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Africanisation of Malaysian Healthcare

Letter by Elmina Joseph

I refer to Chris Anthony’s letter “Ensure quality at 1Malaysia clinics” in Malaysiakini and couldn’t agree more.

It appears both the Consumers Association of Penang (CAP) Chairman, S. M. Idris and the current DG of Health are clearly consumed by politics rather then ethics. Idris in particular chooses conveniently to sing where the wind blows without an iota of decency nor morality. Whatever happened to his lofty ideals of doctors being properly qualified and trained before they are even allowed to touch patients? Not forgetting the fact that he was one of the prime movers that doctors in this country be leashed by the offensive Private Health Care Facilities Act that govern all clinics.

Perhaps his memory has failed him. Or perhaps he now sees himself championing the cause of the poor even though they only get to see Medical Assistants instead of doctors. Miraculously according to him Medical Assistants who used to help in private and estate clinics are “experienced and qualified” to see patients independently. A far cry from his usual “unqualified, unregistered practitioners”. He backs up his claims now quoting various examples such as nurse practitioners he conveniently has picked from other countries where it appears to be the practice.
Continue reading “Africanisation of Malaysian Healthcare”

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How and why has Malaysia swiftly joined the world’s top eight countries with the highest death toll from A (H1N1) flu pandemic in less than a month?

It is a great relief that there has been no single case of fatality from A (H1N1) flu pandemic in the past 24 hours after a meteoric rise in the past week, totaling cumulative death toll of 67 as of yesterday in a matter four weeks since the first case of fatality.

The question remains however how Malaysia has swiftly joined the world’s top eight countries with the highest death toll from A (H1N1) flu pandemic in less than a month, chalking up a cumulative death toll of 67 after United States (482 fatalities), Argentina (404), Brazil (379), Mexico (163), Australia (118), Chile (112), Thailand (97) and tying with Canada (67) for eighth place?

In a matter of four days, the cumulative death toll in Malaysia had increased by eight fatalities, moving it up from world’s ninth placing with 59 deaths to eighth placing with 67 fatalities, while in other countries the mortality rates have stopped or slowed considerably, like Chile which had registered 105 deaths last weekend, with Thailand remaining static at 97 while Canada had increased by one fatality during this period.
Continue reading “How and why has Malaysia swiftly joined the world’s top eight countries with the highest death toll from A (H1N1) flu pandemic in less than a month?”

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Najib should convene an all-party conference involving all MPs and State Assembly members to launch a national emergency campaign in view of worsening A (H1N1) pandemic

Death toll from the A (H1N1) continues to mount unchecked and relentlessly, adding three more fatalities to a grand total of 67, the latest victims being a 71-year-old man, a 10-year-old girl and a 33-year old woman.

There has been considerable confusion emanating from the Health Ministry, for instance, whether a national health emergency due to the killer pandemic has been declared, as reported by some media, and what it implies.

Health Minister Datuk Seri Liow Tiong Lai said a health curfew would only be considered if the mortality rate goes above 0.4 per cent. He said the country’s mortality rate for A(H1N1) flu is currently between 0.1 per cent and 0.4 per cent.

It is clear that the Health Minister has no real notion of what is the current mortality rate for A(H1N1) as the statement that the current mortality rate between 0.1 per cent and 0.4 per cent is quite meaningless. Continue reading “Najib should convene an all-party conference involving all MPs and State Assembly members to launch a national emergency campaign in view of worsening A (H1N1) pandemic”

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Pneumococcal vaccination limits H1N1 death

Dear all,

Not all who gets H1N1 gets pneumonia BUT all who died of H1N1 gets pneumonia.

So, we should focus on how we can prevent pneumonia if we get H1N1…..
not how to prevent H1N1.

For those high risk group, getting pneumococcal vaccination is one of the defense mechanism we could use against dying from H1N1. You might still get H1N1 but at least you have a 30% lower risk of dying from H1N1.

Studies have shown here that 30% of H1N1 pneumonia related deaths are due to Streptococcus pneumoniae. Getting yourself vaccinated means you have eliminated 30% of the possible risk of dying from H1N1 pneumonia.
Continue reading “Pneumococcal vaccination limits H1N1 death”

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A(H1N1) flu death toll climbs to 62 with daily increase of 283 cases to total 3,857 cases – Japan and South Korea confirm their first A(H1N1) death

The A (H1N1) flu death toll in Malaysia has climbed to 62 with another three fatalities with the daily increase of 283 cases to total 3,857 cases in the country.

