NST: KUALA LUMPUR: Nearly 70 per cent of Malaysians aged over 18 do not exercise and have been sedentary in their lifestyles over the past decade, giving rise to health risks.
This alarming indicator comes from a recent Health Ministry survey that found that only 30.9 per cent of Malaysian adults exercised. Of this, only 11.6 per cent did so adequately.
Health Minister Datuk Seri Dr Chua Soi Lek said overeating or poor eating habits contributed to an increase in the prevalence of many chronic diseases like diabetes, obesity and cardiovascular illnesses.
"The proportion of overweight Malaysian adults increased from 16.6 per cent in 1996 to 29.1 per cent last year, while obesity had increased from 4.4 per cent to 14 per cent during the same period."
Dr Chua added that there was an increase from 8.3 per cent in 1996 to 14.9 per cent last year for diabetic adult Malaysians above 30.
"For the same age group, the proportion of those who were hypertensive increased from 29.9 per cent to 42.6 per cent for the same period," he said at the "Sierramas Community Fun Run" at the Sierramas Resort Homes in Sungai Buloh yesterday.
Dr Chua put the blame for the obesity problem on the attitude and change in lifestyle of the people following the socio-economic development of the country after independence.
"There have been dramatic changes in our lifestyle, especially in the last two decades. Food used to be scarce and malnutrition a problem, but we are now consuming less complex carbohydrates like cereals, grains and tubers and consuming more sugar, red meat, eggs, animal products, fats and oils.
"There are also changes in food consumption patterns with increased eating frequency, eating out more often and meals at odd or the wee hours of the day."
He added that despite the efforts and resources of the government to improve health, it was the people themselves who could determine whether to stay healthy. "This is a matter of choice and will-power."
Dr Chua called on Malay-sians to engage in regular physical exercise which was not confined to games but also walking up stairs, dancing, jogging and cycling. This could be done at no cost at all.
"Let us walk the extra mile, take extra fibre and forgo the extra servings. The choice or decision is ours."
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
Monday, November 19, 2007
Saturday, November 17, 2007
Ministry finalising bill to ban smoking in more places
NST: GEORGE TOWN: The Health Ministry is finalising the Tobacco Product Control Bill, which will see smoking being banned in more places in the near future.
Besides a proposal to ban smoking in National Service training camps nationwide, the ministry is looking at expanding the list to include open-air eating premises, health centres and factory buses.
Its parliamentary secretary Datuk Lee Kah Choon, however, said the matter was pending discussions.
"The enlargement of non-smoking areas is constantly under review.
"If all goes well, we hope to present the bill to cabinet for approval by early next year," he said yesterday.
Lee said the bill would consolidate the law on tobacco control together with the Framework Convention on Tobacco Control's requirements.
"The bill is our commitment to reduce diseases and to slow the rise of chronic diseases and early death."
He, however, said until such time the new act came into force, which he said could take a long time, similar amendments would be made to the Control of Tobacco Product Regulation 2004 under the Food Act 1983.
"It will take a long time for a bill to be gazetted into an act, sometime years, because it has to go through numerous processes: the Attorney-General's Chambers, parliament and the Yang di-Pertuan Agong.
"If amendments are made to the existing law, we can implement and enforce the smoking ban on such places faster and I can assure you enforcement will be strict then," he said, adding that once the new act came into force, the existing law would be made obsolete. "The amendments are to cater for the interim period until the new act comes into force."
He also said it was looking at making it mandatory for cigarette manufacturers and importers to make sure that health warnings covered at least half the cigarette packet.
It is understood that the warnings must cover more than half of the front and back of the cigarette packets and may include a graphic illustration of the hazards of smoking.
Many countries, including those in the European Union, require cigarette manufacturers to carry graphic photographs illustrating the consequences of smoking to health.
Singapore has, since Aug 1, required cigarette packs to carry graphic warnings, including images of a cancerous lung and a brain oozing blood after a stroke.
Besides a proposal to ban smoking in National Service training camps nationwide, the ministry is looking at expanding the list to include open-air eating premises, health centres and factory buses.
Its parliamentary secretary Datuk Lee Kah Choon, however, said the matter was pending discussions.
"The enlargement of non-smoking areas is constantly under review.
"If all goes well, we hope to present the bill to cabinet for approval by early next year," he said yesterday.
Lee said the bill would consolidate the law on tobacco control together with the Framework Convention on Tobacco Control's requirements.
"The bill is our commitment to reduce diseases and to slow the rise of chronic diseases and early death."
He, however, said until such time the new act came into force, which he said could take a long time, similar amendments would be made to the Control of Tobacco Product Regulation 2004 under the Food Act 1983.
"It will take a long time for a bill to be gazetted into an act, sometime years, because it has to go through numerous processes: the Attorney-General's Chambers, parliament and the Yang di-Pertuan Agong.
"If amendments are made to the existing law, we can implement and enforce the smoking ban on such places faster and I can assure you enforcement will be strict then," he said, adding that once the new act came into force, the existing law would be made obsolete. "The amendments are to cater for the interim period until the new act comes into force."
He also said it was looking at making it mandatory for cigarette manufacturers and importers to make sure that health warnings covered at least half the cigarette packet.
It is understood that the warnings must cover more than half of the front and back of the cigarette packets and may include a graphic illustration of the hazards of smoking.
Many countries, including those in the European Union, require cigarette manufacturers to carry graphic photographs illustrating the consequences of smoking to health.
Singapore has, since Aug 1, required cigarette packs to carry graphic warnings, including images of a cancerous lung and a brain oozing blood after a stroke.
Five-prong strategy to treat drug users
NST: KUALA LUMPUR: There is no quick fix in treating drug users.
That is why doctors in private practice have introduced a five-prong strategy, which includes looking at drug addiction as a medical problem that needs medical care.
"Five years ago there was hardly any treatment for drug addicts, especially in the private sector. Drug addiction was not even in the realm of medical service," said Dr Steven K.W. Chow.
But to date, he said, nearly 500 doctors had signed up to offer community-based drug addiction treatment programmes, nearly double from the 298 who registered under the National Drug Substitution Therapy (NDST) register in March.
Dr Chow, who is president of the Federation of Private Medical Practitioners' Associations, Malaysia, said that the doctors would be trained to be able to roll out drug substitution services, while ensuring they were equipped with support services like counselling.
"Although 500 is a good figure, this is far from enough compared to the number of drug addicts in the country," said Dr Chow, who was speaking at a Press conference after the launch of the 1st International Conference on Addiction Medicine, which incorporated the 4th National Conference on Addiction Medicine.
This is because since 1988 until last year, the number of drug addicts totalled 300,241, and according to the World Health Organisation, for every one identified drug addict there are three or four others unidentified, which could place the figure to between 900,000 and 1.2 million Malaysians.
The five-prong strategy, termed SMART, which is to be implemented over the next three years, also includes:
- a strategic plan to fight drug addiction;
- to upgrade the level of awareness as drug addiction was society's problem;
- to prevent relapses; and
- to train doctors, counsellors and parents how to handle the problems at an early stage.
Currently, the government, via the Health Ministry and partner non-governmental organisations including the Malaysian AIDS Council, are carrying out Drug Substitution Therapy using methadone and a combination of buprenorphrine and naloxone.
On reports that some drug users on methadone therapy had grown addicted to the substitute, Dr Chow said that an electronic monitoring system, the Natio-nal Drug Substitution Therapy system, monitored treatment given.
"It also prevents patients from hopping from one doctor to another to prevent abuse as all private practitioners dispensing methadone are registered on it."
That is why doctors in private practice have introduced a five-prong strategy, which includes looking at drug addiction as a medical problem that needs medical care.
"Five years ago there was hardly any treatment for drug addicts, especially in the private sector. Drug addiction was not even in the realm of medical service," said Dr Steven K.W. Chow.
But to date, he said, nearly 500 doctors had signed up to offer community-based drug addiction treatment programmes, nearly double from the 298 who registered under the National Drug Substitution Therapy (NDST) register in March.
Dr Chow, who is president of the Federation of Private Medical Practitioners' Associations, Malaysia, said that the doctors would be trained to be able to roll out drug substitution services, while ensuring they were equipped with support services like counselling.
"Although 500 is a good figure, this is far from enough compared to the number of drug addicts in the country," said Dr Chow, who was speaking at a Press conference after the launch of the 1st International Conference on Addiction Medicine, which incorporated the 4th National Conference on Addiction Medicine.
This is because since 1988 until last year, the number of drug addicts totalled 300,241, and according to the World Health Organisation, for every one identified drug addict there are three or four others unidentified, which could place the figure to between 900,000 and 1.2 million Malaysians.
The five-prong strategy, termed SMART, which is to be implemented over the next three years, also includes:
- a strategic plan to fight drug addiction;
- to upgrade the level of awareness as drug addiction was society's problem;
- to prevent relapses; and
- to train doctors, counsellors and parents how to handle the problems at an early stage.
Currently, the government, via the Health Ministry and partner non-governmental organisations including the Malaysian AIDS Council, are carrying out Drug Substitution Therapy using methadone and a combination of buprenorphrine and naloxone.
On reports that some drug users on methadone therapy had grown addicted to the substitute, Dr Chow said that an electronic monitoring system, the Natio-nal Drug Substitution Therapy system, monitored treatment given.
