minister said the amendment to the Tobacco Act would also include more public areas as no-smoking zones.
'As soon as it is passed, we will ensure each pack of cigarette includes a note on the dangers of smoking. When smokers open the pack, they can read all about the harmful things related to the habit,' he said. -- Bernama
Sunday, July 25, 2004
10,000 teenage pregnancies a year
ABOUT 10,000 adolescent girls in Malaysia get pregnant and give birth every year.
This is a cause for concern and there is a need to empower girls with both education and access to methods that help prevent unwanted pregnancies, said Dr Ravindran Jegasothy (right) of the Malaysian Medical Council’s ethics committee.
These girls are also at risk of maternal mortality which is two to four times higher in adolescent mothers than in those in their 20s, he said. Infant mortality is also estimated to be about 30 per cent where adolescent mothers are concerned.
Dr Ravindran, an obstetrician and gynaecologist, was presenting a paper at a four-day regional roundtable conference on population, sexual and reproductive health and poverty, held at Istana Hotel, Kuala Lumpur, from last Tuesday.
“What we need to do is to get away from the moralistic attitude that sex doesn’t happen in this group,” he said.
Dr Ravindran said religious education was important to send the message that sex was not something to be freely indulged in but at the same time, its existence among youngsters should not be ignored.
A 2000 study on adolescent pregnancies in a semi-rural clinic in Malaysia also showed that 65 per cent of adolescent mothers were unmarried, not well educated and had a low usage of contraceptives.
A pilot anonymous HIV-screening programme in Johor also indicated that adolescents, or those aged between 13 and 19 years, were involved in activities that put them at risk of contracting the virus.
“Despite religious education and despite our social values, there are girls and boys in the country who are having sex and we know from the experience of other countries, that this figure is going to increase,” Dr Ravindran said.
The good news is that the school health programme today is providing basic information on reproductive health, he said.
“Girls are being told how they can become pregnant, nobody is hiding the fact anymore and that is good.”
Boys, too, are being told how to avoid getting their partners pregnant and how they can avoid contracting sexually transmitted diseases.
It must also be emphasised that hospitals in Malaysia do not discriminate against unmarried mothers as some people might assume, said Dr Ravindran.
While not denying that unmarried mothers faced social stigma when they sought treatment, Dr Ravindran said the girls were generally treated with empathy.
“They are usually referred to social workers and NGOs, who will continue to provide the emotional and sometimes financial support that these young girls need,” he added.
ABOUT 10,000 adolescent girls in Malaysia get pregnant and give birth every year.
This is a cause for concern and there is a need to empower girls with both education and access to methods that help prevent unwanted pregnancies, said Dr Ravindran Jegasothy (right) of the Malaysian Medical Council’s ethics committee.
These girls are also at risk of maternal mortality which is two to four times higher in adolescent mothers than in those in their 20s, he said. Infant mortality is also estimated to be about 30 per cent where adolescent mothers are concerned.
Dr Ravindran, an obstetrician and gynaecologist, was presenting a paper at a four-day regional roundtable conference on population, sexual and reproductive health and poverty, held at Istana Hotel, Kuala Lumpur, from last Tuesday.
“What we need to do is to get away from the moralistic attitude that sex doesn’t happen in this group,” he said.
Dr Ravindran said religious education was important to send the message that sex was not something to be freely indulged in but at the same time, its existence among youngsters should not be ignored.
A 2000 study on adolescent pregnancies in a semi-rural clinic in Malaysia also showed that 65 per cent of adolescent mothers were unmarried, not well educated and had a low usage of contraceptives.
A pilot anonymous HIV-screening programme in Johor also indicated that adolescents, or those aged between 13 and 19 years, were involved in activities that put them at risk of contracting the virus.
“Despite religious education and despite our social values, there are girls and boys in the country who are having sex and we know from the experience of other countries, that this figure is going to increase,” Dr Ravindran said.
The good news is that the school health programme today is providing basic information on reproductive health, he said.