On the international front, South Korea and Japan have confirmed their first A (H1N1) death.

The first South-Korea death is a 56-year-old man who returned from a visit to Thailand while the first Japanese death, a man in his fifties, had apparently not been overseas.

The H1N1 flu outbreak, declared a pandemic in June, has spread around the world and could eventually affect 2 billion people, according to World Health Organisation estimates.

The virus has killed more than 800 people worldwide since emerging in April.

For the first time, the Health Minister Datuk Seri Liow Tiong Lai has admitted that A (H1N1) virus could affect five million Malaysians, based on the WHO estimate that that if 20% of Malaysia’s 27.7 million or 5.5 million are at risk and exposed to the virus.
Continue reading “A(H1N1) flu death toll climbs to 62 with daily increase of 283 cases to total 3,857 cases – Japan and South Korea confirm their first A(H1N1) death”

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Why is A (H1N1) death rate in Malaysia four times the global case fatality rate?

Health Minister, Datuk Liow Tiong Lai should explain why Malaysia’s A (H1N1) death rate is four times the global case fatality rate.

Malaysia’s death toll from A (H1N1) flu has topped 56 since the first fatality three weeks ago.

Below I have calculated the mortality rates for the following countries, based on reported number of confirmed H1N1 cases, as of 13 August 2009. Some countries like Singapore have ceased to report on total cases, where their current reports are on the number of patients still receiving treatment in hospitals. Some countries have yet to report their most updated total number of cases, hence I have given their numbers as of the date in brackets below. The number of deaths are as of 13 August.

The following are a comparison of Malaysia’s A (H1N1) flu fatality rate with other countries based on confirmed cases and deaths made public yesterday:
Continue reading “Why is A (H1N1) death rate in Malaysia four times the global case fatality rate?”

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Liow Tiong Lai, Where are You? Karen Lee looking for you

At 5.10 pm, on my blog this morning re: “Large-scale H1N1 awareness campaign welcome but why so belated – after 33 deaths and some 2,000 cases?” , I received this heart-rending post from a mother, Karen Lee from Kota Kemuning, worried about her five-year-old son in the A (H1N1) flu killer pandemic, which has claimed 38 lives since the first death was reported 26 days ago on July 16 and recorded 2,253 cases since the first H1N1 case less than three months ago on May 15, 2009..

Karen wants to ask the Health Minister Datuk Seri Liow Tiong Lai four questions about the A (H1N1) flu pandemic and quite desperate for getting an immediate reply as her son’s life is “at stake”.

These four questions are: Continue reading “Liow Tiong Lai, Where are You? Karen Lee looking for you”

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Large-scale H1N1 awareness campaign welcome but why so belated – after 33 deaths and some 2,000 cases?

The Prime Minister, Datuk Seri Najib Razak yesterday announced that the government will launch a large-scale public awareness campaign on influenza A(H1N1) beginning this week to educate the public on the pandemic in view of the worsening scenario in the country.

This is a welcome though belated initiative and the questions uppermost in everyone’s mind is why this decision was taken so late, after 33 deaths and some 2,000 cases.

Furthermore, why must it take the Prime Minister to intervene personally before such a decision is taken? What then is the use of having a Health Minister?

Would more lives had been saved if the large-scale public awareness campaign had been launched when the first death from the A (H1N1) flu had occurred 25 days ago on July 16?

It is not only the Health Minister who had failed to provide the proper leadership in the campaign against A (H1N1) flu, even the Deputy Prime Minister Tan Sri Muhyiddin Yassin who headed the inter-ministerial committee on A (H1N1) was guilty of a most flippant and irresponsible attitude with his shocking remark: “Even if I am health minister, I cannot guarantee your safety.”
Continue reading “Large-scale H1N1 awareness campaign welcome but why so belated – after 33 deaths and some 2,000 cases?”

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Greatest disappointment of all 18 Najib Cabinet meetings – utter failure to address six urgent national issues from crime, corruption, education, health to nation building

The Cabinet meeting this Wednesday (5th August) is the greatest disappointment of all the 18 Cabinet meetings in the 124 days of Najib premiership because of its utter failure to address at least six urgent national issues ranging from crime, corruption, education, health to nation building.

The Cabinet has irresponsibly skirted grave and urgent national issues including:

  1. Cabinet’s failure to heed nation-wide outrage at its refusal to establish a Royal Commission of Inquiry into the causes and circumstances of Teoh Beng Hock’s mysterious death at the Malaysian Anti-Corruption Commission (MACC) on July 16 instead of breaking up the process into two parts – an inquest into the causes of Teoh’s death and a Royal Commission of Inquiry (RCI) into MACC interrogation techniques.

    The Prime Minister, Datuk Seri Najib Razak had said in Pekan on Tuesday that the Commission of Inquiry into the MACC’s interrogation methods would only begin its work after the inquest into Teoh’s death.

    It is Najib’s ensuing statement that the RCI “will take into consideration the findings of the inquest” which has given Teoh’s family the false hope that if they are not satisfied with the inquest findings, Najib is prepared to consider their request for a Royal Commission of Inquiry into the causes and circumstances of Teoh’s death.

    Continue reading “Greatest disappointment of all 18 Najib Cabinet meetings – utter failure to address six urgent national issues from crime, corruption, education, health to nation building”

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Ministry of Health website latest fatal casualty of the A (H1N1) killer pandemic?

The A (H1N1) flu pandemic toll in Malaysia jumped by four in the past 24 hours from nine to 13.

The latest fatality is six-year-old Mohd Hyafiq Aiman Mohd Saiful Afendi, first death from Pahang, who died at 12.40 pm yesterday after he was admitted to the Tengku Ampuan Afzan (HTAA) Hospital, Kuantan after he developed fever and complained of stomach ache.

The other three latest confirmed A (H1N1) deaths were a three-year-old girl, 12-year-old boy and a 20-year man – all from Malacca.

Since the first case of A (H1N1) flu death two weeks ago on July 23 – a 30-year-old Indonesian – the rate of fatality has increased in pace and numbers, as illustrated by the following table of fatalities:

July 23 – 1 (KL)

July 27 – 1 (Subang Jaya)
Continue reading “Ministry of Health website latest fatal casualty of the A (H1N1) killer pandemic?”

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What a shame, would Muhyiddin be another “Nero playing the fiddle while Rome burned” if he had been Health Minister and faced with two killer epidemics, A (H1N1) and dengue?

What a shame! The MCA Health Minister, Datuk Liow Tiong Lai has to seek refuge in an UMNO leader to come to his defence in the face of criticism of his playing truant from his ministerial duties when Malaysians are faced with two killer epidemics – A(N1H1) and dengue – to the extent that there are people who liken him to “Nero playing the fiddle while Rome burned”!

And what a poor, outrageous and unprofessional defence.

Deputy Prime Minister Tan Sri Muhyiddin Yasin defended Liow’s Ministerial performance with the declaration: “Even if I am health minister, I cannot guarantee your safety.”

Is this an admission and even confession by Muhyiddin that he would be another “Nero playing the fiddle while Rome burned” if he had been Health Minister and similarly faced with two killer epidemics, A (H1N1) and dengue?
Continue reading “What a shame, would Muhyiddin be another “Nero playing the fiddle while Rome burned” if he had been Health Minister and faced with two killer epidemics, A (H1N1) and dengue?”

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Does Tiong Lai agree with WHO estimates that some 110,000 to 500,000 people in Malaysia need hospitalization in A(H1N1) outbreak with 5,500 to 28,000 deaths?

The A(N1H1) death list has shot up by another two victims from four to six – an 11-year-old boy who died at 8.30 am at Hospital Sultanah Aminah Johor Baru yesterday and a 10-year-old girl from Bagan Seri who died at the Bagan Seri Health Clinic at 3 am on Friday.

In New Sunday Times yesterday, the Health director-general Tan Sri Dr. Ismail Merican warned that the influenza A(H1N1) outbreak is getting serious and about to break out of its present “cluster” level into a community disaster.

There have been 39 reported new cases of H1N1, all involving Malaysians – bringing the total number of H1N1 cases so far to 1,429.

It is shocking and outrageous that at a time when the country is facing the onslaught of two killer epidemics, A(H1N1) and dengue, they are not the No. 1 priority concern of the Health Minister, Datuk Liow Tiong Lai who abdicated his responsibility as Health Minister Continue reading “Does Tiong Lai agree with WHO estimates that some 110,000 to 500,000 people in Malaysia need hospitalization in A(H1N1) outbreak with 5,500 to 28,000 deaths?”

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Why was health, in particular the war against two killer epidemics – A(H1N1) and dengue – excluded from Najib’s National Key Result Areas (NKRAs) announced last week?

Health Minister, Datuk Liow Tiong Lai cannot be serious about his ministerial commitment to provide the best health services in the country when the health front, in particular the war against the two killer epidemics of A(H1N1) and dengue are excluded from the National Key Result Areas (NKRAs) announced by the Prime Minister, Datuk Seri Najib Razak last week.

In fact, it is not only Liow but also the Minister for KPIs, Tan Sri Dr. Koh Tsu Koon who should also explain why the Prime Minister’s short-term targets for six NKRAs had excluded health, especially with the country facing two killer epidemics.

There have been 69 new locally-transmitted influenza A(H1N1) cases reported on Thursday, bringing the total number in the country to 1,371 with four deaths so far.

At a recent briefing to the National Influenza Pandemic Task Force meeting (July 27, 2009), Dr Tee Ah Sian, director of communicable diseases of WHO, painted a possible scenario for the Malaysian A (H1N1) pandemic.
Continue reading “Why was health, in particular the war against two killer epidemics – A(H1N1) and dengue – excluded from Najib’s National Key Result Areas (NKRAs) announced last week?”

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A(H1N1) and Dengue killer epidemics – Tiong Lai should take leave from MCA party duties to lead a 24/7 national campaign, resign as Health Minister or take leave as Health Minister so that a “full time” Health Minister can provide leadership

It is shocking that instead of leading the national war against the double epidemics of A(H1N1) and dengue, the Health Minister, Datuk Liow Tiong Lai is leading the national blame game with the MCA-owned Star putting him on the front-page headline news blaming “the lack of vigilance by members of the public and even some doctors”.

Let me tell Tiong Lai. Don’t blame others. If you want to blame somebody, blame yourself for failing to provide the needed leadership to mobilize Malaysians to fight the double epidemics as Health Minister.

Liow does not seem to be a Health Minister who is confronted with the two killer epidemics, with A(H1N1) claiming four deaths and recording a total number of 1,302 cases while dengue has killed 64 and recorded 26,446 cases since January, set to break even last year’s worst dengue epidemic of 49,335 cases and 112 casualties.

The worse is yet to come for both deadly epidemics.
Continue reading “A(H1N1) and Dengue killer epidemics – Tiong Lai should take leave from MCA party duties to lead a 24/7 national campaign, resign as Health Minister or take leave as Health Minister so that a “full time” Health Minister can provide leadership”

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Tiong Lai – do not be like ‘Nero playing fiddle while Rome burns” only interested in playing MCA politics despite mounting deaths from dengue and H1N1 epidemics

Health Minister Datuk Seri Liow Tiong Lai should not be like “Nero playing fiddle while Rome burns” only interested in playing MCA politics despite mounting deaths from dengue and H1N1 epidemics.

The influenza A (H1N1) has claimed a fourth casualty in Malaysia – 20-year-old woman who died of “severe community acquired pneumonia” at 9.40 am on Tuesday at the Malacca Hospital, after suffering from the flu for 11 days.

On the dengue front, two more deaths have occurred this year, a 77-year-old man from Sipitang, Sabah and a 45-year-old female teacher from Ampang, Selangor who died last week.

Since January this year, there have been 26,446 cases and 64 fatalities Liow seems to have forgotten what he started six months ago, when he declared an all-out war against dengue, which recorded the highest number of 49,335 dengue cases and 112 lives last year – 50 per cent of whom were preventable deaths.

Now, Malaysia is heading towards an even higher incidence of dengue cases and fatalities than last year. Continue reading “Tiong Lai – do not be like ