berita - Malaysian Medical Association...30 Doctor Dies in Sg Buloh Road Accident 31 Medical Tourism...

beritaMMA Vol.45 • August 2015


ContentsMMA EXECUTIVE COMMITTEE2015 – 2016

President Dr Ashok Zachariah [email protected]

Immediate Past President Dr H. Krishna [email protected]

President–Elect Dr John Chew Chee [email protected]

Honorary General Secretary Dr Ravindran R. [email protected]

Honorary General Treasurer Dr Gunasagaran [email protected]

Honorary Deputy Secretaries Dr Ganabaskaran [email protected]

Dr Rajan [email protected]

SCHOMOS ChairmanDr Vasu Pillai [email protected]

PPS ChairmanDr Muruga Raj [email protected]

Editorial Board 2015 – 2016

Editor Dato’ Pahlawan Dr R. [email protected]

Ex-Offi cio Dr Ravindran R. [email protected]

Editorial Board Members Assoc Prof Dr Jayakumar [email protected]

Dr Gayathri K. Kumarasuriar [email protected]

Dr Juliet [email protected]

Prof Dr M. [email protected]

Publication AssistantMs [email protected]

The views, opinions and commentaries expressed in the Berita MMA (MMA News) do not necessarily refl ect those of the Editorial Board, MMA Council, MMA President nor VersaComm, unless expressly stated. No part of this publication may be reproduced without the permission of the Malaysian Medical Association. Facts contained herewith are believed to be true as of the date that it is published. All content, materials, and intellectual property rights are owned and provided for by Malaysian Medical Association and its members. VersaComm makes no guarantees or representations whatsoever regarding the information contained herewith including the truth of content, accuracy, safety, or the absence of infringement of rights of other parties. In no circumstances shall VersaComm be held liable for the contents, materials, advertisements contained in this publication. VersaComm has no infl uence over the contents of Berita MMA and all opinions, statements and representations made do not in any manner refl ect that of VersaComm or its employees.

Published byMalaysian Medical Association4th Floor, MMA House, 124, Jalan Pahang, 53000 Kuala LumpurTel: +603 4042 0617; Fax: +603 4041 8187, 4041 9929Email: [email protected] / [email protected]: https://www.facebook.com/malaysianmedicalassociationWebsite: www.mma.org.my© Copyright ReservedISSN 0216-7140 PP 1285/02/2013 (031328) MITA (P) 123/1/91

Consultant

12-A, Jalan PJS 8/4, Mentari Plaza, Bandar Sunway,46150 Petaling Jaya, Selangor Darul Ehsan.Tel: +603 5632 3301; Fax: +603 5638 9909Email: [email protected]

This Berita MMA is a publication only for the members of the Malaysian Medical Association. The Malaysian Medical Association does not warrant, represent or endorse the accuracy, reliability or completeness of the contents of Berita MMA (including but not limited to the advertisements published therein). Under no circumstances shall the Malaysian Medical Association be liable for any loss, damage, liability or expense incurred or suffered in respect of the advertisements and/or from the use of the contents in the Berita MMA. Reliance upon any such advice, opinions, statements, advertisements or other information shall be at the readers’ own risk and the advertisers are responsible for ensuring the material submitted for inclusion in Berita MMA complies with all legal requirements. The advice, opinions, statements and other information does not necessarily refl ect those of the Malaysian Medical Association. Nothing in this disclaimer will exclude or limit any warranty implied by law that it would be unlawful to exclude or limit.

ExCo4 Editorial

8 President’s Message

12 From the Desk of the Hon. General Secretary

MMA Book Launch16 Prime Minister’s Message

18 President’s Speech

20 Gallery

SCHOMOS22 SCHOMOS Update

PPSMMA24 Greetings from the PPSMMA

General 25 Understanding the Dengue Threat

28 Calling Dr. Patience!

29 Humour

MMA in the Press30 Malaysia’s Medical Expertise Better Than In Western Countries

30 Doctor Dies in Sg Buloh Road Accident

31 Medical Tourism Boom

32 Employers Should Bear the Medical Cost of Foreign Employees

33 Doctors Reach Out to Orang Asli

Travelogue36 Amazing Argentina

Personality38 Prof Dr Awang Bulgiba Awang Mahmud

Branch News42 MMA Kedah Buka Puasa at Rumah Islam Hidup Matiku

43 MMA Penang MMA Penang Best Student Awards 2015, Penang Medical College

Memoriam44 Prof Dato’ Dr R. Mahathevan

Mark Your Diary


exco • editorial4

Dato’ Pahlawan Dr R. [email protected]

Editor

hl h

Finally we made it! A book of 250 pages, with 165 photographs and portraits, in hard cover, complete with jacket and casing, documenting the 55-year history of the Malaysian Medical Association was completed in May 2015. Initially intended to be a publication commemorating 50 years of the MMA, it did not take off then due to other pressing issues facing the Council at that time. The project was shelved. A relook at the project was made somewhere in early 2014 and the Council of Prof Dato’ Dr N.K.S. Tharmaseelan approved a revival of the book. Datuk Dr Kuljit Singh, then Hon. General Secretary invited me to work along with him on the project. That was the start of a year of hard work, diffi culties, road blocks, nonetheless satisfying at the end!

We appointed the Publishers, who offered a very reasonable price for 2,000 copies of the book. We accepted that offer. But as work progressed, we noted that it was a tough call! We roped in Past Presidents Dr David Quek, Prof Dato’ Dr Tharmaseelan, former Wilayah Branch Chairperson Dr Azizan Aziz and as ex- offi cio Dr Ravi Naidu, into the Editorial Board.

It was decided early, the book will document the founding of the Malaysian (then Malayan) Medical Association, its founding fathers, the progress and development over 55 years, ending in the year 2014. Hence, within that scope, the book has fi nally taken a very national perspective. We have given emphasis to those who had served in the build up of

the Association, and are no longer with us. A full gallery of the Past Presidents has been created.

The MMA does not have an archives unit, or a dedicated offi cer responsible for the archives, hence much time was spent ‘’digging’’ up materials here and there! Fortunately, a publication: The History of MMA: The First 35 Years published in 1995 was available. Annual Reports, the Berita MMA, and interviews with Past Presidents and Senior Members of the MMA helped. We thank all of them.

The Publishers, had all in all, produced 12 drafts! Dato’ Dr R.S. McCoy, Dato’ Dr V. Thuraisingham, and Tan Sri Dr Mani Jegathesan assisted in the fi nal review of the drafts, and we are indebted to them. Despite all the caution, the ‘Printer’s Devil’ still made its appearance, and we had to correct a few errors after the fi nal printing!

YAB Dato’ Sri Mohd Najib Tun Abdul Razak in his message traces the close

relationship his father had with the MMA. The late Tun Abdul Razak as Prime Minister had officiated the opening of the MMA house and Dato’ Sri Mohd Najib has continued maintaining a close association with the MMA.

V e r y f i t t i n g l y , t h e Foreword to the book is written by a very senior Doctor, Tun Dr Mahathir Mohamad, a Founder Member of the MMA and the one Medical Doctor

who led the Nation as

je

VFwDMMt

w

me

tw

1959 to 2014


exco • editorial6

Prime Minister for 22 years. In a very personal foreword, Tun writes about his joining the MMA as a young Medical Offi cer, later becoming a Life Member, and serving the MMA Council under the Presidency of Dato’ Dr A.W.E. Moreira as the Representative of the Northern Region of the MMA.

A message by the Minister of Health YB Datuk Seri Dr S. Subramaniam, a Life Member of the Association and a former Chairman of the MMA Melaka Branch completes the invited messages.

Thirtieth of June, 2015 will be etched in the annals of the MMA. YAB Dato’ Sri Mohd Najib Tun Razak launched the book in a simple yet historic ceremony at the Offi ce of the Prime Minister at Putrajaya. The

event was also attended by the Minister of Health YB Datuk Seri Dr S. Subramaniam, the Secretary General of the Ministry of Health Tan Sri Farida Bt Mohd Ali, the Director General of Health Services Datuk Dr Noor Hisham Abdullah and the Deputy Director of Health (Medical) Datuk Dr S. Jeyaindran. The MMA Council led by the President Dr Ashok Philip and members of the Editorial Board were present. The event was given wide coverage in the print and electronic media.

The books are now available at the MMA Secretariat and the MMA ExCo will decide on its distribution. The Editors of the book would like to thank all those who had come forward to assist in the completion of this project. Happy Reading!


exco • president’s message8

I was privileged to represent the MMA at the Annual Representative Meeting (ARM) of the British Medical Association (BMA) from 21 to 25 June 2015 in Liverpool. This was my fi rst trip to Liverpool, and I was pleased to fi nd it a fairly compact and pedestrian-friendly place. The hotel where I stayed was about a 20-minute walk from the BT Convention Centre at the Albert Dock, where the meeting was held, and much of the area was pedestrianised, so traffi c was the least of my worries.

The easiest way from Malaysia to Liverpool is via Manchester. From Manchester Airport, it is a 45-minute cab ride to the centre of Liverpool. When I arrived, it was to a dismal drizzle and temperatures in the low teens – hardly summer, to my mind. However, the weather improved over the next few days and became warmer, if still not exactly torrid.