"It also prevents patients from hopping from one doctor to another to prevent abuse as all private practitioners dispensing methadone are registered on it."
Drug addiction can be treated as a medical problem
Star: KUALA LUMPUR: Addiction can now be viewed as a treatable disease with the introduction of medicine to replace “hard” drugs such as heroin.
Health Ministry deputy director-general Datuk Dr Ramlee Rahmat said this would result in more drug users coming forward to get help in their fight against addiction.
He added that discrimination against drug users would lessen if the addiction was treated as a medical problem.
The ministry, he said, also provided treatment at its hospitals such as counselling those addicted to drugs, including users of amphetamine-type stimulants (ATS).
“The ministry is encouraged by the results of the methadone maintenance therapy programme,” said Dr Ramlee who opened the First International Conference on Addiction Medicine yesterday.
The conference was organised by the Federation of Private Medical Practitioners’ Associations of Malaysia.
The ministry's harm reduction method comprises methadone maintenance therapy and the needle syringe exchange programme. It focuses on preventing or reducing actual harm associated with risk behaviour. Some drug users will not stop using drugs despite the risk of HIV/AIDS and other blood-borne diseases.
In Phase II of the methadone maintenance therapy programme, the ministry has 58 participating centres – comprising 25 hospitals, 26 health clinics and seven private practitioners.
Health Ministry deputy director-general Datuk Dr Ramlee Rahmat said this would result in more drug users coming forward to get help in their fight against addiction.
He added that discrimination against drug users would lessen if the addiction was treated as a medical problem.
The ministry, he said, also provided treatment at its hospitals such as counselling those addicted to drugs, including users of amphetamine-type stimulants (ATS).
“The ministry is encouraged by the results of the methadone maintenance therapy programme,” said Dr Ramlee who opened the First International Conference on Addiction Medicine yesterday.
The conference was organised by the Federation of Private Medical Practitioners’ Associations of Malaysia.
The ministry's harm reduction method comprises methadone maintenance therapy and the needle syringe exchange programme. It focuses on preventing or reducing actual harm associated with risk behaviour. Some drug users will not stop using drugs despite the risk of HIV/AIDS and other blood-borne diseases.
In Phase II of the methadone maintenance therapy programme, the ministry has 58 participating centres – comprising 25 hospitals, 26 health clinics and seven private practitioners.
Thursday, November 15, 2007
Serdang Hospital Saddled With RM500,000 Unpaid Bills By Foreigners
SERDANG, Nov 13 (Bernama) -- Foreigners owed the Serdang Hospital here some RM500,000 in unpaid bills and this had caused its services to deteriorate, said Parliamentary Secretary to the Health Ministry Datuk Lee Kah Choon.
He said that foreigners still failed to settle their medical bills despite being charged low fees.
"Nearly 30 percent of the total number of patients seeking treatment at the Serdang Hospital are foreigners," he told reporters after visiting the hospital here today.
He added that the hospital could not operate all its wards due to a staff shortage. To date only 381 beds had been used while the other 239 beds will be used in stages.
The Serdang Hospital has a support staff of 400 and has to double that number to meet the needs of its increasing number of patients.
Lee. however, said that the hospital had adequate doctors and specialists.
The RM690 million hospital began operation on Dec 15, 2005 with 620 beds.
It also acts as the teaching hospital Universiti Putra Malaysia's medical Faculty.
He said the hospital's strategic location near Bangi, Puchong and Putrajaya makes it the hospital of choice for over two million people.
He said that foreigners still failed to settle their medical bills despite being charged low fees.
"Nearly 30 percent of the total number of patients seeking treatment at the Serdang Hospital are foreigners," he told reporters after visiting the hospital here today.
He added that the hospital could not operate all its wards due to a staff shortage. To date only 381 beds had been used while the other 239 beds will be used in stages.
The Serdang Hospital has a support staff of 400 and has to double that number to meet the needs of its increasing number of patients.
Lee. however, said that the hospital had adequate doctors and specialists.
The RM690 million hospital began operation on Dec 15, 2005 with 620 beds.
It also acts as the teaching hospital Universiti Putra Malaysia's medical Faculty.
He said the hospital's strategic location near Bangi, Puchong and Putrajaya makes it the hospital of choice for over two million people.
Tuesday, November 13, 2007
Serve with a smile, health staff urged
Star: KUANTAN: Service with a smile can make a lot of difference when dealing with the sick.
This was the message Mentri Besar Datuk Seri Adnan Yaakob had for health services employees.
He said dispensing medication with a smile could do wonders and help speed up the recovery process.
“The health services department is people-oriented and one must display a certain level of pleasantness and sincerity,” Adnan said in his speech before presenting excellence service awards to some 700 recipients at Wisma Belia yesterday.
Also present were State Health, Social and Orang Asli Affairs Committee Chairman Datuk Ishak Muhammad and state department director Datuk Dr Rosnah Ismail.
Adnan said they must continue to provide efficient services by being professional, innovative, pro-active and exercise common sense.
He also said he hoped the service awards would spur the recipients to improve further.
Dr Rosnah, in her speech, said the department had obtained MS ISO 9001:2000 certification in 2005 and would undergo a review at the end of the month so as to qualify for the quality standard for the next three years.
Three hospitals and two district health offices in Kuantan, Bentong, Jerantut and Rompin had also achieved such international standard, she added.
This was the message Mentri Besar Datuk Seri Adnan Yaakob had for health services employees.
He said dispensing medication with a smile could do wonders and help speed up the recovery process.
“The health services department is people-oriented and one must display a certain level of pleasantness and sincerity,” Adnan said in his speech before presenting excellence service awards to some 700 recipients at Wisma Belia yesterday.
Also present were State Health, Social and Orang Asli Affairs Committee Chairman Datuk Ishak Muhammad and state department director Datuk Dr Rosnah Ismail.
Adnan said they must continue to provide efficient services by being professional, innovative, pro-active and exercise common sense.
He also said he hoped the service awards would spur the recipients to improve further.
Dr Rosnah, in her speech, said the department had obtained MS ISO 9001:2000 certification in 2005 and would undergo a review at the end of the month so as to qualify for the quality standard for the next three years.
Three hospitals and two district health offices in Kuantan, Bentong, Jerantut and Rompin had also achieved such international standard, she added.
Healthcare insurers must register
Star: KUALA LUMPUR: All insurance companies providing healthcare facilities must register with the Health Ministry by March 31 next year.
Minister Datuk Seri Dr Chua Soi Lek said the companies should not think that they were not regulated by anyone except Bank Negara.
“Bank Negara deals with the financial regulations.
“But all health and health related matters come under the Health Ministry, including insurance companies which provide healthcare facilities,” he told the press after launching Vamed's 20th anniversary celebrations here last night.
He said all healthcare providers were regulated under the Private Healthcare Facilities and Services Act 1998 and doctors by the Medical Act 1971.
“This is a warning. If they do not comply, they can be fined up to RM500,000.
“Hospitals that provide healthcare to patients through such insurance schemes must also register with us, or they can be fined up to RM300,000,” he said.
He added that he was “not happy” with recent cases of insurance companies that “arm- twisted doctors to not only cap their fee but reduce their charges.”
It was recently reported that an insurance company had proposed a new Healthcare Service Provider Agreement, which doctors had claimed was unethical and would limit patients' access to healthcare.
The new terms included doctors not being properly reimbursed for emergency and critical care outside of office hours and a limit to the number of chargeable visits allowed for specialists in certain disciplines.
“When people are sick and go to a doctor, and they (insurance companies) put all sorts of caps on the charges ... that is not fair,” he said.
For online registration, go to medpcs.moh.gov.my
Minister Datuk Seri Dr Chua Soi Lek said the companies should not think that they were not regulated by anyone except Bank Negara.
“Bank Negara deals with the financial regulations.
“But all health and health related matters come under the Health Ministry, including insurance companies which provide healthcare facilities,” he told the press after launching Vamed's 20th anniversary celebrations here last night.
He said all healthcare providers were regulated under the Private Healthcare Facilities and Services Act 1998 and doctors by the Medical Act 1971.
“This is a warning. If they do not comply, they can be fined up to RM500,000.
“Hospitals that provide healthcare to patients through such insurance schemes must also register with us, or they can be fined up to RM300,000,” he said.
He added that he was “not happy” with recent cases of insurance companies that “arm- twisted doctors to not only cap their fee but reduce their charges.”
It was recently reported that an insurance company had proposed a new Healthcare Service Provider Agreement, which doctors had claimed was unethical and would limit patients' access to healthcare.
The new terms included doctors not being properly reimbursed for emergency and critical care outside of office hours and a limit to the number of chargeable visits allowed for specialists in certain disciplines.
“When people are sick and go to a doctor, and they (insurance companies) put all sorts of caps on the charges ... that is not fair,” he said.
For online registration, go to medpcs.moh.gov.my
Monday, November 12, 2007
Younger women are getting breast cancer
NST: IPOH: Breast cancer is on the rise and the patients are getting younger, said Ipoh Hospital surgery department head Dr Stephen Jacob.
"The trend we are seeing now is that when the younger ones contract breast cancer, it tends to be more aggressive.
"It spreads all over and there's a shorter time between the time of diagnosis and death," he said.
For example, there was a 26-year-old patient who underwent a complete treatment for breast cancer but died after the cancer spread to the rest of her body, he said.
In Ipoh Hospital, 26 women died of breast cancer in 2006 and the number increased to 27 women within the first 10 months of this year, he said.
The statistics are limited to those who died in the wards and do not include those who died at home or elsewhere, he added.
On average, about 20 per cent of cancer patients at the hospital suffer from breast cancer.
There were 189 patients admitted for breast cancer treatment at the hospital last year.
Men were also susceptible to breast cancer but such cases were extremely rare, said Dr Stephen, who encountered "one or two" cases during his 15 years as a surgeon.
"We need to get people to come to us early.
"If they come early, they can be cured," he said when highlighting a half-day forum on breast cancer awareness to be held at the hospital tomorrow.
It will be on from 8am to 1pm at the hospital's ambulatory care centre.
"The trend we are seeing now is that when the younger ones contract breast cancer, it tends to be more aggressive.
"It spreads all over and there's a shorter time between the time of diagnosis and death," he said.
For example, there was a 26-year-old patient who underwent a complete treatment for breast cancer but died after the cancer spread to the rest of her body, he said.
In Ipoh Hospital, 26 women died of breast cancer in 2006 and the number increased to 27 women within the first 10 months of this year, he said.
The statistics are limited to those who died in the wards and do not include those who died at home or elsewhere, he added.
On average, about 20 per cent of cancer patients at the hospital suffer from breast cancer.
There were 189 patients admitted for breast cancer treatment at the hospital last year.
Men were also susceptible to breast cancer but such cases were extremely rare, said Dr Stephen, who encountered "one or two" cases during his 15 years as a surgeon.
"We need to get people to come to us early.
"If they come early, they can be cured," he said when highlighting a half-day forum on breast cancer awareness to be held at the hospital tomorrow.
It will be on from 8am to 1pm at the hospital's ambulatory care centre.
‘Lack of human warmth’ behind negligence cases
Star: MUAR: The commercialisation of medical care has produced doctors and nurses who are impersonal to patients and this will lead to negligence, Health Minister Datuk Seri Dr Chua Soi Lek said yesterday.
The lack of human warmth in dispensing medical care was due to the shortage of doctors, nurses and supporting officers and also the over-reliance on machines, he added.
"The medical officers and staff depend more on machines for diagnosis and this affects their attitude towards their patients," he said after a seminar at the Johor MCA Public Service and Complaints Bureau here.
Dr Chua said universities offering medical courses should look into the issue immediately and put greater emphasis on courses concerning the doctor-patient relationship.
He was commenting on a New Sunday Times report on medical negligence in the country's healthcare industry.
Health Ministry statistics show that four out of every 10 negligence cases are from the field of obstetrics and gynaecology.
Second in the medical field with the most negligence suits is orthopaedics (18 per cent), followed by medical (13), surgery (11), paediatrics (7) and others (10).
From 2000 to 2006, 61 negligence cases involving government healthcare providers, mainly doctors, have been settled in and out of court.
Dr Chua said an independent body comprising professionals and local leaders had been set up to investigate errors which resulted in death and promised that there would be no cover-up by his ministry.
"A mechanism is also present for patients to make complaints," he added.
The lack of human warmth in dispensing medical care was due to the shortage of doctors, nurses and supporting officers and also the over-reliance on machines, he added.
"The medical officers and staff depend more on machines for diagnosis and this affects their attitude towards their patients," he said after a seminar at the Johor MCA Public Service and Complaints Bureau here.
Dr Chua said universities offering medical courses should look into the issue immediately and put greater emphasis on courses concerning the doctor-patient relationship.
He was commenting on a New Sunday Times report on medical negligence in the country's healthcare industry.
Health Ministry statistics show that four out of every 10 negligence cases are from the field of obstetrics and gynaecology.
Second in the medical field with the most negligence suits is orthopaedics (18 per cent), followed by medical (13), surgery (11), paediatrics (7) and others (10).
From 2000 to 2006, 61 negligence cases involving government healthcare providers, mainly doctors, have been settled in and out of court.
Dr Chua said an independent body comprising professionals and local leaders had been set up to investigate errors which resulted in death and promised that there would be no cover-up by his ministry.
"A mechanism is also present for patients to make complaints," he added.
2.6 million locals expected to suffer from diabetes
NST: PETALING JAYA: The number of Malaysians having diabetes mellitus by the end of this year is expected to reach 2.6 million with the majority in the Type 2 category.
According to the national mortality and morbidity survey by the Health Ministry, the rise from 8.7 per cent in 1997 to 10.2 per cent this year represents about a 25 per cent increase in the total number of cases over the last 10 years.
The rise corresponds with worldwide projections by the World Health Organisation which anticipates the numbers to increase by 120 per cent by the year 2025, affecting 300 million people.
University Malaya Medical Centre director Prof Dr Ikram Shah Ismail, who is also Malaysian Diabetes Association (MDA) president, said:
"There are many Malaysians with this incurable disease who risk diabetic complications like a heart attack, stroke and kidney failure."
He said the root cause of such fatalities was the unwillingness to practise good diabetes management.
There was a need for the people to take a right attitude by having a balanced diet, managing body weight, taking medication and undergoing regular medical follow-ups from young to reduce the risk of diabetic complications, Ikram said at the launch of World Diabetes Day 2007 yesterday.
The ministry's deputy director of disease control, Dr Zainal Ariffin Omar, who launched the event, said there was an increase of diabetes in children.
There were 837 cases in 1999 compared with 1,305 in 2004.
"The main causes of diabetes are lifestyle changes and family genetics which have led to obesity, lack of exercise and nutritional imbalance.
"Although incurable, the disease can be controlled with a combination of exercise, diet and drug therapy," he added.
Diabetes mellitus Type 1 is a disease that results from the permanent destruction of insulin-producing beta cells of the pancreas, normally since birth.
This category represents two per cent of the cases in Malaysia.
Diabetes mellitus Type 2 or adult-onset diabetes is a metabolic disorder characterised by insulin deficiency in the human body.
This accounts for 98 per cent of cases in the country.
In conjunction with the event, Ford Malaysia also launched its RM30,000 Ford Diabetic Children's Fund to help underprivileged children diagnosed with diabetes to get monitoring tools and to help them lead a normal life.
According to the national mortality and morbidity survey by the Health Ministry, the rise from 8.7 per cent in 1997 to 10.2 per cent this year represents about a 25 per cent increase in the total number of cases over the last 10 years.
The rise corresponds with worldwide projections by the World Health Organisation which anticipates the numbers to increase by 120 per cent by the year 2025, affecting 300 million people.
University Malaya Medical Centre director Prof Dr Ikram Shah Ismail, who is also Malaysian Diabetes Association (MDA) president, said:
"There are many Malaysians with this incurable disease who risk diabetic complications like a heart attack, stroke and kidney failure."
He said the root cause of such fatalities was the unwillingness to practise good diabetes management.
There was a need for the people to take a right attitude by having a balanced diet, managing body weight, taking medication and undergoing regular medical follow-ups from young to reduce the risk of diabetic complications, Ikram said at the launch of World Diabetes Day 2007 yesterday.
The ministry's deputy director of disease control, Dr Zainal Ariffin Omar, who launched the event, said there was an increase of diabetes in children.
There were 837 cases in 1999 compared with 1,305 in 2004.
"The main causes of diabetes are lifestyle changes and family genetics which have led to obesity, lack of exercise and nutritional imbalance.
"Although incurable, the disease can be controlled with a combination of exercise, diet and drug therapy," he added.
Diabetes mellitus Type 1 is a disease that results from the permanent destruction of insulin-producing beta cells of the pancreas, normally since birth.
This category represents two per cent of the cases in Malaysia.
Diabetes mellitus Type 2 or adult-onset diabetes is a metabolic disorder characterised by insulin deficiency in the human body.
This accounts for 98 per cent of cases in the country.
In conjunction with the event, Ford Malaysia also launched its RM30,000 Ford Diabetic Children's Fund to help underprivileged children diagnosed with diabetes to get monitoring tools and to help them lead a normal life.
Lee: Help workers with mental woes
Star: PETALING JAYA: Employers should initiate an employee assistance programme for the prevention and early intervention of mental health problems among workers, said National Institute of Occupational Safety and Health (Niosh) chairman Tan Sri Lee Lam Thye.
“This is because the workplace is not immune from employees who succumb to stress-related problems which could lead to sudden anger, violence, depression and suicide,” he said.
He said the neglect of mental health and psychological factors at the workplace would also directly affect the efficiency and output of any enterprise.
Lee even suggested that insurance providers offer coverage to mentally ill patients, saying it was unfair to deny them such coverage.
“In addition, there should also be income tax relief for parents or other caregivers looking after the mentally ill,” he said in a statement.
As for government hospitals, Lee said there should be better healthcare services for them, as well as efforts to make psychiatric drugs more affordable.
“Society should also be more open and not discriminate against persons who had recovered from mental illnesses. They must be given the chance to re-integrated into society,” he said.
“This is because the workplace is not immune from employees who succumb to stress-related problems which could lead to sudden anger, violence, depression and suicide,” he said.
He said the neglect of mental health and psychological factors at the workplace would also directly affect the efficiency and output of any enterprise.
Lee even suggested that insurance providers offer coverage to mentally ill patients, saying it was unfair to deny them such coverage.
“In addition, there should also be income tax relief for parents or other caregivers looking after the mentally ill,” he said in a statement.
As for government hospitals, Lee said there should be better healthcare services for them, as well as efforts to make psychiatric drugs more affordable.
“Society should also be more open and not discriminate against persons who had recovered from mental illnesses. They must be given the chance to re-integrated into society,” he said.
Sunday, November 11, 2007
Snap! You wake up ciggie-free
NST: 'Sleep' an hour and wake up a non-smoker? Can it really be that easy? A doctor and a couple of hypnotherapists tell TAN CHOE CHOE that this is true
KUALA LUMPUR: He had been puffing away for over 30 years and tried desperately to stop for the last 10.
Nicotine patch, mints, nicotine gum; you name it, Dr Omar Abdul Hamid has tried it all.
Each Ramadan, he'd renew his efforts to stop smoking.
"The longest I managed to stay away from ciggies was a mere two weeks. That was during last year's fasting month," said Dr Omar, 53, the managing director of Darul Ehsan Medical Centre in Shah Alam.
But he was desperately craving for a cigarette fix in that "seemingly never-ending two weeks".
On top of it, he was becoming a "grumpy bear" to those around him.
"I had terrible withdrawal symptoms -- I was restless, irritable, easily angered, and I couldn't sleep or think properly!"
Inevitably, he succumbed to the craving and started to smoke again.
But all that became history when he took up a friend's advice and tried hypnotherapy to stop smoking about two months ago.
"My best friend, who is also a physician, introduced me to hypnotherapy. He told me he was taking a course in clinical hypnosis at this school in Pusat Bandar Damansara."
Dr Omar said that he was keen to try anything at that point.
"I was sceptical but also desperate, so I thought 'why not?'"
With that in mind, he met Sheila Menon, the principal of the Malaysian branch of the London College of Clinical Hypnosis, where his friend was studying.
"Dr Omar came to us with a high desire and motivation to stop smoking.
"On a scale of one to 10 -- with one being 'no, I like my smoking habit and I want a cigarette now' and 10 being 'I want to quit this very minute' -- he told us he was a nine," said Sheila.
So she recommended that he try the one-session-stop-smoking therapy -- which takes no more than two hours -- with Peter Mabbutt, a hypnotherapist and founder fellow of the British Association of Medical Hypnosis.
"Seven to eight out of every 10 patients who have gone for this therapy session will stop smoking. Dr Omar and my own husband are good testimonies of its efficacy," said Sheila, whose college is also the first of its kind in Asia.
So how does it work?
The founder of this technique, Michael Joseph, the principal of LCCH in London, said it works uniquely for each individual.
"The therapist first obtains information from the patient about his or her smoking pattern, then while hypnotised, employs (usually strong, direct) suggestions that he stop the habit."
Sheila describes the process as "bringing back the non-smoker that is within the patient" -- the feelings and memories before the person first started smoking.
Joseph has been employing this one-session-stop-smoking technique for over 30 years.
"People were sceptical at first, some even hostile. But since those early years, LCCH has trained thousands of practitioners, many of them doing sterling work in the community now."
Before starting, Sheila said it's important to understand what a patient associates a cigarette with -- like the feelings of absolute control when lighting up; personal reward after a successful deal; or momentary freedom from a boring meeting.
"Most people don't smoke because of nicotine -- you can get that in the first few puffs. Yet why do smokers hold to that last drag?
"It's due to psychological, social or emotional problems, or just simple habit."
Sheila said Joseph's technique worked by helping the patients rationalise the reasons behind why they were smoking and to point out the logic behind the reasons why they could not stop the habit.
"We're using the memory that they have of themselves as a non-smoker and using it to help build a new image of themselves today as a non-smoker, replacing (their smoking) habits with new healthy habits."
Then the hypnotherapist will suggest to the patient during hypnosis to utilise that image when thinking of himself in the future.
Dr Omar's session lasted about two hours but he was only hypnotised for less than an hour -- about 45 minutes.
"We spent the early part of the session talking about my habit, my smoking history. Then Peter (Mabbutt) told me he would hypnotise me and gently told me to go to sleep.
"It was strange because I did go to sleep, yet I was aware. I still remember what he said to me before and during the hypnosis, not all, but bits and pieces of it.
"But mostly, I remember thinking that I could hear him, although I couldn't move and my eyes were closed. You have to try it to know what I'm saying," said Dr Omar of his experience.
He hasn't picked up a cigarette for over two months -- not even during the most tempting time of the year, the Hari Raya holidays.
"To friends who offered me a ciggie, I just told them what Peter suggested: 'Thank you, (but) I'm not a smoker'."
And best of all, he's experienced no withdrawal symptoms whatsoever.
"I also don't suffer from insomnia any more. I'm sleeping better, eating better, and I feel great."
Joseph, who was in town to attend the Master Class in Smoking Cessation Through Hypnosis, especially for doctors, healthcare professionals and students of LCCH, Malaysia, said thousands of people stopped smoking every year, with or without any help whatsoever.
He said everybody already had, within themselves "all the strength and willpower they need to become non-smokers".
"It is the skill of the therapist to find and liberate this 'power' within that will allow them to conquer their habit."
It was important to understand that a hypnotherapist could not "make" anyone do anything they already were not fully capable of doing, he added.
KUALA LUMPUR: He had been puffing away for over 30 years and tried desperately to stop for the last 10.
Nicotine patch, mints, nicotine gum; you name it, Dr Omar Abdul Hamid has tried it all.
Each Ramadan, he'd renew his efforts to stop smoking.
"The longest I managed to stay away from ciggies was a mere two weeks. That was during last year's fasting month," said Dr Omar, 53, the managing director of Darul Ehsan Medical Centre in Shah Alam.
But he was desperately craving for a cigarette fix in that "seemingly never-ending two weeks".
On top of it, he was becoming a "grumpy bear" to those around him.
"I had terrible withdrawal symptoms -- I was restless, irritable, easily angered, and I couldn't sleep or think properly!"
Inevitably, he succumbed to the craving and started to smoke again.
But all that became history when he took up a friend's advice and tried hypnotherapy to stop smoking about two months ago.
"My best friend, who is also a physician, introduced me to hypnotherapy. He told me he was taking a course in clinical hypnosis at this school in Pusat Bandar Damansara."
Dr Omar said that he was keen to try anything at that point.
"I was sceptical but also desperate, so I thought 'why not?'"
With that in mind, he met Sheila Menon, the principal of the Malaysian branch of the London College of Clinical Hypnosis, where his friend was studying.
"Dr Omar came to us with a high desire and motivation to stop smoking.
"On a scale of one to 10 -- with one being 'no, I like my smoking habit and I want a cigarette now' and 10 being 'I want to quit this very minute' -- he told us he was a nine," said Sheila.
So she recommended that he try the one-session-stop-smoking therapy -- which takes no more than two hours -- with Peter Mabbutt, a hypnotherapist and founder fellow of the British Association of Medical Hypnosis.
"Seven to eight out of every 10 patients who have gone for this therapy session will stop smoking. Dr Omar and my own husband are good testimonies of its efficacy," said Sheila, whose college is also the first of its kind in Asia.
So how does it work?
The founder of this technique, Michael Joseph, the principal of LCCH in London, said it works uniquely for each individual.
"The therapist first obtains information from the patient about his or her smoking pattern, then while hypnotised, employs (usually strong, direct) suggestions that he stop the habit."
Sheila describes the process as "bringing back the non-smoker that is within the patient" -- the feelings and memories before the person first started smoking.
Joseph has been employing this one-session-stop-smoking technique for over 30 years.
"People were sceptical at first, some even hostile. But since those early years, LCCH has trained thousands of practitioners, many of them doing sterling work in the community now."
Before starting, Sheila said it's important to understand what a patient associates a cigarette with -- like the feelings of absolute control when lighting up; personal reward after a successful deal; or momentary freedom from a boring meeting.
"Most people don't smoke because of nicotine -- you can get that in the first few puffs. Yet why do smokers hold to that last drag?
"It's due to psychological, social or emotional problems, or just simple habit."
Sheila said Joseph's technique worked by helping the patients rationalise the reasons behind why they were smoking and to point out the logic behind the reasons why they could not stop the habit.
"We're using the memory that they have of themselves as a non-smoker and using it to help build a new image of themselves today as a non-smoker, replacing (their smoking) habits with new healthy habits."
Then the hypnotherapist will suggest to the patient during hypnosis to utilise that image when thinking of himself in the future.
Dr Omar's session lasted about two hours but he was only hypnotised for less than an hour -- about 45 minutes.
"We spent the early part of the session talking about my habit, my smoking history. Then Peter (Mabbutt) told me he would hypnotise me and gently told me to go to sleep.
"It was strange because I did go to sleep, yet I was aware. I still remember what he said to me before and during the hypnosis, not all, but bits and pieces of it.
"But mostly, I remember thinking that I could hear him, although I couldn't move and my eyes were closed. You have to try it to know what I'm saying," said Dr Omar of his experience.
He hasn't picked up a cigarette for over two months -- not even during the most tempting time of the year, the Hari Raya holidays.
"To friends who offered me a ciggie, I just told them what Peter suggested: 'Thank you, (but) I'm not a smoker'."
And best of all, he's experienced no withdrawal symptoms whatsoever.
"I also don't suffer from insomnia any more. I'm sleeping better, eating better, and I feel great."
Joseph, who was in town to attend the Master Class in Smoking Cessation Through Hypnosis, especially for doctors, healthcare professionals and students of LCCH, Malaysia, said thousands of people stopped smoking every year, with or without any help whatsoever.
He said everybody already had, within themselves "all the strength and willpower they need to become non-smokers".
"It is the skill of the therapist to find and liberate this 'power' within that will allow them to conquer their habit."
It was important to understand that a hypnotherapist could not "make" anyone do anything they already were not fully capable of doing, he added.
Maids who bring diseases with them
NST: KUALA LUMPUR: Less than a quarter of the Indonesian maids working in the country underwent medical check-ups in their country before being employed here.
This was revealed by Indonesian Health Department authorities who have recorded only 78,000 women as having undergone medical check-ups as a prerequisite to being employed as maids in Malaysia.
Immigration Department foreign labour division director Abdul Rahman Othman said this represented only 24 per cent of the 320,000 Indonesians working in Malaysia as maids.
This, he said, could possibly expose employers, family members and those who came in contact with the maids to diseases like hepatitis B and tuberculosis.
"Those who were not registered with the Indonesian Health Department are believed to have got medical certificates illegally.
"So, there is a high risk of contracting contagious diseases from these people," he told a dialogue session at the 13th Malaysian Association of Foreign Maid Agencies' annual general meeting.
Also present yesterday were Immigration deputy director-general Yusof Abu Bakar and association president Datuk Raja Zulkepley Dahalan.
Abdul Rahman said this was the reason why the department was not planning to reduce the number of compulsory medical check-ups.
Answering a query from the floor, he said a Medical Examination Monitoring Agency (Fomema) report stated that two per cent (6,400) of the foreign maids in the country had hepatitis B or tuberculosis.
This was revealed by Indonesian Health Department authorities who have recorded only 78,000 women as having undergone medical check-ups as a prerequisite to being employed as maids in Malaysia.
Immigration Department foreign labour division director Abdul Rahman Othman said this represented only 24 per cent of the 320,000 Indonesians working in Malaysia as maids.
This, he said, could possibly expose employers, family members and those who came in contact with the maids to diseases like hepatitis B and tuberculosis.
"Those who were not registered with the Indonesian Health Department are believed to have got medical certificates illegally.
"So, there is a high risk of contracting contagious diseases from these people," he told a dialogue session at the 13th Malaysian Association of Foreign Maid Agencies' annual general meeting.
Also present yesterday were Immigration deputy director-general Yusof Abu Bakar and association president Datuk Raja Zulkepley Dahalan.
Abdul Rahman said this was the reason why the department was not planning to reduce the number of compulsory medical check-ups.
Answering a query from the floor, he said a Medical Examination Monitoring Agency (Fomema) report stated that two per cent (6,400) of the foreign maids in the country had hepatitis B or tuberculosis.
Design of toilets merits serious discussion
NST: PETALING JAYA: Gone are the days when toilets were just toilets. Now, they have morphed into restrooms used for a variety of purposes.
Participants at a half-day public colloquium organised by the Institution of Engineers Malaysia (IEM) yesterday were told that toilet design was not an exact science, but has evolved to suit the changing needs of society.
Fong Tian Yong, adviser to the Housing and Local Government Ministry, said the toilet revolution began in Korea in order to upgrade the country's toilet facilities in preparation for hosting the 1988 Olympics and the 2002 World Cup.
Similarly, he said, China is now investing in toilets in preparation for next year's Beijing Olympics.
As far as design issues were concerned, Fong said toilets in the West were usually dry while the ones in Malaysia were always wet and had smaller space.
"Equipment-wise, toilets in Malaysia are not user-friendly, with no hooks to hang bags and unsuitable piping for body cleansing. There is also weak enforcement and no uniformity and method in toilet management."
City Hall Drainage and River Management Department director Hooi Yoke Meng said toilet designs should take into account the culture, behaviour and social habits of users.
He said Muslims need water for cleaning the body after using the washroom and airport toilets needed to be bigger as people bring in a lot things, including their suitcases and trolley.
Toilet doors for the disabled should be sliding for easy accessibility. Women's needs include facilities for breast-feeding and changing diapers.
Participants at a half-day public colloquium organised by the Institution of Engineers Malaysia (IEM) yesterday were told that toilet design was not an exact science, but has evolved to suit the changing needs of society.
Fong Tian Yong, adviser to the Housing and Local Government Ministry, said the toilet revolution began in Korea in order to upgrade the country's toilet facilities in preparation for hosting the 1988 Olympics and the 2002 World Cup.
Similarly, he said, China is now investing in toilets in preparation for next year's Beijing Olympics.
As far as design issues were concerned, Fong said toilets in the West were usually dry while the ones in Malaysia were always wet and had smaller space.
"Equipment-wise, toilets in Malaysia are not user-friendly, with no hooks to hang bags and unsuitable piping for body cleansing. There is also weak enforcement and no uniformity and method in toilet management."
City Hall Drainage and River Management Department director Hooi Yoke Meng said toilet designs should take into account the culture, behaviour and social habits of users.
He said Muslims need water for cleaning the body after using the washroom and airport toilets needed to be bigger as people bring in a lot things, including their suitcases and trolley.
Toilet doors for the disabled should be sliding for easy accessibility. Women's needs include facilities for breast-feeding and changing diapers.
USM's placenta bandage to be exported next year
NST: KOTA BARU: Universiti Sains Malaysia's "biological bandage", an amniotic membrane to treat lacerations and scalding, is expected to be on the international market by next year.
The country's leading research university signed a memorandum of agreement with Cryocord, a Malaysian medical biotechnology company specialising in cord blood banking and stem cell research, to market the product in Indonesia, Cambodia and Vietnam, among others.
The membrane is useful in treating first- and second-degree burns, with the healing taking between three and five days without leaving scars.
It is derived from the placenta and was developed by USM's National Tissue Bank (NTB) 15 years ago. Now, 12,000 amniotic membranes have been used to treat patients.
NTB co-ordinator Dr Suzina Sheikh Ab Hamid said the amniotic membrane was being used in government and private hospitals nationwide.
"Since we did not have any channels to market the product outside the country, the amniotic membrane is only used in local hospitals. We were involved in researching and marketing the product.
"Now, we can focus on doing more research on the product and improve its quality since Cryocord will handle the marketing."
Dr Suzina said NTB was also planning to expand its role as the supplier of skin graft and cornea tissues by offering medical biotechnology services in South-east Asia.
At the signing ceremony, USM was represented by its vice-chancellor, Datuk Prof Dzulkifli Abdul Razak, and Dr Suzina, while Cryocord was represented by its managing director Dr James Then and executive director Henry Low.
The country's leading research university signed a memorandum of agreement with Cryocord, a Malaysian medical biotechnology company specialising in cord blood banking and stem cell research, to market the product in Indonesia, Cambodia and Vietnam, among others.
The membrane is useful in treating first- and second-degree burns, with the healing taking between three and five days without leaving scars.
It is derived from the placenta and was developed by USM's National Tissue Bank (NTB) 15 years ago. Now, 12,000 amniotic membranes have been used to treat patients.
NTB co-ordinator Dr Suzina Sheikh Ab Hamid said the amniotic membrane was being used in government and private hospitals nationwide.
"Since we did not have any channels to market the product outside the country, the amniotic membrane is only used in local hospitals. We were involved in researching and marketing the product.
"Now, we can focus on doing more research on the product and improve its quality since Cryocord will handle the marketing."
Dr Suzina said NTB was also planning to expand its role as the supplier of skin graft and cornea tissues by offering medical biotechnology services in South-east Asia.
At the signing ceremony, USM was represented by its vice-chancellor, Datuk Prof Dzulkifli Abdul Razak, and Dr Suzina, while Cryocord was represented by its managing director Dr James Then and executive director Henry Low.
Act to make all docs report abuse
NST: KUALA LUMPUR: As part of its increased efforts to curb child abuse, the government plans to widen the mandatory reporting of suspected child abuse under the Child Act 2001.
"At present, it is only mandatory for government medical officers and child minders to make a report if there are signs a child has been abused.
"An amendment will also cover private medical practitioners, teachers and non-governmental organisations linked to the welfare of children," said Women, Family and Community Development Minister Datuk Seri Shahrizat Abdul Jalil.
She added that the amendments would be tabled in parliament by the end of this year or early next year, after the tabling of the new Disabled Persons Act.
A Child Protection Policy that promoted child-safe and child-friendly environments would also be submitted to the cabinet this year, she said.
She was speaking at the 53rd national Children's Day celebration, organised by the Ministry of Women, Family and Community Development.
Some 2,000 guests attended the celebration, opened by the prime minister's wife Datin Seri Jeanne Abdullah.
Shahrizat said the government would get tough with those who "are careless and neglect the safety and protection of children".
"We have been very sensitive in dealing with such cases, but from now on we are going to get tough," she said, adding that cases of child abuse and mishandling had increased from just over 1,600 in 2004 to nearly 2,000 last year.
The child abuse and neglect cases reported include physical, sexual or emotional abuse, incest and abandoning of babies.
Jeanne said the deaths of Nurin Jazlin Jazimin, Ooi Ying Ying and Preeshena Varshiny were reflective of the dangers that existed in the world today.
She added the theme for this year -- Safety and Protection of Children is our Priority -- was apt, given the issues at hand.
"Let us not turn a blind eye or a deaf ear when we see a child in trouble. It is not solely the duty of the police, but everyone's responsibility to ensure the safety of our children," she said.
Jeanne also presented the Hang Tuah Award for bravery to 11-year-old Muhammad Zulfahmi Zuraidi who saved his two younger brothers from their burning home last year.
The award carries a cash prize of RM5,000.
On June 17, his parents had left him in charge of his two brothers, then aged 6 and 7. He smelled something burning and went into the boys' room to find their beds on fire.
Muhammad Zulfahmi's first reaction was to try and douse the flames with pails of water.
But he soon realised that he would not be able to save his home, and picked up the two boys and fled. The house was razed and the family of five lost all their belongings.
"We lost all our belongings, but my parents and I are glad that we are all safe," said Muhammad Zulfahmi.
"At present, it is only mandatory for government medical officers and child minders to make a report if there are signs a child has been abused.
"An amendment will also cover private medical practitioners, teachers and non-governmental organisations linked to the welfare of children," said Women, Family and Community Development Minister Datuk Seri Shahrizat Abdul Jalil.
She added that the amendments would be tabled in parliament by the end of this year or early next year, after the tabling of the new Disabled Persons Act.
A Child Protection Policy that promoted child-safe and child-friendly environments would also be submitted to the cabinet this year, she said.
She was speaking at the 53rd national Children's Day celebration, organised by the Ministry of Women, Family and Community Development.
Some 2,000 guests attended the celebration, opened by the prime minister's wife Datin Seri Jeanne Abdullah.
Shahrizat said the government would get tough with those who "are careless and neglect the safety and protection of children".
"We have been very sensitive in dealing with such cases, but from now on we are going to get tough," she said, adding that cases of child abuse and mishandling had increased from just over 1,600 in 2004 to nearly 2,000 last year.
The child abuse and neglect cases reported include physical, sexual or emotional abuse, incest and abandoning of babies.
Jeanne said the deaths of Nurin Jazlin Jazimin, Ooi Ying Ying and Preeshena Varshiny were reflective of the dangers that existed in the world today.
She added the theme for this year -- Safety and Protection of Children is our Priority -- was apt, given the issues at hand.
"Let us not turn a blind eye or a deaf ear when we see a child in trouble. It is not solely the duty of the police, but everyone's responsibility to ensure the safety of our children," she said.
Jeanne also presented the Hang Tuah Award for bravery to 11-year-old Muhammad Zulfahmi Zuraidi who saved his two younger brothers from their burning home last year.
The award carries a cash prize of RM5,000.
On June 17, his parents had left him in charge of his two brothers, then aged 6 and 7. He smelled something burning and went into the boys' room to find their beds on fire.
Muhammad Zulfahmi's first reaction was to try and douse the flames with pails of water.
But he soon realised that he would not be able to save his home, and picked up the two boys and fled. The house was razed and the family of five lost all their belongings.
"We lost all our belongings, but my parents and I are glad that we are all safe," said Muhammad Zulfahmi.
Patients must be told about the risks
NST: THERE were undisputed elements of negligence in the treatment of baby Lai Yok Shan, which caused her to lose her left forearm.
Health Minister Datuk Seri Dr Chua Soi Lek reportedly said she should have been treated by a specialist, not a trainee doctor.
This case isn't about higher patient expectations or large amounts of money spent and not getting the desired results -- but a clear case of negligence and of medical error.
Similar stories of medical negligence have been repeatedly highlighted by the media over the years.
The statistics may not look alarming -- 62 negligence cases over seven years and less than 200 cases at court. But, each story of negligence, of a life affected by medical error, is one story too many.
Yet, Dr Tim Hegan of the Medical Protection Society said medical negligence wasn't getting more rampant and the quality of healthcare wasn't sliding.
What then is causing these cases of negligence, time and again? Dr Hegan said it was because of a lack of communication between doctors and patients.
"Doctors should explain to patients what the outcome of a treatment could be and show them that it might go wrong, or there might be an infection or a scar. We try to encourage our doctors to do that and maybe that isn't happening here as much," he said.
Medical Defence Malaysia executive director Dr Eddie Soo said doctors sometimes refused to talk to patients or patients' relatives.
"It's vital that the doctor talks to the patient, explains what's the diagnosis and the treatments available," said Dr Soo, who is also a consultant orthopaedic surgeon with a private hospital.
"Sometimes surgery's not the only answer. The patient must be given a choice -- it's his life, his suffering, his money."
In a landmark ruling by the Court of Appeal last year in the case of Foo Fio Na versus Dr Soo Fook Mun & Anor (see also Page 22), it was affirmed that doctors had a duty to disclose the risk to their patients before performing critical operations and it's for patients to decide whether to go for surgery.
Foo was awarded RM1.2 million in damages, including interest.
She was paralysed 25 years ago following an operation on the spine by Dr Soo to treat her dislocated cervical vertebrae after a car accident.
"If doctors don't really listen to their patients, they won't make the right decisions," said Dr Ponnusamy Muthaya of the Medico-Legal Society.
"Some don't give proper advice or explanation and, more often than not, doctors don't get informed consent from patients before starting any course of treatment."
But sometimes it was not communication, but sheer exhaustion that caused medical error, said Dr Ponnusamy.
"Doctors in the public healthcare system are often overworked. Some countries allow their doctors to work a maximum number of hours, after which they must go off-duty.
"But in Malaysia, we're more worried about bus drivers who work continuously, but are not as worried about our doctors working 18 to 20 hours. Why?"
Dr Soo said the privatisation of healthcare had led to increased competition among doctors and this sometimes resulted in unnecessary procedures or surgeries.
"I get patients who come and tell me that doctors don't say much but just tell them to go for operation.
"If doctors only want to make money, they should go into business, not medicine," said Dr Soo.
There's also a lack of focus on the prevention of error among healthcare workers "from doctors to ambulance drivers", said Dr Ponnusamy.
"There is no mechanism to prevent medical errors from occurring during treatment, where risks are identified and assessed from A to Z and measures are put in place to avoid or minimise risks," he said.
In a statement, the Association of Private Hospitals Malaysia said medical audits were carried out regularly by doctors and hospital management in larger hospitals to ensure good clinical governance.
But Dr Ponnusamy said most hospitals did not have proper medical audits.
And they are not compelled to report cases of medical error or negligence to the Health Ministry, unless it's related to the death of an infant or mother.
APHM said a "sudden mortality conference" was held among doctors for all cases of death, irrespective of normal or sudden or unexplained -- as required under the Private Healthcare Facilities and Services Act 1998.
"Sudden or unexplained deaths are reported to the police. Post- mortems are also conducted. This review is always carried out on a monthly basis," said APHM.
But, not all negligence incidents caused deaths, said Dr Ponnusamy. What about medical errors which caused non-fatal but devastating results such as permanent paralysis?
In addition, Dr Ponnusamy said some people in the medical field did not have the aptitude for the job.
"Patients question everything and medical information is available with a click of the mouse.
"So if a disease isn't treated the way they think it should, they may rightly or wrongly conclude that the doctor has been negligent."
Health Minister Datuk Seri Dr Chua Soi Lek reportedly said she should have been treated by a specialist, not a trainee doctor.
This case isn't about higher patient expectations or large amounts of money spent and not getting the desired results -- but a clear case of negligence and of medical error.
Similar stories of medical negligence have been repeatedly highlighted by the media over the years.
The statistics may not look alarming -- 62 negligence cases over seven years and less than 200 cases at court. But, each story of negligence, of a life affected by medical error, is one story too many.
Yet, Dr Tim Hegan of the Medical Protection Society said medical negligence wasn't getting more rampant and the quality of healthcare wasn't sliding.
What then is causing these cases of negligence, time and again? Dr Hegan said it was because of a lack of communication between doctors and patients.
"Doctors should explain to patients what the outcome of a treatment could be and show them that it might go wrong, or there might be an infection or a scar. We try to encourage our doctors to do that and maybe that isn't happening here as much," he said.
Medical Defence Malaysia executive director Dr Eddie Soo said doctors sometimes refused to talk to patients or patients' relatives.
"It's vital that the doctor talks to the patient, explains what's the diagnosis and the treatments available," said Dr Soo, who is also a consultant orthopaedic surgeon with a private hospital.
"Sometimes surgery's not the only answer. The patient must be given a choice -- it's his life, his suffering, his money."
In a landmark ruling by the Court of Appeal last year in the case of Foo Fio Na versus Dr Soo Fook Mun & Anor (see also Page 22), it was affirmed that doctors had a duty to disclose the risk to their patients before performing critical operations and it's for patients to decide whether to go for surgery.
Foo was awarded RM1.2 million in damages, including interest.
She was paralysed 25 years ago following an operation on the spine by Dr Soo to treat her dislocated cervical vertebrae after a car accident.
"If doctors don't really listen to their patients, they won't make the right decisions," said Dr Ponnusamy Muthaya of the Medico-Legal Society.
"Some don't give proper advice or explanation and, more often than not, doctors don't get informed consent from patients before starting any course of treatment."
But sometimes it was not communication, but sheer exhaustion that caused medical error, said Dr Ponnusamy.
"Doctors in the public healthcare system are often overworked. Some countries allow their doctors to work a maximum number of hours, after which they must go off-duty.
"But in Malaysia, we're more worried about bus drivers who work continuously, but are not as worried about our doctors working 18 to 20 hours. Why?"
Dr Soo said the privatisation of healthcare had led to increased competition among doctors and this sometimes resulted in unnecessary procedures or surgeries.
"I get patients who come and tell me that doctors don't say much but just tell them to go for operation.
"If doctors only want to make money, they should go into business, not medicine," said Dr Soo.
There's also a lack of focus on the prevention of error among healthcare workers "from doctors to ambulance drivers", said Dr Ponnusamy.
"There is no mechanism to prevent medical errors from occurring during treatment, where risks are identified and assessed from A to Z and measures are put in place to avoid or minimise risks," he said.
In a statement, the Association of Private Hospitals Malaysia said medical audits were carried out regularly by doctors and hospital management in larger hospitals to ensure good clinical governance.
But Dr Ponnusamy said most hospitals did not have proper medical audits.
And they are not compelled to report cases of medical error or negligence to the Health Ministry, unless it's related to the death of an infant or mother.
APHM said a "sudden mortality conference" was held among doctors for all cases of death, irrespective of normal or sudden or unexplained -- as required under the Private Healthcare Facilities and Services Act 1998.
"Sudden or unexplained deaths are reported to the police. Post- mortems are also conducted. This review is always carried out on a monthly basis," said APHM.
But, not all negligence incidents caused deaths, said Dr Ponnusamy. What about medical errors which caused non-fatal but devastating results such as permanent paralysis?
In addition, Dr Ponnusamy said some people in the medical field did not have the aptitude for the job.
"Patients question everything and medical information is available with a click of the mouse.
"So if a disease isn't treated the way they think it should, they may rightly or wrongly conclude that the doctor has been negligent."
When docs get it wrong
NST: A baby loses her forearm due to the alleged negligence of a trainee doctor, HIV-tainted blood is given to a woman, and a surgical gauze is left in a woman's abdomen after surgery. These and other incidents highlight medical negligence that is on the rise. TAN CHOE CHOE talks to the experts and the ministry for facts and figures
THE highest number of medical negligence cases in Malaysia occurs in the delivery room.
Health Ministry statistics show that about 4 out of every 10 negligence cases are from the field of obstetrics and gynaecology (O&G).
From 2000 to last year, 61 negligence cases involving government healthcare providers, mainly doctors, have been settled in and out of court.
O&G accounted for 27 of them, or 44 per cent.
Over RM3.47 million has been paid out as compensation. O&G alone accounted for RM1.54 million.
In view of the seriousness of medical negligence, the Attorney-General's Chambers set up a medical negligence unit in 2001 to tackle such cases.
From 2002 until October this year, figures from the unit show there are 186 negligence suits pending in court
Of these, O&G tops the list, accounting for about 41 per cent of the suits.
Media reports of alleged medical negligence in recent years also mostly involve O&G cases.
The most gripping is arguably the death of Felda settler Norizan Ismail last year, four years after she allegedly contracted HIV during blood transfusion after giving birth at a district hospital in Johor.
Then there's Lim Que Moi's story, where a piece of surgical gauze was left in the abdomen during an ovarian surgery in Malacca.
And who can forget the ordeal of baby Lai Yok Shan, who lost her left forearm to gangrene after a houseman inserted an intravenous needle filled with antibiotics into the arm muscles instead of a blood vessel.
Second in the medical field with the most negligence suits is orthopaedics (18 per cent), followed by medical (13), surgery (11), paediatrics (7) and others (10).
This trend is also reflected in the private sector but there's no data to verify this.
But if it's any indication, Medical Protection Society (MPS), the largest indemnifier of private doctors in Malaysia, is recording the highest number of negligence cases in O&G.
However, its head of international medical services, Dr Tim Hegan, declined to reveal figures.
"Many factors could influence (the statistics)... the denominator is up to how many doctors we've got in each group," he said.
"If you're a mum, what you want is a perfect baby. If you don't get it, you'll try to look for an explanation. That's worldwide."
British-based MPS, which has been in Malaysia for more than 40 years, is a world-leading indemnifier of health professionals with about 245,000 members worldwide.
In Malaysia, the medical defence organisation provides coverage for more than 3,000 private doctors, the majority in the private sector.
Dr R. Gunasegaran, an O&G specialist with a private hospital here, said national health indices showed the maternal mortality rate, the infant mortality rate and the neonatal mortality rate had been declining sharply.
"These are the indices to measure how healthcare is doing and these have always been declining, meaning that healthcare has improved. So obviously, there is no worsening of healthcare."
Comparing the indices with the negligence statistics, he found them "a bit of a mismatch" -- the quality of care is improving but litigation is rising.
"It could be because of patient's perception and demand of maternity care."
It may also be that the medical profession has become "a victim of its own success".
"Twenty or 30 years ago, when someone went into labour, there was a fear that the outcome would be quite poor, that you may not have a live mother or a live baby.
"But because we've improved that much, people now expect zero defects," said Dr Gunasegaran.
"There's no perfect outcome. There are risks, both maternal and neonatal, but they are largely minimised."
The total of negligence cases in public hospitals that has been settled by the government averages about nine cases a year in the past seven years, except for a spike last year of 16 cases.
But settled or not, Dr Gunasegaran thinks these cases do not necessarily reflect actual negligence.
"They (the ministry) settle (the cases) on the legal advice that it's better to shorten the whole process by coming to some kind of agreement.
"Like any other legal thing, (when) it's settled, it doesn't mean somebody is wrong, it's settled because (the involved parties) want to move on."
Last year, the ministry's Medical Practice Division received 251 complaints, primarily on unsatisfactory quality of service (54.58 per cent). Most were directed at doctors (49.06 per cent).
MPS is also seeing a gradual increase in overall claims and in the last two years, they average over 200 per year.
Does this mean medical negligence is more rampant?
Not really, said Dr Hegan.
"It's likely to do with increased patients' expectation, as well as their knowledge of their rights and ability to sue and make complaints. (Negligence claims) are increasing in other countries, too. It's a global trend.
"It's not that healthcare is getting worse or doctors are doing funny things. It doesn't relate to that."
This increase could also be due to a better complaints mechanism, said Dr Gunasegaran.
"We've made it very easy for the public to complain. Stop any guy on the street and ask him where he can complain if he's got a medical problem, he'll tell you the MMC (Malaysian Medical Council) or the Health Ministry.
"For other types of complaints, like transport, the person probably won't know where to go."
Interestingly, MPS is recently seeing a rise in claims related to cosmetics surgery. It is recording the second highest number of claims received.
"If I go in (to surgery) to look beautiful and I don't look beautiful when I come out... also, the money thing is important," said Dr Hegan.
"People often sue not because something went wrong and often it isn't. It's because of the amount of money they've paid and the outcome isn't what they wanted."
THE highest number of medical negligence cases in Malaysia occurs in the delivery room.
Health Ministry statistics show that about 4 out of every 10 negligence cases are from the field of obstetrics and gynaecology (O&G).
From 2000 to last year, 61 negligence cases involving government healthcare providers, mainly doctors, have been settled in and out of court.
O&G accounted for 27 of them, or 44 per cent.
Over RM3.47 million has been paid out as compensation. O&G alone accounted for RM1.54 million.
In view of the seriousness of medical negligence, the Attorney-General's Chambers set up a medical negligence unit in 2001 to tackle such cases.
From 2002 until October this year, figures from the unit show there are 186 negligence suits pending in court
Of these, O&G tops the list, accounting for about 41 per cent of the suits.
Media reports of alleged medical negligence in recent years also mostly involve O&G cases.
The most gripping is arguably the death of Felda settler Norizan Ismail last year, four years after she allegedly contracted HIV during blood transfusion after giving birth at a district hospital in Johor.
Then there's Lim Que Moi's story, where a piece of surgical gauze was left in the abdomen during an ovarian surgery in Malacca.
And who can forget the ordeal of baby Lai Yok Shan, who lost her left forearm to gangrene after a houseman inserted an intravenous needle filled with antibiotics into the arm muscles instead of a blood vessel.
Second in the medical field with the most negligence suits is orthopaedics (18 per cent), followed by medical (13), surgery (11), paediatrics (7) and others (10).
This trend is also reflected in the private sector but there's no data to verify this.
But if it's any indication, Medical Protection Society (MPS), the largest indemnifier of private doctors in Malaysia, is recording the highest number of negligence cases in O&G.
However, its head of international medical services, Dr Tim Hegan, declined to reveal figures.
"Many factors could influence (the statistics)... the denominator is up to how many doctors we've got in each group," he said.
"If you're a mum, what you want is a perfect baby. If you don't get it, you'll try to look for an explanation. That's worldwide."
British-based MPS, which has been in Malaysia for more than 40 years, is a world-leading indemnifier of health professionals with about 245,000 members worldwide.
In Malaysia, the medical defence organisation provides coverage for more than 3,000 private doctors, the majority in the private sector.
Dr R. Gunasegaran, an O&G specialist with a private hospital here, said national health indices showed the maternal mortality rate, the infant mortality rate and the neonatal mortality rate had been declining sharply.
"These are the indices to measure how healthcare is doing and these have always been declining, meaning that healthcare has improved. So obviously, there is no worsening of healthcare."
Comparing the indices with the negligence statistics, he found them "a bit of a mismatch" -- the quality of care is improving but litigation is rising.
"It could be because of patient's perception and demand of maternity care."
It may also be that the medical profession has become "a victim of its own success".
"Twenty or 30 years ago, when someone went into labour, there was a fear that the outcome would be quite poor, that you may not have a live mother or a live baby.
"But because we've improved that much, people now expect zero defects," said Dr Gunasegaran.
"There's no perfect outcome. There are risks, both maternal and neonatal, but they are largely minimised."
The total of negligence cases in public hospitals that has been settled by the government averages about nine cases a year in the past seven years, except for a spike last year of 16 cases.
But settled or not, Dr Gunasegaran thinks these cases do not necessarily reflect actual negligence.
"They (the ministry) settle (the cases) on the legal advice that it's better to shorten the whole process by coming to some kind of agreement.
"Like any other legal thing, (when) it's settled, it doesn't mean somebody is wrong, it's settled because (the involved parties) want to move on."
Last year, the ministry's Medical Practice Division received 251 complaints, primarily on unsatisfactory quality of service (54.58 per cent). Most were directed at doctors (49.06 per cent).
MPS is also seeing a gradual increase in overall claims and in the last two years, they average over 200 per year.
Does this mean medical negligence is more rampant?
Not really, said Dr Hegan.
"It's likely to do with increased patients' expectation, as well as their knowledge of their rights and ability to sue and make complaints. (Negligence claims) are increasing in other countries, too. It's a global trend.
"It's not that healthcare is getting worse or doctors are doing funny things. It doesn't relate to that."
This increase could also be due to a better complaints mechanism, said Dr Gunasegaran.
"We've made it very easy for the public to complain. Stop any guy on the street and ask him where he can complain if he's got a medical problem, he'll tell you the MMC (Malaysian Medical Council) or the Health Ministry.
"For other types of complaints, like transport, the person probably won't know where to go."
Interestingly, MPS is recently seeing a rise in claims related to cosmetics surgery. It is recording the second highest number of claims received.
"If I go in (to surgery) to look beautiful and I don't look beautiful when I come out... also, the money thing is important," said Dr Hegan.
"People often sue not because something went wrong and often it isn't. It's because of the amount of money they've paid and the outcome isn't what they wanted."
Monday, November 05, 2007
Suicide data to be ready in August
NST: KUALA LUMPUR: Official statistics on the incidence of suicides in the country will be published from next year.
The first data, comprising suicide cases reported this year, will be released by the National Suicide Registry Malaysia in August.
The data is being compiled by the Psychiatry and Mental Health Services, the Forensic Medicine Services, the Mental Health Registry Unit and the Clinical Research Centre.
The Accident and Emergency Departments of all major hospitals, university hospitals and the police have also been roped in to provide information on suicide cases.
The launch of the registry comes in the wake of a Health Ministry forecast that in the next 10 to 15 years, suicide will emerge as the second highest cause of death in the country after heart diseases.
Kuala Lumpur Hospital's Department of Psychiatry and Mental Health and Mental Health Registry Unit chairman Datuk Dr Abdul Aziz Abdullah said there were no accurate figures on suicides in Malaysia.
Recent estimates put the figure at between nine and 13 per 100,000 people compared with eight in the 1980s. However, health experts say the figure could be higher.
Of particular concern is the suicide rate in the Indian community in peninsular Malay- sia. It is estimated that 30 to 35 Indians in 100,000 commit or attempt suicide as against 15 Chinese and six Malays.
There are no statistics for Sabah and Sarawak or among the Orang Asli.
Dr Abdul Aziz said only confirmed and highly probable suicide cases would be put in the registry.
As such, the real figures could be higher because some suicides might be categorised as accidental death because it was taboo in some communities to spare the psychological burden on survivors or to avoid loss of life insurance payments.
"Whatever it is, there is always the question of reliability whenever suicide figures are presented or discussed. The ministry and others are aware of the gap in information about suicide and have been emphasising the need for a national surveillance system," he told the New Straits Times.
He said the data collected by the registry would be used to identify areas that health providers should focus on.
A website, www.nsrm.gov.my, is being set up for this purpose.
Dr Abdul Aziz said the main causes of suicide in Malaysia were financial problems, depression, drug and alcohol abuse, poverty, childhood abuse and mental problems such as schizophrenia.
Some of the factors that triggered suicides included stress, job loss, examination woes and relationship problems.
Over the last decade, threats and harassment from loan sharks have also resulted in a number of suicides and attempted suicides.
Poisoning, hanging, jumping from high-rise buildings and inhaling carbon monoxide are among the methods used.
The first data, comprising suicide cases reported this year, will be released by the National Suicide Registry Malaysia in August.
The data is being compiled by the Psychiatry and Mental Health Services, the Forensic Medicine Services, the Mental Health Registry Unit and the Clinical Research Centre.
The Accident and Emergency Departments of all major hospitals, university hospitals and the police have also been roped in to provide information on suicide cases.
The launch of the registry comes in the wake of a Health Ministry forecast that in the next 10 to 15 years, suicide will emerge as the second highest cause of death in the country after heart diseases.
Kuala Lumpur Hospital's Department of Psychiatry and Mental Health and Mental Health Registry Unit chairman Datuk Dr Abdul Aziz Abdullah said there were no accurate figures on suicides in Malaysia.
Recent estimates put the figure at between nine and 13 per 100,000 people compared with eight in the 1980s. However, health experts say the figure could be higher.
Of particular concern is the suicide rate in the Indian community in peninsular Malay- sia. It is estimated that 30 to 35 Indians in 100,000 commit or attempt suicide as against 15 Chinese and six Malays.
There are no statistics for Sabah and Sarawak or among the Orang Asli.
Dr Abdul Aziz said only confirmed and highly probable suicide cases would be put in the registry.
As such, the real figures could be higher because some suicides might be categorised as accidental death because it was taboo in some communities to spare the psychological burden on survivors or to avoid loss of life insurance payments.
"Whatever it is, there is always the question of reliability whenever suicide figures are presented or discussed. The ministry and others are aware of the gap in information about suicide and have been emphasising the need for a national surveillance system," he told the New Straits Times.
He said the data collected by the registry would be used to identify areas that health providers should focus on.
A website, www.nsrm.gov.my, is being set up for this purpose.
Dr Abdul Aziz said the main causes of suicide in Malaysia were financial problems, depression, drug and alcohol abuse, poverty, childhood abuse and mental problems such as schizophrenia.
Some of the factors that triggered suicides included stress, job loss, examination woes and relationship problems.
Over the last decade, threats and harassment from loan sharks have also resulted in a number of suicides and attempted suicides.
Poisoning, hanging, jumping from high-rise buildings and inhaling carbon monoxide are among the methods used.
Sunday, November 04, 2007
Increasing awareness on dementia
Star: PETALING JAYA: Filial piety may be the cause of late detection of Alzheimer's Disease among Malaysians, Alzheimer's Disease Foundation Malaysia (ADFM) patron Datin Seri Wendy Ong said.
“Many families, especially in the rural areas, still consider Alzheimer's as part of the aging process and do not seek help and treatment until the situation worsens,” she said.
She said this when opening a public forum entitled “Dementia is Everyone's Business” organised by ADFM yesterday. The forum was held to create awareness and share information on caring for those suffering from dementia.
Wendy Ong, who is the wife of Housing and Local Government Minister Datuk Seri Ong Ka Ting, urged those diagnosed with early dementia to seek medical treatment.
She said this could help caregivers be better prepared and cope with the problem.
“Early treatment will also enable them to maintain a reasonable quality of life,” she said.
Based on international statistics, she said 5% of people between the ages of 65 and 80, and 20% of those aged above 80 will have dementia.
“It is a disease that hits people as young as 45 years old.
“As our population ages, we are going to experience more and more cases of dementia, especially Alzheimer's Disease,” she said.
Speaker Willie Kwa, an ADFM exco member, said it was hard having to look after people with early dementia because they were sometimes rational and other times confused and would talk gibberish.
“Quite often they lose the ability of knowing what they are doing, and have very short attention span and frequent memory lapses,” said Kwa, a retired mental health practitioner for the elderly in Britain.
“Many families, especially in the rural areas, still consider Alzheimer's as part of the aging process and do not seek help and treatment until the situation worsens,” she said.
She said this when opening a public forum entitled “Dementia is Everyone's Business” organised by ADFM yesterday. The forum was held to create awareness and share information on caring for those suffering from dementia.
Wendy Ong, who is the wife of Housing and Local Government Minister Datuk Seri Ong Ka Ting, urged those diagnosed with early dementia to seek medical treatment.
She said this could help caregivers be better prepared and cope with the problem.
“Early treatment will also enable them to maintain a reasonable quality of life,” she said.
Based on international statistics, she said 5% of people between the ages of 65 and 80, and 20% of those aged above 80 will have dementia.
“It is a disease that hits people as young as 45 years old.
“As our population ages, we are going to experience more and more cases of dementia, especially Alzheimer's Disease,” she said.
Speaker Willie Kwa, an ADFM exco member, said it was hard having to look after people with early dementia because they were sometimes rational and other times confused and would talk gibberish.
“Quite often they lose the ability of knowing what they are doing, and have very short attention span and frequent memory lapses,” said Kwa, a retired mental health practitioner for the elderly in Britain.
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