“Girls are being told how they can become pregnant, nobody is hiding the fact anymore and that is good.”
Boys, too, are being told how to avoid getting their partners pregnant and how they can avoid contracting sexually transmitted diseases.
It must also be emphasised that hospitals in Malaysia do not discriminate against unmarried mothers as some people might assume, said Dr Ravindran.
While not denying that unmarried mothers faced social stigma when they sought treatment, Dr Ravindran said the girls were generally treated with empathy.
“They are usually referred to social workers and NGOs, who will continue to provide the emotional and sometimes financial support that these young girls need,” he added.
Saturday, July 24, 2004
Anti-smoking drive yet to reach its mark, says Chua
KUALA LUMPUR: The RM100mil “Tak Nak” anti-smoking campaign is not achieving much success but has instead raised cries of dissatisfaction from healthcare-related NGOs.
Health Minister Datuk Dr Chua Soi Lek said the private company running this five-year campaign had not contacted any of the NGOs ever since its launch.
“It was agreed earlier that activities between the NGOs and the company would be co-ordinated but there has been no initiative shown.
“The ministry agrees that this campaign has not reached a level of success that we can be proud of,” he told a press conference after the Health Dialogue Council 2004 attended by 20 NGOs yesterday.
The NGOs, Dr Chua said, had raised this matter during the dialogue.
The participants also raised concern over sensitivity to female victims of abuse and rape among the ministry’s officials, including health experts and support staff.
“We will have programmes to increase sensitivity of our staff to needs of female victims.
“There will be an official launch and awareness campaign to promote the One-Stop Crisis Centre (OSCC) in September or October,” he said.
The centre, which provides medical and follow-up care such as counselling and shelter to survivors of violence against women and children in state hospitals, will also be set up in district hospitals in the next two years.
“Victims will have a simple form to fill in to prevent any missing information needed for legal action later,” said Dr Chua.
He also said the 9th Malaysia Plan would place emphasis on education, treatment and aftercare of mental health patients, quoting a research conducted by the ministry that 13% of children aged five to 15 have mild mental health problems.
“The director-general has been appointed to look into these and to see if there is a need to build half-way house for borderline cases,” he said.
KUALA LUMPUR: The RM100mil “Tak Nak” anti-smoking campaign is not achieving much success but has instead raised cries of dissatisfaction from healthcare-related NGOs.
Health Minister Datuk Dr Chua Soi Lek said the private company running this five-year campaign had not contacted any of the NGOs ever since its launch.
“It was agreed earlier that activities between the NGOs and the company would be co-ordinated but there has been no initiative shown.
“The ministry agrees that this campaign has not reached a level of success that we can be proud of,” he told a press conference after the Health Dialogue Council 2004 attended by 20 NGOs yesterday.
The NGOs, Dr Chua said, had raised this matter during the dialogue.
The participants also raised concern over sensitivity to female victims of abuse and rape among the ministry’s officials, including health experts and support staff.
“We will have programmes to increase sensitivity of our staff to needs of female victims.
“There will be an official launch and awareness campaign to promote the One-Stop Crisis Centre (OSCC) in September or October,” he said.
The centre, which provides medical and follow-up care such as counselling and shelter to survivors of violence against women and children in state hospitals, will also be set up in district hospitals in the next two years.
“Victims will have a simple form to fill in to prevent any missing information needed for legal action later,” said Dr Chua.
He also said the 9th Malaysia Plan would place emphasis on education, treatment and aftercare of mental health patients, quoting a research conducted by the ministry that 13% of children aged five to 15 have mild mental health problems.
“The director-general has been appointed to look into these and to see if there is a need to build half-way house for borderline cases,” he said.
Half-way homes for mentally ill patients
KUALA LUMPUR July 23 - The Health Ministry will introduce half-way homes for mentally ill patients who are not suitable to be placed in mental hospitals.
Its minister, Datuk Dr Chua Soi Lek, said the project would be implemented in 2006 under the Ninth Malaysia Plan (9MP) and was necessary to cope with mental patients having mental stress.
It was also hoped that the half-way homes would help those with mental stress to prevent them from having a tendency to commit suicide, he told a media conference after chairing the Health Dialogue 2004, here Friday.
Dr Chua also revealed a study by the ministry that found 13 percent of children aged between five and 13 were experiencing mental health problems.
He said the problems were detected when the affected children had difficulties in sleeping, refused to go to school, felt uncomfortable and experienced phobia.
"The percentage, even though small, is worrying enough," he said, adding that mental health problems, if left untreated could result in mental illness.
Besides that, Dr Chua said his ministry planned to set up a One-Stop Crisis Centre in all government hospitals to help rape and violence victims.
Dr Chua said the one-stop crisis centres were expected to be completed in two years but for a start, a centre were already operational in the Kuala Lumpur Hospital since the end of last year and had received a total of 75 cases to date.
He said all medical officers and supporting staff in government hospitals had been directed to give special attention to woman and girl patients, especially for rape and violence cases.
For easier treatment for Down Syndrome patients, Dr Chua said the patients would be issued a special card known as the Disabled Self Identification Card, which was hoped to help the patients to obtain early treatment and repeat treatments in any hospitals nationwide.
KUALA LUMPUR July 23 - The Health Ministry will introduce half-way homes for mentally ill patients who are not suitable to be placed in mental hospitals.
Its minister, Datuk Dr Chua Soi Lek, said the project would be implemented in 2006 under the Ninth Malaysia Plan (9MP) and was necessary to cope with mental patients having mental stress.
It was also hoped that the half-way homes would help those with mental stress to prevent them from having a tendency to commit suicide, he told a media conference after chairing the Health Dialogue 2004, here Friday.
Dr Chua also revealed a study by the ministry that found 13 percent of children aged between five and 13 were experiencing mental health problems.
He said the problems were detected when the affected children had difficulties in sleeping, refused to go to school, felt uncomfortable and experienced phobia.
"The percentage, even though small, is worrying enough," he said, adding that mental health problems, if left untreated could result in mental illness.
Besides that, Dr Chua said his ministry planned to set up a One-Stop Crisis Centre in all government hospitals to help rape and violence victims.
Dr Chua said the one-stop crisis centres were expected to be completed in two years but for a start, a centre were already operational in the Kuala Lumpur Hospital since the end of last year and had received a total of 75 cases to date.
He said all medical officers and supporting staff in government hospitals had been directed to give special attention to woman and girl patients, especially for rape and violence cases.
For easier treatment for Down Syndrome patients, Dr Chua said the patients would be issued a special card known as the Disabled Self Identification Card, which was hoped to help the patients to obtain early treatment and repeat treatments in any hospitals nationwide.
Friday, July 23, 2004
Saudi, Malaysian Firms Sign Joint Venture Deal in Health Care
JEDDAH, 22 July 2004 — A major joint venture agreement in the field of health care was signed yesterday between Saudi Arabia’s Al-Sharif Group and Malaysia’s Pantai Medivest.
“Both parties believe that the Saudi health care market is large and stable. The market is looking for quality services, which we intend to provide,” said Abdulaziz Al-Naser, CEO of Al-Sharif Group, after signing the agreement with Azman Ibrahim, managing director of Pantai Medivest.
“We wish to benefit from the strong experience and expertise of Pantai and emulate their success in the Saudi market,” he added.
Naim Abdul Rahman, Malaysian vice consul and assistant trade commissioner, and Zalizam Zakaria, director (overseas) Malaysia Tourism Promotion Board, based in Jeddah witnessed the signing.
Al-Sharif Fayez said that with the increasing need for better health care facilities and services in the Kingdom, Al-Sharif Group has decided to take a major leap in the sector with Pantai.
His group searched for about three years for the right partner. Pantai have seven hospitals in Malaysia — in Kuala Lumpur, Selangor, Melaka, Perak and Penang — with a total capacity of some20 , 000beds.
Al-Sharif Group plans to build two hospitals — one in Makkah and another in Madinah, each with200 -bed capacity.
“We are a comprehensive private health care provider, the largest in Malaysia, and hope that with this joint venture we will be able to explore, together with Al-Sharif Group, all aspects of the health care market, particularly hospitals and management in the Kingdom,” explained Ibrahim.
Established 29 years ago, Pantai has grown to include hospitals and clinical support services such as laboratory and blood bank services, clinical waste disposal, hospital maintenance, cleaning and laundry services, nursing school, and health tourism.
Al-Sharif Fayez said the group also planned to build a medical institute to train Saudis in all areas of hospital requirements including x-rays, laboratory work and blood banks.
“We want to contribute to the Saudi economy, provide jobs for locals, and with the best of health care available locally, encourage people to stay in the Kingdom for medical treatment.”
He said Al-Sharif Group, established nearly two decades ago, has diversified from trading and construction into such areas as electrical power generation plants, and distribution systems, property, commercial centers and health care
JEDDAH, 22 July 2004 — A major joint venture agreement in the field of health care was signed yesterday between Saudi Arabia’s Al-Sharif Group and Malaysia’s Pantai Medivest.
“Both parties believe that the Saudi health care market is large and stable. The market is looking for quality services, which we intend to provide,” said Abdulaziz Al-Naser, CEO of Al-Sharif Group, after signing the agreement with Azman Ibrahim, managing director of Pantai Medivest.
“We wish to benefit from the strong experience and expertise of Pantai and emulate their success in the Saudi market,” he added.
Naim Abdul Rahman, Malaysian vice consul and assistant trade commissioner, and Zalizam Zakaria, director (overseas) Malaysia Tourism Promotion Board, based in Jeddah witnessed the signing.
Al-Sharif Fayez said that with the increasing need for better health care facilities and services in the Kingdom, Al-Sharif Group has decided to take a major leap in the sector with Pantai.
His group searched for about three years for the right partner. Pantai have seven hospitals in Malaysia — in Kuala Lumpur, Selangor, Melaka, Perak and Penang — with a total capacity of some20 , 000beds.
Al-Sharif Group plans to build two hospitals — one in Makkah and another in Madinah, each with200 -bed capacity.
“We are a comprehensive private health care provider, the largest in Malaysia, and hope that with this joint venture we will be able to explore, together with Al-Sharif Group, all aspects of the health care market, particularly hospitals and management in the Kingdom,” explained Ibrahim.
Established 29 years ago, Pantai has grown to include hospitals and clinical support services such as laboratory and blood bank services, clinical waste disposal, hospital maintenance, cleaning and laundry services, nursing school, and health tourism.
Al-Sharif Fayez said the group also planned to build a medical institute to train Saudis in all areas of hospital requirements including x-rays, laboratory work and blood banks.
“We want to contribute to the Saudi economy, provide jobs for locals, and with the best of health care available locally, encourage people to stay in the Kingdom for medical treatment.”
He said Al-Sharif Group, established nearly two decades ago, has diversified from trading and construction into such areas as electrical power generation plants, and distribution systems, property, commercial centers and health care
Thursday, July 22, 2004
Private wing fees would be lower
Source: New Straits Times Wednesday, July 21, 2004
Kuala Lumpur, Tues. -
Malaysians are assured that treatment at the proposed private wings of public hospitals will be cheaper than at private hospitals.
Health Minister Datuk Dr. Chua Soi Lek assured Malaysians today that the new fee schedule for private wings would ensure this.
"We will examine fees charged by the private sector. We cannot charge the same fees as the private sector. Government service must always have an element of subsidy," he said in an interview.
He cited the example of Magnetic Resonance Imaging (MRI) which costs an average of RM1,200 in private hospitals but only RM150 at government hospitals.
He said the ministry wanted to introduce a more equitable rate for such specialised procedures.
"We have not worked out the details of the new rates yet. There is a lot of red tape to look into," he said.
He said a team headed by ministry secretary-general Datuk Ismail Adam and Deputy Health Minister Datuk Dr Abdul Latiff Ahmad has been appointed to look into the matter.
Dr. Chua, who acknowledged that private hospitals were not happy with the decision to set up private wings in public hospitals, said they should not worry about the financial bottomline.
"Market forces will determine, especially in a service industry like health, where people will go. Health is a very personal and important matter and will affect every family."
He said there should be sufficient business for both public and private hospitals as the economy expanded and the public became more affluent.
He said the new schedule would not have to go through Parliament as it was not an amendment to the existing fee structure under the Fee Act (medical) 1994.
On the variables in determining the new fee structure, he said payments to doctors and nurses would top the list.
"We have to look at how much to pay doctors and nurses. We also have to look at the insurance aspect and who should pay for it.
"We also have to look at how many hours doctors and nurses are allowed to work," he said.
Dr. Chua said there was also the issue of where private wings should be located.
"This is a huge issue to be tackled. There are many variables involved and I need a few months to put everything in place."
Dr. Chua yesterday announced that private wings would be set up at public hospitals next year, adding that a pilot project would begin once administrative matters are settled.
Under the Act, government hospitals can charge maximum surgical fees of RM200 for third class, RM1,200 for second class, and RM3,000 for first class patients. This does not include ward, food, medicine and other charges.
Meanwhile, the Association of Private Hospitals of Malaysia (APHM), which is against the move, said the private wings would create a "two-tier" system, where patients' access to treatment would depend on their ability to pay.
Source: New Straits Times Wednesday, July 21, 2004
Kuala Lumpur, Tues. -
Malaysians are assured that treatment at the proposed private wings of public hospitals will be cheaper than at private hospitals.
Health Minister Datuk Dr. Chua Soi Lek assured Malaysians today that the new fee schedule for private wings would ensure this.
"We will examine fees charged by the private sector. We cannot charge the same fees as the private sector. Government service must always have an element of subsidy," he said in an interview.
He cited the example of Magnetic Resonance Imaging (MRI) which costs an average of RM1,200 in private hospitals but only RM150 at government hospitals.
He said the ministry wanted to introduce a more equitable rate for such specialised procedures.
"We have not worked out the details of the new rates yet. There is a lot of red tape to look into," he said.
He said a team headed by ministry secretary-general Datuk Ismail Adam and Deputy Health Minister Datuk Dr Abdul Latiff Ahmad has been appointed to look into the matter.
Dr. Chua, who acknowledged that private hospitals were not happy with the decision to set up private wings in public hospitals, said they should not worry about the financial bottomline.
"Market forces will determine, especially in a service industry like health, where people will go. Health is a very personal and important matter and will affect every family."
He said there should be sufficient business for both public and private hospitals as the economy expanded and the public became more affluent.
He said the new schedule would not have to go through Parliament as it was not an amendment to the existing fee structure under the Fee Act (medical) 1994.
On the variables in determining the new fee structure, he said payments to doctors and nurses would top the list.
"We have to look at how much to pay doctors and nurses. We also have to look at the insurance aspect and who should pay for it.
"We also have to look at how many hours doctors and nurses are allowed to work," he said.
Dr. Chua said there was also the issue of where private wings should be located.
"This is a huge issue to be tackled. There are many variables involved and I need a few months to put everything in place."
Dr. Chua yesterday announced that private wings would be set up at public hospitals next year, adding that a pilot project would begin once administrative matters are settled.
Under the Act, government hospitals can charge maximum surgical fees of RM200 for third class, RM1,200 for second class, and RM3,000 for first class patients. This does not include ward, food, medicine and other charges.
Meanwhile, the Association of Private Hospitals of Malaysia (APHM), which is against the move, said the private wings would create a "two-tier" system, where patients' access to treatment would depend on their ability to pay.
CAP: Poor patients will be shortchanged
The Consumers’ Association of Penang (CAP) today decried the government’s move to set up ‘commercial private wings’ in public-funded hospitals, warning that the move would end up shortchanging other patients who use subsidised services.
Its president SM Mohamed Idris pointed out that privatising hospital wings would not solve the manpower shortage in public hospitals - there are currently about 3,000 vacancies for doctors.
“As a result of this shortage, medical officers are very much overworked. How is this to be addressed with the commencement of the commercial private wings?” he said in a statement,
“How are hospitals going to deploy staff to the commercial private wings and still cope with the ever increasing number of patients?”
Mohamed also asked how general hospitals - which have a shortage of first class wards - would accommodate additional patients.
He said the move raised concerns that poor patients could be deprived of treatment, if beds are converted for more profitable use in the private wings.
“CAP regrets that the Health Ministry is going ahead with its plan...in spite of various concerns raised by CAP and other parties. So far, these concerns have not been addressed,” he added.
Higher fees?
Mohamed pointed out that corruption may also become an issue once a two-tier system is implemented in public-funded hospitals.
“Corrupt doctors could see patients in the commercial private wings but admit them to the public side for procedures. He could then pocket fees illegally by offering a concession to the patient. This practice is rampant in places like India and Egypt where there is a public-private mix,” he said.
He also noted that once public hospitals adopt private wings, it would likely adopt private sector practices of charging high, marked up prices for services.
“If the aim is to increase remuneration for medical staff, then there are a number of means whereby additional income for the government could be generated,” he said.
“CAP calls on the ministry not to go ahead with the plan to start private wings in public hospitals. All the concerns that have been raised should be addressed.”
The Consumers’ Association of Penang (CAP) today decried the government’s move to set up ‘commercial private wings’ in public-funded hospitals, warning that the move would end up shortchanging other patients who use subsidised services.
Its president SM Mohamed Idris pointed out that privatising hospital wings would not solve the manpower shortage in public hospitals - there are currently about 3,000 vacancies for doctors.
“As a result of this shortage, medical officers are very much overworked. How is this to be addressed with the commencement of the commercial private wings?” he said in a statement,
“How are hospitals going to deploy staff to the commercial private wings and still cope with the ever increasing number of patients?”
Mohamed also asked how general hospitals - which have a shortage of first class wards - would accommodate additional patients.
He said the move raised concerns that poor patients could be deprived of treatment, if beds are converted for more profitable use in the private wings.
“CAP regrets that the Health Ministry is going ahead with its plan...in spite of various concerns raised by CAP and other parties. So far, these concerns have not been addressed,” he added.
Higher fees?
Mohamed pointed out that corruption may also become an issue once a two-tier system is implemented in public-funded hospitals.
“Corrupt doctors could see patients in the commercial private wings but admit them to the public side for procedures. He could then pocket fees illegally by offering a concession to the patient. This practice is rampant in places like India and Egypt where there is a public-private mix,” he said.
He also noted that once public hospitals adopt private wings, it would likely adopt private sector practices of charging high, marked up prices for services.
“If the aim is to increase remuneration for medical staff, then there are a number of means whereby additional income for the government could be generated,” he said.
“CAP calls on the ministry not to go ahead with the plan to start private wings in public hospitals. All the concerns that have been raised should be addressed.”
Wednesday, July 21, 2004
KL to send medical team to Iraq
KL to send medical team to Iraq
By Roger Mitton
WASHINGTON - Malaysia is ready to send a medical team to Iraq and mobilise an international Muslim force to rehabilitate the war-torn country, said Prime Minister Abdullah Ahmad Badawi on Monday, after talks with US President George W. Bush.
Datuk Seri Abdullah, who is chairman of the 57-member Organisation of the Islamic Conference (OIC), said the world will risk another failure in nation-building if Iraq is left in the cold at this stage.
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'We are prepared to rally support among Muslim countries for OIC participation in rebuilding Iraq and strengthening its institutions of governance and its economic system,' he said.
The meeting between the two leaders came after a long period of strained ties between the US and Malaysia - and went well apparently.
Datuk Seri Abdullah said: 'Bilateral relations between the United States and Malaysia are certainly very strong.'
On many levels, that is unquestionably true. Economic ties have never been better. Malaysia is now the 10th largest trading partner of the US.
Cooperation in defence and security matters has improved tremendously. And compared to his predecessor, Tun Dr Mahathir Mohamad, Datuk Seri Abdullah is much appreciated in Washington.
Mr Peter Singer, director of the US-Islamic World relations programme at the Brookings Institution, said: 'He's far less controversial and so therefore it makes the relationship a lot less bumpy.'
Mr Bush also thanked Datuk Seri Abdullah 'for the cooperation on counter-terrorism efforts'.
Ms Angel Rabasa, a senior policy analyst at the Rand Corporation, said: 'The perception in Washington is that Malaysia's cooperation has been quite good in countering terrorism. So they each have a vested interest in putting their best foot forward.'
That said, some felt the Malaysian leader deserved a higher profile reception. He was squeezed in for barely half an hour between Mr Bush's lunch with the Chilean President and his photo-shoot for an American automobile race.
As a result, the US media gave his visit little, if any, coverage. That reinforced a common perception that the US has failed to fully utilise the example of Malaysia and other moderate, pro-development Muslim nations.
However, Datuk Seri Abdullah did not shirk from reiterating his country's opposition to recent actions by the Bush administration.
Malaysia opposed the invasion of Iraq from the start. It was an action that has 'inflicted a terrible blow to international relations', he said.
He said Muslims still doubted the good faith of the US in tackling the root causes of terrorism, but he also welcomed recent developments, notably the setting up of an Iraqi interim government.
KL to send medical team to Iraq
By Roger Mitton
WASHINGTON - Malaysia is ready to send a medical team to Iraq and mobilise an international Muslim force to rehabilitate the war-torn country, said Prime Minister Abdullah Ahmad Badawi on Monday, after talks with US President George W. Bush.
Datuk Seri Abdullah, who is chairman of the 57-member Organisation of the Islamic Conference (OIC), said the world will risk another failure in nation-building if Iraq is left in the cold at this stage.
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'We are prepared to rally support among Muslim countries for OIC participation in rebuilding Iraq and strengthening its institutions of governance and its economic system,' he said.
The meeting between the two leaders came after a long period of strained ties between the US and Malaysia - and went well apparently.
Datuk Seri Abdullah said: 'Bilateral relations between the United States and Malaysia are certainly very strong.'
On many levels, that is unquestionably true. Economic ties have never been better. Malaysia is now the 10th largest trading partner of the US.
Cooperation in defence and security matters has improved tremendously. And compared to his predecessor, Tun Dr Mahathir Mohamad, Datuk Seri Abdullah is much appreciated in Washington.
Mr Peter Singer, director of the US-Islamic World relations programme at the Brookings Institution, said: 'He's far less controversial and so therefore it makes the relationship a lot less bumpy.'
Mr Bush also thanked Datuk Seri Abdullah 'for the cooperation on counter-terrorism efforts'.
Ms Angel Rabasa, a senior policy analyst at the Rand Corporation, said: 'The perception in Washington is that Malaysia's cooperation has been quite good in countering terrorism. So they each have a vested interest in putting their best foot forward.'
That said, some felt the Malaysian leader deserved a higher profile reception. He was squeezed in for barely half an hour between Mr Bush's lunch with the Chilean President and his photo-shoot for an American automobile race.
As a result, the US media gave his visit little, if any, coverage. That reinforced a common perception that the US has failed to fully utilise the example of Malaysia and other moderate, pro-development Muslim nations.
However, Datuk Seri Abdullah did not shirk from reiterating his country's opposition to recent actions by the Bush administration.
Malaysia opposed the invasion of Iraq from the start. It was an action that has 'inflicted a terrible blow to international relations', he said.
He said Muslims still doubted the good faith of the US in tackling the root causes of terrorism, but he also welcomed recent developments, notably the setting up of an Iraqi interim government.
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