The BT Convention Centre is relatively new and stands by the riverside. It has the advantage of having a fairly large number of variously sized rooms so many sessions can run concurrently. The fi rst day (21st June) I went there to pick up my name tag and conference materials, and then attended the welcome dinner. The next day, in the morning, was the start of the ARM proper.

There are several differences between our own AGM and the BMA ARM. The fi rst is that the ARM is a meeting of the 560 or so members of the Representative Body (RB). These members are elected to represent various groups, such as junior doctors and specialists, and geographical regions. The current chair of the RB is Dr Ian Wilson, and it was he who more or less ran the show at

the meeting. The whole process ran very swiftly and smoothly – motions to be discussed had to be submitted earlier, as at our AGM, but the speakers for and against also had to submit their names ahead of time. If your name is not on the list, you could not speak. Having said that, at the very beginning of the meeting, I became aware of a young doctor at the microphone at the front of the hall. However, because the mic was off, nothing of what she said could initially be heard. Shortly thereafter, the mic was turned on, and we became aware that she was deeply upset that what she considered the “gutting” of

At the Annual Meeting of the British Medical

Association, 2015Dr Ashok Zachariah [email protected]

[email protected]

D A h k Z h i h Ph

~~~The BMA were

gracious hosts, we can learn a lot from

each other, both what to do and, perhaps more importantly,

what to avoid

~~~

With Dr Mark Porter BMA Chair of Council


the NHS by the Government was not being discussed. However, because the motion had not been submitted earlier and her name was not on any list of speakers, Dr Wilson tried to get her to stop so scheduled business could go on. She did not stop, though, and he had to ask the RB delegates whether to proceed or allow her to continue. The consensus was to proceed with business, and the young lady was gently escorted from the stage.

Aside from this slight hiccup, things proceeded smoothly. There was an electronic voting system, but most votes were made by holding up fluorescent pink cards, and usually the majority was overwhelmingly clear and no formal count was taken, even on constitutional amendments. It was only where the difference was not obvious that the electronic voting system was used. This enabled matters to move along quite swiftly, since vote counting manually was not needed, as it is at our AGM. We really must look into getting an electronic voting system as soon as possible.

The BMA was described to me by a member at the welcome dinner as a successful publishing house with a small trade union attached. Though spoken partly in jest, there is more than a little truth in this statement. Firstly, the large amounts of money the BMJ makes for the BMA enables it to run its activities with few fi nancial worries. All the delegates had their travel and accommodation paid for. Secondly, the major function of the BMA, aside from making or responding to healthcare proposals, is to negotiate the terms of service and pay of doctors.

Given this, it is clear that many of the issues which the BMA deals with would be more the realm of SCHOMOS here, as most doctors in the UK work in the NHS. However, as the possibility of a restructuring of the Malaysian healthcare system moves ever closer, we should try to learn from those who have walked this path before and try to avoid repeating their mistakes. The main grouse I heard at the ARM is that general practitioners are quitting in droves because of the pressure they are under. If we in Malaysia go towards a single-payer healthcare system, we must ensure the

primacy of well-trained general practitioners – they will be the backbone of the system. Another thing we must avoid is lumping traditional and complementary medicine under the same fi nancing system. The NHS provides homeopathic services, and one of the debates was on getting rid of such non-evidence based systems. They consume money and resources the NHS has not enough of. Finally, in looking to the future, we must remember that our burden of non-communicable diseases is rising steeply. Without adequate emphasis on health promotion and disease prevention our healthcare budget will be overwhelmed within a decade or two.

The BMA places something of a premium on tradition and ritual. The installation of the new President, on the 23rd of June, was held at the beautiful St George’s Hall and was marked by ceremony and tradition. The ceremony was followed by dinner. The new President, Sir Al Aynsley-Green, is the fi rst Commissioner for Children appointed by the UK Parliament, and he is obviously passionate about his work. He told me later that he is no stranger to Malaysia, as he had worked here as a lecturer many years ago. Incidentally, the position of President is an appointed one, not elected as ours is.

The BMA were gracious hosts, and I hope that we will be able to reciprocate their hospitality in the near future. We can learn a lot from each other, both what to do and, perhaps more importantly, what to avoid.

With new BMA President Sir Al Aynsley-Green and his wife. He is holding MMA’s gift to BMA


Meeting with Director-General of Health, YBhg Datuk Dr Noor Hisham Abdullah and the following issues were discussed:1. National Health Financing – The Ministry of Health

(MoH) is taking a serious view of this matter. They are looking for the right model which will be benefi cial to all concerned parties namely the public, doctors and the MoH. Consultants from Harvard have been appointed to present a model to MoH. Discussions are ongoing and no decision has been made.

2. Pharmacy Bill (RUUF) – The feedback received after discussions with the various stakeholders is “lack of engagement”. Therefore the DG has assured us that the whole bill has been returned to the committee who drafted the bill to redraft the bill. It will then be presented to be viewed and approved by the MoH and the DG. Following that, it will then be uploaded onto the MoH website for feedback. Then all stakeholders will be engaged to give their views and comments. Once that is done, the draft will be submitted to the Attorney General’s Chambers for approval before being forwarded to the Parliament.

3. Induction Course for Trainee Doctors – MMA has requested a slot be given as in the past during this course to promote MMA to the junior doctors. The DG has requested that we write to him offi cially (which has been done).

4. Promotions for those in UD54 and JUSA A, B and C have been delayed. Due to this delay several specialists have resigned. The reply given here was vague and the DG informed that all promotions will be based on performance. Promotions for sub-speciality will also be based on the same performance criteria as all other specialities.

5. Industry sponsorship for Government doctors by pharma companies is not allowed. The DG clarifi ed that the reason for this ban is to prevent any special privileges for these companies by doctors who have been sponsored. However, sponsorship by MMA or other Associations is allowed. MMA has requested for clear guidelines from the MoH on this issue.

6. Request by SCHOMOS MMA was made that MoH becomes a co-sponsor/co-organiser for seminars on Rights and Responsibilities of Government doctors. This is basically to create awareness among junior doctors about their moral and ethical responsibilities towards patients and society. DG rejected this request as MoH will have to be accountable to their auditors. However, he said MoH would rather sponsor their doctors or provides speakers for these seminars as they have been doing in the past. The DG was requested to inaugurate and address these seminars and he has asked for this to be in writing.

7. Personal Data Protection Act (PDPA) – The DG has been given a verbal agreement by his counterpart in the Ministry of Multimedia and Communication that this will come under the purview of the Malaysian Medical Council. He is still waiting for an offi cial letter.

8. Shortage of Medical Offi cers – There is discussion with the Public Services Department to increase the number of posts for medical offi cers.

9. Flexi Hours System – It was brought to the attention of the DG that House Offi cers are not getting enough clinical exposure under the fl exi hours system. The DG responded that the House Offi cer has the option to choose the Flexi Hours System or the 24-Hour Shift System.

Dr Ravindran R. Naidufl [email protected]. General Secretary

From the Desk of theHon. General Secretary

exco • hgs12

Meeting with Director-General of Health, YBhg Datuk Dr Noor Hisham Abdullah at Putrajaya

7 July 2015


Meeting with Bahagian Amalan, Ministry of Health, MMA and PERDIM. The discussion was with regards to the proposed amendments of the Private Healthcare Facilities and Services Act. MMA has:

1. STRONGLY OBJECTED TO ANY OF THE JAIL TERMS in the regulations. To remove all jail terms that are in the regulations.

2. All fi nes to be made compoundable and to set a maximum limit.

Membership and Its Privileges

a) Personal accident insurance for Government doctors provided by AON Insurance Brokers is RM30.00 per year for insured amount of RM100,000. If the member wants a higher coverage he can choose from a choice of ten plans with higher annual premiums.

b) For all other doctors in Private Practice there are six plans for personal accident ranging from RM100,000 to RM1,000,000 from age 18 to 65 years. The premium for RM100, 000 is RM75 annually.

c) Travel Partner – AirAsia – Now every doctor can fl y. Please get into AirAsia Go Corporate Website and select Premium Flex. The perks when you book the premium fl ex are:

1. 20kg bag allowance

2. Complimentary infl ight meal included

3. Complimentary seat selection

4. Any number of fl ight changes up to two hours before departure

5. Dedicated counter for your convenience

6. Fast-track – dedicated lane at KLIA2 Immigration Counter

7. Priority boarding

8. Priority baggage collection at check out

d) Purchase a brand new BMW and get a 5% discount on any model

e) Any new VOLVO purchased get a 3% discount

f) Special rates for hotels in Malaysia

These privileges are only available for MMA members. We are negotiating for more benefi ts and I shall keep all of you updated. Please get your colleagues to become members to enjoy all the above benefi ts as there are more to come.

Meeting with Bahagian Amalan,

MoH, MMA and PERDIM

13 July 2015


MMA Book Launch:The Prime Minister’s Message

Improving the health of all Malaysians and curtai l ing diseases has always been a priority for the Government.

Increasing life expectancy, the growing number of doctors per head of our population, lowered infant mortality and the reduction of affl ictions such as blindness and hearing problems are heartening signs of success in the healthcare fi eld. As a nation we have also managed to keep at bay sporadic incidences of serious public health problems such as dengue fever and foot and mouth disease and we have in place public health programmes for the management of such newer diseases as obesity and diabetes.

There is little doubt that the healthcare system in Malaysia is among the best in the world and we are also fast becoming a successful hub for medical tourism, thereby helping our neighbours to improve their health.

These achievements could not have been possible without the dedication and perseverance of many parties, one of which undoubtedly being the Malaysian Medical Association.

Fifty fi ve years of loyal servitude to the Nation, not only to the practice of medicine but also towards collaborative efforts in continuously working with the Government for the betterment of medicine as evidenced throughout this book.

The relationship between the Ministry of Health and the Malaysian Medical Association is one that is steadfast and symbiotic, resulting in countless advancements in medicine, representation of Malaysia in the global arena, the general business practices of doctors and the welfare of the public in receiving the best treatment and care possible. This relationship deserves praise and unbridled support.

As some readers would know,

my family and I have had a long association with the MMA. My father, Tun Abdul Razak Hussein as Prime Minister in fact attended the opening ceremony of the current headquarters of the MMA in Jalan Pahang opposite the General Hospital in Kuala Lumpur. I have attended a number of special events of the MMA and always found the discussions we have both informative and constructive.

Our vision for Malaysia to be a successful 21st century nation is within sight, but it is imperative that we have remembered that our achievements had their foundation in the hard work, dedication and sacrifi ces of our forefathers. That is why this fi fty fi ve year commemorative book is so important. It is important that we recognise the rich history and vibrant and infl uential personalities that brought the MMA to the respected and iconic position it now holds.

Allow me to take this opportunity to congratulate the Malaysian Medical Association on this historic milestone. The MMA’s unwavering support for doctors and patients does not go unnoticed and I know the MMA will continue its best efforts in improving the healthcare of our nation and the welfare of all doctors in Malaysia.

~~~It is important that

we recognise the rich history and vibrant and influential personalities

that brought the MMA to the respected and iconic

position it now holds

~~~

mma book launch16


mma book launch18

MMA Book Launch:Speech byDr Ashok Zachariah Philip, President MMA30 June 2015

Today, we have gathered to launch a handsome book chronicling fi fty fi ve years of the Malaysian Medical Association (MMA). First, let me record my gratitude to the Prime Minister, who has managed to fi t us into his busy schedule at short notice, for agreeing to offi cially launch this book. As I think many of us are aware, the late Tun Abdul Razak was a friend of the MMA, who offi ciated the opening of MMA House, and his son is continuing the friendship.

Sometimes, in the rush of our daily lives, we do not take time to refl ect on where we have been. We have our eyes fi rmly fi xed ahead of us, focused on our goals. We forget that we are not the fi rst to travel this way. If we look at the experiences of the people who have gone this way before, perhaps we can avoid some of the traps and pitfalls ahead. This is the reason we have brought out this book on the history of the MMA. It would have been more logical or neat, perhaps, if this had been a 50th Anniversary book, but we were also guilty of looking forward too much. By the time we thought about a 50th Anniversary book, the time was too short to allow of its production. Rather than wait till the 60th Anniversary, the MMA Council decided to go for a 55th Anniversary book – perhaps out of fear that in another fi ve years many of our pioneer members might no longer be around to see the book.

Putting this book together was no easy task, and I would like to thank the members of the Editorial Board, especially Dato’ Pahlawan Gen. Dr R. Mohanadas and Datuk Dr Kuljit Singh, as well as our Hon. General Secretary Dr Ravindran R. Naidu for all their hours of hard work. Thanks must also go to our senior members and ex-Presidents who shared their memories freely.

On looking through this book, I was struck by how much things have changed, both for Malaysia and for the Malaysian Medical Association. How much we have both grown and modernised! Yet, despite all that, we still have struggles and diffi culties in healthcare.

In the old days, there were too few doctors and clinics to serve the populace. Now, we have enough doctors, though not enough specialists, and there is an excellent

network of clinics and hospitals, both public and private. However, in the past we dealt a lot with infective diseases, which we could often cure. Now we deal with diabetes, hypertension and heart disease, among others, which we can with great effort and expense control, but not cure. Without a paradigm shift, something will have to give way.

Let us learn from history, both our own and that of more advanced countries. Advances and improvements in healthcare have been made not by replacing or sidelining doctors but by engaging and coopting them.

The Malaysian Medical Association is a vast repository of knowledge and experience which we invite the Ministry of Health to utilise, free of charge. As doctors, we want to ensure that our patients, rich and poor, continue to have unconditional access to one of the best healthcare systems in the world.

Prime Minister, I believe this book will show you how much the doctors and the Malaysian Medical Association have contributed to the development of the country. Let us ensure that these contributions are not just history, but the future as well.

Thank you.

~~~This book will show you how

much the doctors and the Malaysian Medical Association

have contributed to the development of the country.

Let us ensure that these contributions are not just

history, but the future as well

~~~


At th

e Bo

ok L

aunc

h, w

ith th

e Rt

Hon

’ble

Prim

e M

inis

ter

Putr

ajay

a, 3

0 Ju

ne 2

015


Putrajaya30 June 2015

mma book launch 21


schomos22

Dr Kevin Ng Wei [email protected]. Secretary National SCHOMOS

SCHOMOS 1st National Working Committee (NWC) Meeting – 27 June 2015The NWC met for the fi rst time on 27 June 2015 at MMA House and the meeting was well attended. The MMA ExCo was represented by the Immediate Past President and the President-Elect as well as the Hon. General Secretary, Hon. Treasurer, Deputy Secretary and the National PPS Chairman.

A variety of issues were discussed, including issues brought up by the members during the recent AGM. Amongst the issues were:• Conference sponsorship by the industry

and associations• Papers to the MBK as well as follow-ups on

the approved papers• Promotions and staff positions• Housing allowances• Specialist training and retention of trained specialists• Membership drives and membership perks

We discussed the issues in depth and will further discuss the matters with the Ministry during our meetings with them.

The NWC also proposed the activities for the year. There will be two ‘Rights & Responsibilities’ (R&R) seminars hosted by Sabah and Johor respectively. There will also be a National SCHOMOS Conference to be held at Melaka in early 2016, and this would be combined with the previously planned Women Empowerment seminar. Other activities planned include a National Futsal Tournament to be hosted by SCHOMOS Kedah, National Badminton Tournament to be hosted by SCHOMOS Johor and a National Paintball Tournament to be hosted by SCHOMOS Selangor and Wilayah Persekutuan.

Majlis Perdana Perkhidmatan Awam Ke-14 (MAPPA XIV) – 17 June 2015 This annual meeting is a forum to allow the Prime Minister to meet with the upper hierarchy of the Government Servants as well as the associations representing them. The Prime Minister, YAB Dato’ Sri Mohd Najib Bin Tun Abdul Razak chaired the meeting at the Putrajaya Convention Centre which was attended by almost

2,500 civil servants. The forum was a chance for Dato’ Sri Najib to share and explain his vision and aims for the Government Service in the years to come and the implementation of the 11th Malaysia Plan.

Amongst the topics broached by Dato’ Sri Najib were:• Incentives to encourage a more efficient and

innovative public service. Any ministry or department that is able to increase productivity while reducing cost and increasing savings from the proposed budget would be rewarded a percentage of the savings to be given to the staff of the ministry or department. This incentive would be used to reward the staff for innovation and increasing productivity.

• The 11th Malaysia Plan encompasses all aspects to stimulate and maintain growth of the country in the hope that we can achieve developed nation status with a high income population.

• Dato’ Sri Najib also stressed on the importance of professionalism, confidentiality, productivity and improvement in the services provided.

Dato’ Sri Najib also announced the implementation of a new housing allowance scheme for Civil Servants below the 41 grade. This was not extended to those from 41 and above. He also announced a modest bonus of RM500 per person for the Hari Raya celebrations.

Subsequently, after the forum, we then had a chance to visit the various booths from various ministries,

SCHOMOS UpdatesA new term has started for SCHOMOS and on behalf of the committee I would like to express our gratitude to all members who made it up to Kota Bharu for the Annual General Meeting (AGM) and for placing your trust in us to lead SCHOMOS to greater heights. The year has just started and we have a lot of activities planned so look forward to an exciting year ahead.

The Prime Minister at the MoH booth


including our own Ministry of Health (MoH), showcasing new innovations to improve productivity. The MoH was promoting new High Impact Projects under the Public Service Delivery Transformation (PSDT) namely the Cluster Hospital Pilot Project in three states; Melaka (Hospital Melaka, Hospital Alor Gajah and Hopital Jasin), Pahang (Hospital Sultan Haji Ahmad Shah, Temerloh, Hospital Jengka and Hospital Jerantut) and Sabah (Hospital Tawau, Hospital Kunak and Hospital Semporna). Clustering of the hospitals allows for sharing of resources, improving utilisation and decongestion of the lead hospital.

Another project showcased was the LEAN healthcare project from Hospital Tengku Ampuan Rahimah, Klang (HTAR). This project was initiated to decrease the waiting time in the Green Zone of the Emergency and Trauma Department and improve the discharge time from the medical wards in HTAR. Currently, the LEAN AGILE project is being implemented in all main hospitals in the country. It aims to eliminate wastage and increase the productivity of the health system.

Meeting with the Director-General of Health, YBhg Datuk Dr Noor Hisham Abdullah – 7 July 2015 YBhg Datuk Dr Noor Hisham was gracious enough to meet the MMA ExCo as well as representatives from SCHOMOS and PPS for a discussion on issues pertaining to the doctors and healthcare in Malaysia. The meeting started with the DG sharing some input on the direction of healthcare in Malaysia.

He went on to inform us on the transformation of healthcare in Malaysia, where currently efforts are being made to study the possibility of integration of the Private and Government arms of healthcare in our country. He brought up the issues of the shortage of beds in both the Private and Government sector where the ratio is currently around 1.9 beds/1,000 population and ideally

the Government was targeting a ratio of 2.5-3 beds/ 1,000 population. He stressed the importance of having primary care that was affordable, easily obtainable and of the highest quality. One other issue he was keen to see improve was the percentage of day-care surgery to increase from 5% to about 40%-50% of all surgical procedures.

The DG also stressed the importance of sol idar i t y and col lec t ive discussion for all matters. He was keen to engage all involved parties in ensuring transparency of any new regulations to be introduced.

The issues raised by SCHOMOS were:• A short session for introduction to the MMA and

membership drive during the Kursus Induksi for Housemen

– SCHOMOS was given a slot since 22 July 2011 by Bahagian Pengurusan Latihan KKM to speak to new house offi cers during the Kursus Induksi Pegawai Perubatan Pelatih. This gave SCHOMOS a chance to have an interactive session with the new doctors and expose them to MMA. This had been stopped since three years ago. The DG was supportive of this and we will follow-up with his offi ce with regards to this matter.

• R&R Seminar – Datuk Dr Noor Hisham was briefed on the objectives

of this event and he again was supportive in allowing the participants to attend. We requested for him to deliver the keynote address at the upcoming seminars. He has asked us to follow-up on this.

• Promotions and allowances – Subspecialist and specialist allowance – Promotions from UD54 to Jusa C and onwards – Promotions for UD41 to UD44 and so forth – Shortage of positions ▪ Datuk Dr Noor Hisham reiterated that there are

plans for an increase in available positions and promotions.

▪ However, the JUSA promotions will be more stringent and selection for promotion will be performance-based.

• Sponsorship from industry agents for conferences and tax-exemption

– This issue was brought up by the MACC offi cer as this was deemed to be unethical.

– Sponsorship of societies to their members is still allowed.

• Endorsement of MBK Papers – the DG was informed regarding the papers being prepared

– Sabbatical leave – Increment in medical record fees

• House offi cers fl exi hours – The house offi cers are given options to choose

fl exi hours or the previous on-call system. The difference being, double number of calls for fl exi hours as compared to the on-call system

SCHOMOS started working on many of these issues and are hoping to see some results.

Dr Julian Tey (left) and the author represented SCHOMOS at the meeting


Dr Muruga Raj [email protected]

ChairmanNational PPS

Greetingsfrom the PPSMMASince PPSMMA represents all the doctors from the private sector with many contentious issues, it is prudent to have two representatives from PPS at any meetings with the relevant authorities. I must thank Hon. General Secretary Dr Ravi Naidu and the current MMA ExCo Members who are very accommodative of our request.

MMA President, Dr Ashok’s speech at the launch of the “Malaysian Medical Association 55 Years” book was very apt and has touched on pertinent issues faced by the medical fraternity at large and more specifi cally the patients. MMA is still regarded as the number one association that represents the doctors. The Hon. Prime Minister in his speech also mentioned that he has not forgotten about the land that he had promised MMA, and will certainly help.

We were very pleased to get a prompt appointment for a courtesy call and bring up the issues faced by the medical fraternity with the Director-General of Health (MoH), Datuk Dr Noor Hisham Abdullah. PPSMMA was represented by me and Hon. Secretary Dr Arasu. Various contentious issues like TPA/MCO/TPPA and clinic registration were brought up with Datuk Seri Dr Noor Hisham, and he has advised us to continue engaging with the relevant departments in the Ministry of Health. The controversial Pharmacy Bill was also brought up and Datuk Dr Noor Hisham promised that all stakeholders will be consulted before it is posted again in MoH for public feedback. We have promised that during our engagement, we will always place the interest of our patients fi rst. Dr Ashok also discussed about doctors facing jail sentences for minor issues and the DG had promised to look into it and discuss further.

I had also asked the DG if the GPs would be allowed to admit patients in a 24-hour clinic to manage simple cases and dressing patients, which take up hospital beds as there is always a shortage in both the private and Government hospitals. He shot down the idea by saying that we would then need a hospital license. I had asked if we could operate with a nursing home license which would be easier to get but he said NO to that. I intend to continue exploring alternative options with him.

PPS ExCos are meeting up again on 2nd August and we will discuss with all the PPS state chairmen on issues and activities. We are still waiting for our appointment that we have asked the National Secretary to write and invite the pharmaceutical department, associations and FOMEMA for a round table meet.

We shall update you about our progress in the upcoming Berita issues.

~~~We have a good team as the main Council and PPS

will work together with them to produce the

best for all MMA members

~~~

ppsmma24


Dengue is a major public health concern in the tropical and subtropical regions. About 75% of the population exposed to dengue are in the Asia Pacifi c region. Prior to the 1970s, only nine countries reported dengue cases, but now more than 100 countries are affected. Dengue is reported throughout the year.

Dengue is a mosquito-borne viral infection, carried mainly by the Aedes aegypti mosquito. The dengue virus belongs to the genus Flavivirus. There are four genetically distinct but related types of the virus, known as serotypes which are linked by serology, epidemiology and disease pathogenesis, named DENV-1, DENV-2, DENV-3, and DENV-4 respectively. All four dengue serotypes are found to co-circulate and the distribution of the predominant serotypes continues to vary and fl uctuate unpredictably between and within regions.

Dengue disease burden Based on annually reported cases, the World Health Organization (WHO) estimates that approximately 50-100 million new dengue infections occur each year1,2. A recent paper published in the journal ‘Nature’ based on literature reviews and disease distribution modelling, estimated a total of 390 million new dengue infections occur each year3. Asymptomatic cases (294 million cases) accounted for three-fourths of this estimate, and symptomatic cases (96 million cases) accounted for a quarter of infections. While asymptomatic infections may not contribute to the clinical burden of dengue, they provide a large reservoir for potential transmission and have implications for the accurate representation of disease burden.

In Malaysia, dengue was fi rst reported in 1902 in Penang4. It became a public health problem in the 1970s, and became endemic since the early 1990s. Dengue is now highly endemic in Malaysia where all four dengue virus serotypes are found to co-circulate. Malaysia is among the top ten highest dengue-

endemic countries, as reported by the WHO in 2004-2010.

According to the Ministry of Health (MoH), between January and 11 July 2015, there were 62,648 reported cases of dengue, compared to 46,681 cases in the same period in 2014, showing an increase of 34.2% (15,967 cases). Cumulative number of deaths due to dengue was 173, compared to 87 deaths in the same period in 2014, an increase of 98.9%5,6. Selangor contributed the most number of cases by far.

Dengue serotypes 1 (DENV-1) and 2 (DENV-2) are the predominant circulating serotypes in the country in recent years. It is predicted that the current increasing trend will continue in the near future due to the serotype shift between DENV-1 and DENV-2 which occurred in April 2015, as well the cyclical pattern observed in previous years (Figure 3). The Ministry of Science, Technology and Innovation (MOSTI), in collaboration with MoH have produced a daily-updated platform to inform the public on dengue hotspots. It can be accessed at http://idengue.remotesensing.gov.my.

Figure 1: Trends of dengue cases in Malaysia in 2014 and 2015,

Department of Health, Malaysia7

Understandingthe Dengue Threat

Assoc Prof Dr Zetti Zainol [email protected]

Senior Lecturer & Clinical MicrobiologistDepartment of Medical Microbiology & Immunology

Faculty of MedicineUniversiti Kebangsaan Malaysia Medical Centre

Member, MMA Wilayah Branch

r Zr Zr Zr ZZr ZZr Zr Zr Zr ZZZZettettetettettettettettttttttettettettettettttttet ii Zi Zi Zi ZZZZZZZi ZZ iiainiainainaaininnolololololoo RasRasasRasRasRRR hidhidhidhidhidhidhihihih

TREN KES DENGGI DI MALAYSIATahun 2014 dan 2015 (Minggu 26 sehingga 4 Julai 2015)

4000

3500

3000

2500

2000

1500

1000

500

0

JUM

LAH

KE

S

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51

MINGGU EPID

Median 2010-2014 2014 2015

general 25


general26

Figure 2: Comparison of deaths due to dengue in Malaysia

in 2014 and 20157

Figure 3: Serotypes of dengue virus circulating in Malaysia

in 2013, 2014, 20157

Primary versus secondary dengue infectionThe severity of dengue infection varies considerably between primary and secondary dengue infections, due to the immunopathogenesis of dengue. While infection and recovery from one of the four dengue serotypes gives lifelong immunity to that particular strain, subsequent infection or secondary infection by a heterogeneous dengue serotype increases the risk of developing severe dengue or dengue haemorrhagic fever (DHF) (Figure 4). There are 12 possible sequences of infection by any two different serotypes, where each sequence could possibly give rise to a different spectrum of dengue disease. Changes in the predominant circulating serotype have signifi cant implications for the incidence and severity of dengue disease.

The spectrum of dengue illness range from undifferentiated mild febrile illness to severe disease. The clinical course changes with disease progression. Three distinct phases are recognized in dengue, namely febrile, critical and recovery phases1,8.

Febrile phase – description of fever accompanied by body ache, myalgia, arthralgia, headache and

retro-orbital pain. Mild haemorrhagic manifestations may be present, such as petechiae or a positive tourniquet test.

Critical phase – usually between the third day and fi fth day of fever, when the fever subsides and may coincide with increased capillary permeability and circulatory abnormalities. Patients may develop plasma leakage and loss of plasma volume, which may progress to shock and death without appropriate fl uid resuscitation. Severe organ impairment and severe bleeding may also be present.

Recovery phase – plasma leakage stops after 24-48 hours of defervescence and extravascular fl uid is reabsorbed. Patients’ haemodynamics stabilise and the well-being and symptoms improve. However, some patients may be at risk of hypervolaemia at this phase due to excessive or extended fl uid therapy.

Laboratory diagnostic methods A range of laboratory diagnostic methods is available in diagnosing dengue. The choice would depend on the purpose of testing, the time of illness or sample collection, type of laboratory facilities and costs. The methods may involve detection of the virus, viral genome or antigens, or the host’s immune response to the virus (antibodies), or a combination of these. Virus isolation, genome or antigen detection such as the NS1 antigen test can be used during the early phase of infection (fi rst fi ve days). After this time, these tests become less sensitive once the host antibodies develop. Serology (IgG and IgM) can be used to detect antibodies at the end of the acute phase of infection. It is important to gauge the stage of illness in order to obtain the appropriate test. For virus surveillance and epidemiology, molecular methods such as polymerase chain reaction (PCR) is the method of choice, as it is able to determine both the presence of the virus and the serotype.

A need to raise awareness There is a need to raise awareness on dengue

Perbandingan Kematian Denggi2014 dan 2015

1 3 5 7 9 11 13 15 17 19 21 23 25 27 31 33 35 37 39 41 43 45 47 49 5129 53

2014 2015

18

16

14

12

10

8

6

4

2

0

DENGUE SEROTYPEYEAR 2013, 2014 AND 2015

70%

60%

50%

40%

30%

20%

10%

0%

2013 2014 2015

JAN

FEB

FEB

MAR APR

MAY JUN

JUL

AUG

SPT

OCT

NOV

DEC

MAR APR

MAY JUN

JUL

AUG

SPT

OCT

NOV

DEC

JAN

FEB

MAR APR

MAY JUN

JAN

DENV1 DENV2 DENV3 DENV4

Dengue virus 4 serotypes

DENV1

DENV1

Recovery from oneserotype gives lifelongimmunity to that strain

“Antibody-dependentenhancement

Subsequent infections(secondary infections) by different

serotypes increase the risk ofdeveloping

severe dengue/DHF

DENV2

DENV1

DENV3

DENV4

Figure 4: Primary versus secondary dengue infection

transmission and disease. Education at all levels of society, social mobilisation, community empowerment and government legislations should be employed to fi ght dengue. Current prevention methods such as vector control and fogging have had limited success in controlling mosquito proliferation. More active attempts should be undertaken to prevent mosquito breeding sites such as at construction sites and proper waste management.

Precautions should be taken to avoid getting bitten by mosquitos, particularly at the time between dawn and dusk when mosquitos are most active, and measures taken to eliminate mosquitoes around the house and living areas.

There is currently no specifi c antiviral treatment for dengue. Early detection and diagnosis, medical attention, appropriate supportive care and close monitoring of the patients’ progress remain the measures to reduce mortality from dengue. Alternative remedies may supplement but should not replace timely medical attention and lifesaving appropriate management.

A dengue vaccine is thought to provide a major opportunity to reduce the burden of dengue. Several dengue vaccine candidates are now in various stages of development, with technologies such as recombinant, live-attenuated, inactivated, DNA and viral vector vaccines. Currently, the most advanced vaccine is the Sanofi tetravalent, live-attenuated recombinant chimeric vaccine (CYD TDV), which has completed two large phase III clinical trials in Asia and Latin America.

References:

1 WHO, 2009, Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control. Available at http://www.who.int/tdr/publications/documents/dengue-diagnosis.pdf

2 WHO, 2012, Global Strategy for Dengue Prevention and Control.

3 Bhatt S et al. The global distribution and burden of dengue 2013. Nature 496: 504–507.

4 Skae FMT. Dengue fever in Penang. The British Medical Journal 1902, 2:1581-1582.

5 http://idengue.remotesensing.gov.my/idengue/index.php

6 Ministry of Health Malaysia website. http://www.moh.gov.my/index.php/database_stores/attach_download/337/722

7 http://kpkesihatan.com/2015/07/08/

8 Clinical Practice Guidelines on the Management of Dengue Infection in Adults (Revised 2nd Edition), 2010. Available at http://www.moh.gov.my/attachments/5502.pdf


general28

~~~In the process of counselling many

of my patients with relationship

issues, I have also come across many “right yet wrong” situations as well, where the proper tone of voice had not been applied

~~~

Have you ever been in situations where, you are supposed to give something to someone who actually deserves it but do not want to because of the way they asked for it? Or instead of answering someone’s question directly, which could be really appropriate according to the situation, you decide to keep mum and shrug the shoulders instead, because of the way they asked the question?

How about when they offer you something that you really need but you refuse to take it anyway, for the same reason, the way they offered it? The tone of voice was JUST not right, wasn’t it? Join the club, folks. Heard of “ajak–ajak ayam”? It is when someone invites you to an occasion, though he or she does not really want you there, in order to avoid a very uncomfortable situation for all. Imagine the relief when, after perceiving their insincerity through the tone of voice applied to the invitation, you say,” So sorry dear, got another appointment the same day.” You folks believe in “It is not what you ask for that matters but how you ask it, not what you say that matters but how you say it, not what you give that matters but how you give it, and not what you take that matters but how you take it?”

I am sure many would wonder what the big deal is, why should it matter how the phrase is uttered. “I ask you give-lah, what’s the BIG problem? I’m not asking for free what!”. In my practice, I wish sometimes that I could reveal the suppressed Mr Hyde in me (or should it be Mrs Hyde?), and retort back sarcastically to what I consider as nonsensical questions. “You better give me a MC (medical certifi cate); I can’t go to work with this fractured leg, can I?”. I wish I could answer, “Sure, you can hop to work on your other healthy leg” but, that would not be very appropriate. “You are going to give me antibiotics aaaahhh! Is that safe?”. My preferred answer here would have been, “Noooo, it is not safe at all, that is why I am prescribing it. It may even get you bedridden, in which case, I won’t have to see you here again.” a sure way of saying goodbye to my medical career!

In the process of counselling many of my patients with relationship issues, I have also come across many “right yet wrong” situations as well, where the proper tone of voice had not been applied. A housewife came to me one day complaining about an incident which drove her to bed in tears the night before. The family had just settled into the car to drive off for an evening out, when a big sigh escaped from her husband, the breadwinner of the house.

“What’s the problem, honey, tired?” asked the concerned wife. “Of course-laaaaah, it’s been a long day at work, wish I could just stay home and watch TV, but what to do? HAVE to get the children’s books today right? And you did not even cook anything for dinner as well.”. A big huff apparently followed that outburst. It was

the truth, but man, what a way to express it! Imagine what could have happened if the answer was buttered-up a little instead, “I’m tired darling, it’s been a long day at work and I wish I could stay home. Let’s just do this quickly and grab dinner on the way, so I can come home and watch some TV. Maybe you can join me on the couch later?”. The wife proclaimed that she would have even thrown in a long foot massage as well for her beloved, if the scenario had been as such!

While one can argue that the same drama can take place in reversed gender roles, in my opinion, it is all about the tone of voice. How you ask for it,

how you say it, how you give it, how you take it, how you show it, or how you react to it. Most importantly however, is how we, within the medical fraternity, can accept these common faults

as part of normal human behaviour and still move on triumphantly – as in my

case, with lots of patience with our patients!

Calling Dr. Patience!

Dr Juliet [email protected]

Editorial Board MemberLife Member, MMA Wilayah

D J li t M th


HumourPrayers in the Delivery Room:

...the placenta took more than half an hour to be delivered. I tried all the methods I have learned to get the placenta out,

but to no avail. Finally, after some prayers, the placenta came out easily. God helped in the delivery of the placenta,

but I still got the fees! I must remember to give some of the fees to God.

Longest Name:The longest name of a medical speciality is

probably Otonasolaryngology, a term not often used by the doctors themselves. They are often called Ear, Nose and Throat (ENT) specialists

for short. However, some of them have extended their fields to head and neck. So their signboards have gone longer: Clinic Ear, Nose,

Throat, Head and Neck!

If other specialities called themselves by the organs they treat, Gastroenterologists would be called specialists in oesophagus, stomach, intestines and rectum! Gynaecologists will

have more embarrassing terms to use!

Car Plates:In the seventies, the car plates in Penang had two

letters. The Gynaecologists were booking their cars with PV, the Urologists

would choose PU and the Rectal Surgeons PR. Then in Kelantan, doctors were

waiting for the DR car plates!

Tying the Tubes:In my 30 years as a Gynaecologist, I must have sterilised at least 400 women who had decided to complete their family. Unfortunately four of them got pregnant after the ligation. The remarkable power of the human sperm! Two were ectopic pregnancies and surgery was done. One opted for

abortion while the fourth continued the pregnancy with no regret.

On the other hand I had two patients who had successful pregnancies after surgery to re-anastamose their ligated tubes after they remarried. One of them delivered twins!

For some laughter from Dr SK Teoh,[email protected]

Life Member, Ipoh, Perak


general 29


Bernama – 30 June 2015

Malaysia’s Medical Expertise Better Than In Western Countries – Najib

PUTRAJAYA: The m e d i c a l e x p e r t i s e i n Malaysia is comparable and sometimes better than in most Western countries, said prime minister Datuk Seri Najib Tun Razak today. He pointed out that earlier this year, the country’s healthcare system received the top score out of 25 countries surveyed by an American publication, ahead of Spain, France, Ireland and New Zealand.

“We should all be proud of such recognition and I congratulate members of the Malaysian Medical Association (MMA) for the hard work they have put into making Malaysia as one of the best healthcare system in the world. “That is no small achievement,” he said at the launching of the Book, Malaysan Medical Association Fifty Five Years 1959-2014, here today.

N a j i b a d d e d t h a t excellence was also refl ected in the number of foreigners w h o w e r e c o m i n g t o Malaysia to have medical procedures. He noted that Malaysia’s share of the medical tourism market had nearly doubled in the last four years. In 2014, it reached 770,000 patients bringing in revenue of around RM700 million, and this year, the fi gures were expected to rise further to 930,000 patients and a revenue of RM1 billion, he said. “(The fact) that people from around the world have such confi dence in the quality of our doctors and hospitals is visible proof that Malaysia is on course to achieving our goal of becoming a high income status nation by 2020,” he said.

Najib sa id he a lso intended to make Malaysia’s h e a l t h c a r e s y s t e m a s the pr ior ity to enhance competit iveness in the

medical tourism market.”If we are to compare with our neighbouring countries, we have a long way to go and I hope MMA would cooperate with us to help us achieve this challenge,” he said. Through its history, Najib noted the MMA had maintained a close working relationship with the government specially the Ministry of Health, sharing responsibility for the health of the nation. Stressing that the Government viewed the challenges faced by the medical fi eld seriously, Najib pointed out that in the 2015 Budget, the government set out to priortise the well-being of the rakyat and allocated RM23.3 billion for healthcare and facilities.

Also present at the event were Health Minister Datuk Seri Dr S.Subramaniam, Health Director-General Datuk Dr Noor Hisham A b d u l l a h , a n d M M A P r e s i d e n t D r A s h o k Zachariah Philip.

KUALA LUMPUR: A 27-year-old anaesthesiol-ogist died in a road accident in Sungai Buloh while returning home from the Sungai Buloh Hospital yesterday.

Sungai Buloh Police chief Supt Junaidi Bujang said Dr Afi fah Mohd Ghazi died on the spot after the Kelisa car she was driving hit a tree at about 3 pm.

“Her body was sent to the Sungai Buloh Hospital,” he told Bernama when contacted here today.

D r A f i f a h l e a v e s

behind husband Dr Mohd Hafi zuddin Azman, who is a neuro-surgical doctor at the Sungai Buloh Hospital, and a year-old son.

M e a n w h i l e , t h e M a l a y s i a n M e d i c a l Associa t ion ex tended condolences to the family of Dr Afi fah.

Its President, Dr Ashok Zachariah Philip, said in a statement that it was a tragedy for the family and a loss to the profession.

“It is clear from the outpouring of messages of praise and sorrow from her

colleagues and seniors that Dr Afi fah was a well-liked and hardworking doctor,” he said.

Dr Ashok said that “though we cannot be sure yet, it is likely that post-call fatigue and perhaps low blood sugar were factors in the accident”.

He said the MMA would like to support the efforts of the Ministry of Health to increase the number of posts available for medical off icers throughout the country.

“Though civil service

posts have been frozen, we feel special consideration should be extended to the medical fi eld, because both patient load and patient expectations are increasing rapidly, and new services are being offered,” he said.

Shor tages have the potential for devastating effects on patients and doctors alike, and the MMA hopes the efforts of the Ministry of Health to increase medical offi cers post will be successful, he said.

Bernama – 9 July 2015

Doctor Dies In Sungai Buloh Road Accident

featuresxx mma in the press30


New Straits Times – 1 July 2015

PM: Medical Tourism Boom ExpectedPUTR A JAYA: The

Government plans to make Malaysia’s hea lthca re system a priority to boost competitiveness in the medical tourism market.

Prime Minister Datuk Ser i Najib Razak said the country’s share of the medical tourism market had nearly doubled in the last four years, with more than 770,000 patients and RM700 million in revenue recorded last year.

“ T h i s y e a r , t h e f ig u re i s expec ted to rise to 900,000 patients, bringing in RM1 billion in revenue. Compared with neighbouring countries, we have a long way to go.

“That is why we hope to get the Malaysian Medical Associa t ion’s (M M A) cooperat ion (to boost medical tourism),” he said during the launch of the book, Malaysian Medical Associa t ion 55 Years , a t t he P r ime Min is te r’s Depa r t ment Complex i n Perd ana P ut ra here yesterday.

Najib said the country’s healthcare system emerged tops out of 25 countries surveyed by an American p u b l i c a t i o n , p l a c i n g Malaysia ahead of Spain, France, Ireland and New Zealand.

This recognition, he said, showed that medical expertise in the country was comparable and , sometimes, better than that in most Western countries.

“This demonstrates our commitment to healthcare in Malaysia, and to making it available and affordable to all.

“ Indeed , no other healthcare (system) in the world charges such low rates. An outpatient has to pay only RM1 (for treatment), while a visit to a specialist doctor costs only RM5. And, the medicine is free.”

He reiterated that the Government’s RM23.3 billion allocation in the 2015 Budget would be used to build two hospitals in Dungun, Terengganu, and

Seri Iskandar, Perak, as well as 20 clinics and four dental clinics.

The Government will also replace hundreds of haemodialysis machines, and prov ide space i n Government hospitals and clinics for the private sector to contribute 244 machines as part of their corporate social responsibility.

“We have increased tax relief on expenses incurred for the treatment of serious diseases, such as cancer, kidney failure and heart attack. We have also set up a programme that will provide free transportation for sen ior c i t i zens to hospitals,” said Najib.

The Government also announced that it would establish an additional 30 1Malaysia clinics, bringing the total to 290 nationwide.

Present were Health Minister Datuk Seri Dr S. Subramaniam, Health Ministry secretary-general Tan Sr i Datuk Far ida Mohd Ali, Health director-general Datuk Dr Noor

H isham Abdu l lah and MMA President Dr Ashok Zachariah Philip.

M e a n w h i l e , N a j i b commented on the reported poor health of opposition leader Datuk Seri Anwar Ibrahim, who is serving a f ive-year jail term at Sungai Buloh Prison for sodomising his former aide, Mohd Saiful Bukhari Azlan, in 2008.

A n w a r ’s l a w y e r s yesterday claimed that his health has worsened, saying he should be transferred to house arrest.

Najib, in a Facebook post, said: “I want the author it ies to ensu re that he (Anwar) receives the requ i red med ica l treatment.”

Earlier this month, Anwar was admitted to Kuala Lumpur Hospital for scheduled tests.

Upon his discharge, the hospital said Anwar showed no sign of any acute medical condition.

is organized by the Lifestyle Science Cluster at Advanced Medical & Dental Institute,

Universiti Sains Malaysia and sponsored by the Ministry of Education Malaysia.This

international conference will cover various multidisciplinary areas including physical

activity and health as well as clinical exercise physiology.

Registration feesIndividual RegistrationLocal Participant - MYR475International Participant - USD200

Group Registration(5 to a group from the same intitution)Local Participant - MYR2125International Participant - USD850

Important Date :01 May 2015 - Conference Registration & Abstract Submission Open.31 August 2015 - Deadline for Abstract Submission.04 September 2015 - Notification of Acceptance of Abstract to the Corresponding Authors.11 September 2015 - Deadline for Registration of Presenting Authors.5 - 7 October 2015 - Conference Day.Website : http://2015.moheconference.info/Email : [email protected]/[email protected]

International Conference onMovement, Health & Exercise (MoHE)

2015

features xxmma in the press 31

The Sun Daily – 22 July 2015

Employers Should Bear the Medical Cost of Foreign Employees

P E T A L I N G JAYA: Employers must bear the medical cost for their foreign employees and not have them subsidised by tax payers ringgit.

The Federat ion of Malaysian Consumers Associat ions (Fomca) Secretary General Datuk Paul Selvaraj said tax payers have a right to o p p o s e s u b s i d i s i n g im mig rant s’ med ica l fees as their employers should bear the full cost of healthcare and insurance.

“The public healthcare system is for citizens, it is not right that the government to bear the medical cost for these immigrants, the responsibility should fall on the employer’s to bear their medical costs,” he said.

S p e a k i n g i n a n interview with theSun, he also said that this could be a grey area for doctors as their principles dictate that they should not refuse treatment to anyone.

“Of course there will be some compassionate grounds where doctors in the public sector will have to treat these patients. It is hard to turn them away, but who is going to bear the cost for their treatment?

It was reported earlier in the week that Sungai

Siput MP Dr Michael Jeyakumar fi led a leave application for a judicial review over the Health Ministry’s guideline on medical fees for foreigners in the country.

He sa id that the new guidelines would discourage immigrants, both legal and illegal, from seeking medical help as it is too costly and they fear deportation.

D r J e y a k u m a r r a i s e d t h e c o n c e r n that: if neglected, these foreigners might spread diseases like tuberculosis which is currently on the rise in the country.

D a t u k S e l v a r a j however, said that the issue of illegal immigrants needs to be stemmed from border control.

“Illegal immigrants are a bigger issue, the authorities need to stem it from the borders, they can’t be allowed to enter the country illegally and seek medical treatment on public funds,” he said.

T h e M a l a y s i a n Med ica l Associat ion (MMA) also echoed the call saying the impetus lies on the employers to provide medical insurance for their workers, which will be used for treatment fees.

“Some employers a re reluc t ant to allow the workers to use the

insurance for fear the premium will increase the next year. Such employers should have action taken against them,” said MMA President Dr Ashok Philip in an interview with theSun.

Dr Ashok also agreed with Jeyakumar’s stand on diseases spreading if these immigrants are neglected.

“What Dr Jeyakumar fears is that the fees may dissuade foreign workers from seeking treatment for infectious diseases until very late, and during the period they are untreated they might spread the disease. This is a legitimate concern,” he said.

He also said that there is no question of doctors turning away patients for their inability to pay.

“If the doctor feels that treatment is urgent, there will be no question of turning the patient away for inability to pay – humanitarian principles will be maintained,” he said.

D r A s h o k a l s o s u g g e s t e d t h a t t h e health ministry take into considerat ion re-negotiating rates with insurers given the large number of foreign workers in the country.

Dr Ashok also urged for a study to be done by the Health Ministry

to ascertain how many illegal foreign workers are actually treated at government hospitals and also to determine the impact fees might have.

H e a l s o a s k e d the ministry to make exceptions to their policy, especially when public health is at risk. The MoH guidelines state that there is a charge of RM92 for immigrants whereas illegal immigrants will be reported to the police o r t h e I m m ig r a t io n department.

“ T h e M a l a y s i a n Med ica l Associat ion would suggest to the Ministry of Health to carve out exceptions to the policy of charging foreigners where public health is at risk, as for instance in the treatment of infectious diseases like tuberculosis,” he said.

In February last year, Health Minister Datuk Seri Dr S Subramaniam said foreigners were taking about 30% to 40% of the allocation for medical treatment meant for Malaysians.

“They are eating up our medical subsidy,” he was quoted as saying.

W h e n c o n t a c t e d , the Ministry of Health declined to comment on the issue.

featuresxx mma in the press32


The Star – 26 July 2015

Doctors Reach Out to Orang Asli

T H E M a l a y s i a n Med ica l Associa t ion (MMA) Voluntary Corp is planning to construct 50 houses for the orang asli community at Chenderiang in Tapah.

Its chairman, Prof Dr Lekhraj Rampal, said the houses would be built in phases within the next two years in 40 different villages.

P rof Lek h raj , who is a lso a consu lt ant e p i d e m i o l o g i s t i n Un iversit i Put ra Malaysia’s (UPM) Faculty of Medicine and Health Sciences, said the cost of each house is between RM9,000 and RM10,000.

He said MMA paid for the materials needed to bu i ld the houses , while the orang asli community carried out the construction.

The projec t is an i n i t i a t i v e b e t w e e n

Chenderiang assemblyman Datuk Dr Mah Hang Soon, MMA and UPM.

“UPM’s architecture students designed the houses based on the needs of orang asli families.

“The MMA approved RM130,000 for the project, wh ich a lso i ncludes m e d i c a l c a m p s a n d building of the houses.

“We want to reach out to the orang asli, help them, and make them feel that they are part of society and that they are not marginalised,” he said after the offi cial launch of four completed houses at the Batu 16 orang asli village in Tapah last weekend.

Also present were Dr Mah, MMA president Dr Ashok Philip, MMA past president Datuk Dr N.K.S Tharmaseelan and other committee members.

There are 10 houses

located in the village, and so far, four houses have been completed.

Prof Lekhraj said the orang asli community prefer wooden stilt houses i ns tead of concrete structures. He said they feel traditional houses were more comfortable and airy, and therefore the architects from UPM came up with the designs for the houses after many discussions with all parties concerned.

He also said the project would continue to engage, encourage and empower the community.

Citing an example of the village chief of Batu 16, Rose Bah Ranvih, who had helped in the construction of the houses at his village, Prof Lekhraj said with the experience gained Rose would be able to train heads of other villages.

Prof Lekhraj said a de-

worming exercise would also be carried out for the orang asli children in September.

Dr Mah said he was thankful to all involved in the construction of the houses.

He said the government allocated funds for the Housing Project for the Hardcore Poor (PPRT), but the orang asli community preferred to stay in houses they grew up in.

He said the cost of the PPRT houses is generally higher, and the idea to come up with different designs is defi nitely a brilliant idea.

“In time to come, the government and the Department of Orang Asli Development can use the concept as their model for future development,” he added.

Rose, 46, said he felt lucky that his village was chosen for the project.

“I don’t want to stay in a building constructed from cement, but in the type of house that I was born and brought up in.

“Most of the orang asli families don’t like to stay in modern houses, as they prefer to stay in traditional ones,” he added.

Another community member, Bah Jol Bah Dek, 45, said he was very happy that his house had been refurbished.

“Now my six children and my wife can stay comfortably in the house, compared to our old dilapidated structure,” he added.

Dr Mah (left) and Prof Lekhraj (third right) congratulating some of the house owners. Looking on is MMA president Dr Ashok Philip (centre).


features xxmma in the press 33

beritaMMA Vol.45 • August 2015Ushuaia

El Calafate

ARGENTINA

Amazing Argentina!!! travelogue36

Dr Sharon [email protected] Care Medical Centre

Member, MMA Wilayah Branch

To the right is the entire route of this trip.

From Rio de Janeiro, Brazil, we travelled by flight for 2.5 hours to

Iguazzu Falls…The Iguazzu Falls was formed as a result of a volcanic eruption millions of years ago with a tri-border between Brazil, Argentina and Paraguay. The falls are arranged in a way that resembles an inverted alphabet ‘J’ where the borders between Brazil and Argentina runs through a narrow chasm known as the Devil’s Throat. The 2.7km wide and 60-82m high Iguazzu Falls is higher than and twice as wide as the Niagara Falls. We travelled along on a foot trail in admiration of the breathtaking view. We watched this awesome sight as tonnes of water was thrown off the cliffs and the mist rose amongst the jungle. The spectacular waterfall strikes a good balance between natural beauty and the magnifi cient liaison between land and water. Once into the National Park, we were each given plastic raincoats and we walked along the Brazillian side of the canyon to the lower base of the Devil’s Throat. The view was simply amazing.

On the next day we travelled the Argentinian track by foot getting up close to the spectacular splash. It does not end there. Subsequently we went on a private service great adventure boat ride right into the falls and rapids with no concerns of getting drenched. The excitement as we clung on to our seats at the base of the falls was again simply hea r th robb ing . Helicopter rides too are available to give you a bird’s eye view of the impressive f a l l s . T h i s UNESCO World Heritage Site has been used in many movies such as Miami Vice, Indiana Jones and the Kingdom of Crystal Skull, Mr Magoo and Happy Together. Upon visiting Iguazu Falls, US First Lady Eleanor Roosevelt exclaimed, “Poor Niaga ra”.

The idea of travelling to South America was defi nitely not plucked out from thin air, but with much thought, many months of planning and precise preparation leading to the mammoth vacation of 23 Malaysians. We took off on 4 June 2015 to Sao Paulo, Brazil, where we attended the annual Rotary International Convention and subsequently set off on our Amazing Argentina Adventure, which I’d like to share with my fellow colleagues.


BUENOSAIRES

Iguazzu Falls

From Iguazzu Falls, we travelled for two hours by fl ight to Buenos Aires, where we spent a night. Next morning from Buenos Aires, we travelled for 3.5 hours to

El-Calafate.El-Calafate is a small town with a population of 20,000 situated in the southwest part of Santa Cruz Province, Patagonia, Argentina, that meets the Andes and is the gateway t o P e r i t o M o re n o G l a c i e r. Calafate is the name of dark blue-purplish berries found during summer. According to tradition, those who eat this fruit will always return to Patagonia. The primary

industry in this town is tourism, and also of interest are the glaciers. It was told that it is unlike most other glaciers in the world where it is actually advancing rather than receding.

Okay now... what’s the big deal about frozen water in large amounts and chunks of ice? We boarded a private navigation cruise crossing the Canal de las Tempanas heading south and arrived at the majestic Perito Moreno Glacier. The close-up view of the glacier was jaw-dropping and beyond our expectation. We stood in awe of the immense white-and-blue ice glacier right in front of our eyes. We jolted to sudden sounds resembling thunder and gunshots as the icebergs groaned and cracked, sending chunks to plunge right down into the waters. Pictures alone

cannot capture the true experience felt. In the afternoon we were served a sumptuous lunch and champagne as we bid farewell to the blue Arctic circle slushies.

From El-Calafate, we travelled by fl ight for 1.5 hours to

Ushuaia.A busy port and adventure hub, Ushuaia is known as the southernmost city in the world or commonly known as End of the World, where steep streets, cobble stones and jumbled buildings are seen. Upon arrival, we were transferred to Arakur Resort & Spa located 800ft above sea level surrounded by stunning panoramic views, native forest and natural terraces.

The next morning, we set off on the Southern Fuegian Railway or also known as the Train to the End of the World. The scenic journey was an overwhelming experience and the magnifi cent

grandeur of nature was truly worth witnessing. In the afternoon, from the Ushuaia Pier, we sailed on a catamaran through the beautiful landscape

that perfectly combines mountains, woods and the sea into the Beagle Channel passing through Bird Island and Seal Island with photo stops as we watched the Atlantic bird species such as the black-browed albatross,

the skua (type of seagull), steamer duck and sea lions.

Next on the channel was the famous ‘Les Eclaireurs’ Lighthouse, also known as Lighthouse at the End of the World. This 74ft structure guards the sea entrance to Ushuaia. Shortly, we headed back to the pier.

In the evening, we went into a magical winter wonderland nocturnal tour known as the ‘Snow and Fire Excursion’. We each rode on a snowbike through thick snow in Valle Tierra Mayor until we reached an open hut where we were served

delicious brochettes, stew, freshly brewed hot wine and Hachero’s Coffee around a bonfi re in a mountain refuge entertained by music and sing-along session. We returned to our starting

point by hopping onto sleds pulled by husky dogs. I must say though the dogs looked fi erce, but they were actually very friendly, to the extent of allowing us to pet them.

Next morning we travelled back to Buenos Aires for a night of Tango and then fi nally to Kuala Lumpur via Istanbul after 16 days of fun and fellowship.

Truly a trip to be remembered for a lifetime!


personality38

A Morning with Prof Awang Bulgiba

Awang Mahmud

It was the fi fth day of Hari Raya Puasa when we had a pleasant drive in the streets of Kuala Lumpur, devoid of the notoriety of the hustle and bustle of traffi c and human movement that usually dawned in Kuala Lumpur.

As we headed into the Chancellery compound of University of Malaya, ample or rather vast lots of empty car parks invited us. The mission of the day was an interview with Prof Awang Bulgiba Awang Mahmud, the Deputy Vice Chancellor (DVC) of University of Malaya (Academic and International).

We walked into the elegant building to his offi ce that was nestled on the ninth fl oor of the rather quiet post-holiday ambience offi ce section. His secretary greeted us warmly. After a couple of minutes of waiting (we were 20 minutes ahead of our interview time!), we were ushered in to Prof Awang’s offi ce.

A pleasant, smiling gentleman, sporting a beard and glasses befi tting an academician welcomed us. The usual Hari Raya greetings were exchanged with Prof Awang. We were at the right place, at the right time and occasion to sit in his plush offi ce sofa amidst Hari Raya cookies served to us with coffee.

Prof Awang, a son from the Land of the Hornbills, Sarawak, did his early primary and secondary studies at the St Joseph’s primary and secondary school in Kuching. Studies, not unexpectedly was his forte from the start. He excelled at every level; from primary right through secondary school. He had the distinction of being a senior prefect at his school. A believer in holistic education, he excelled in badminton, was active in the debating team of his school and was an active member of the Red Crescent Society.

Upon completing his Foundation studies, like many of us on the crossroads, he pondered his career pathway ahead of him. A real dilemma! Scholarships were showered on him including for studies abroad. Ironically, medicine was not on his fi rst to do list! His late mother was keen that he went for Medicine since he was the eldest in his family

and excelled at school. She set up a tête-à-tête with his uncle, Dr M Sharkawi Jaya who was then an Occupational Physician with Shell Malaysia. The chat with his uncle was the catalyst for him to immerse himself into the world of medicine. The rest is history!

He obtained a place to study medicine at the University of Malaya (UM). His holistic nature of pursuing education continued during his university days where he was the secretary of the college, played badminton and cricket for his residential college and was President of the Medical Society. ‘’Cricket is an intelligent man’s game’’, exclaimed Prof Awang! In addition, he involved himself in photography; worthy to note photography then was a different ball game!

As he reached his fourth year in the medical programme, his extracurricular activities took a back seat as he put his heart and soul in studies. Akin to the lyrics of the song by Tom Jones, love was in the air for the young man. He met the love of his life, a lass from Penang, later girlfriend and now his life partner and wife, Wan Salmiah Eshak. Prof Awang’s

Written by,Assoc Prof Dr Jayakumar Gurusamy [email protected] of Faculty & International CollaborationPerdana University Graduate School of MedicinePerdana University

A smile from the DVC at his table


eyes glowed with pride as he repeatedly emphasised the role his gorgeous lady had in his life. We suppose without her realising it, she has had such a dramatic effect on his life since they met and the changes were mind blowing.

He graduated with a medical degree in 1988. By 1989, a year after his graduation, he added a marriage certifi cate to his MBBS!

Prof Awang’s fi rst posting as a houseman was in Penang on 1 August 1988. Depending on which side of the coin one may look at and wish to be in to experience and learn during a housemanship, Obstetrics and Gynaecology (O&G) was the fi rst posting he was thrown into. 1988 was the Chinese Zodiac Year of the Dragon. The Dragon enjoys a very high reputation in the

Chinese culture. It is the token of authority, dignity, honour, success, luck, and capacity for the Chinese. What a place (Penang!) to be? It was a boom year for babies with 1,500 babies delivered every month at the Penang General hospital. A delivery conducted at the toilet is still etched in his memory. Moving on, he switched over to the medical posting for six months.

As a rookie medical offi cer, he was posted to the Ophthalmology unit under the helm of the late Dr Gomathy Arumugam. Prof Awang later requested for a stint in Surgery under Mr Heah where he served for nine months.

His wife was then studying at the Universiti Kebangsaan Malaysia. He requested for a secondment to University Hospital (UH) to be with his wife in the Klang Valley. At UH, he was posted to the Accident and Emergency (A&E) unit for two years.

Upon his completing the two-year secondment at UH, he returned to Penang with his teacher wife. In the early nineties, Sungai Bakap Hospital became his place of work for the next one year. His early exposure to amniotic fl uid at the O&G department, medicine calls later followed by at Ophthalmology and the excitement and challenges at the surgical as well as A&E did not pave the way for him to hop into the road of curative medicine. He was somehow inclined to the preventive medicine pathway. Lo and behold, Prof Awang subsequently requested and was transferred to the Southern Seberang Prai Health Offi ce. It was here where he started immersing himself and learning the ropes of the Public Health Physician.

After having served at various healthcare facilities for seven years, he applied for and obtained a place at his alma mater to pursue his Master of Public Health. His

immaculate academic track record continued and he exited as the torchbearer of his graduating class.

Somehow, he wanted to move again to Penang to work. Well as they say, Man proposes, God disposes; the Ministry of Health had other plans for him. He was posted to work at the Public Health Institute in Kuala Lumpur.

After a period of one and a half years, Prof Awang felt the moment was right for him to get back to his roots in Sarawak. In 1999, he applied for a post as a lecturer at Universiti Malaysia Sarawak (UNIMAS), Sarawak. The whole application and interview process was tedious. However,

the fi nal outcome to his surprise was a message that he received….”Dukacita dimaklumkan bahawa permohonan tuan gagal.”

Frustrated but not defeated, he went for another interview at the UM for a similar position. In contrast to UNIMAS, the interview process at UM was a walk in the park! The interview panel was chaired by Prof Dato’ Dr Anuar Zaini Md Zain, the then Dean of the Medical Faculty and Prof Jason Teoh who was the head of the Department of Social and Preventive Medicine at UM. At the beginning of the interview, Prof Annuar Zaini quipped, “When can you join us?” The Deputy Director-General of Health (Public Health) during the period, Dato Dr Wan Mahmood gave him the blessings to move over to the academia after almost a decade of service at the Ministry of Health. The journey began than onwards at the premier university!

As a young adrenalised lecturer at UM, he took cognisance of the challenges at the university. The department website was non-functional and the computer laboratory was not linked to the Internet. He volunteered to be the webmaster and within a short span of time he created the department website. This effort was the stimulus for the increase of international students to the department. He made further inroads! Being a doctor did not deter him to learn the nitty gritty aspects in the world of Information Technology (IT). He got hold of 1,000 feet of network cable and hooked up the 12 computers in the IT laboratory to the Internet for a mere RM200.

All good work is appreciated and further work was in store for him! Prof Dato’ Dr Mohd Amin Jalaludin who

Prof Awang gesturing in a jest

~~~With the current rise in the

prevalence of NCDs, we are already seeing parents outliving

their childlren

~~~

berita - Malaysian Medical Association...30 Doctor Dies in Sg Buloh Road Accident 31 Medical Tourism...

Documents

Transcript of berita - Malaysian Medical Association...30 Doctor Dies in Sg Buloh Road Accident 31 Medical Tourism...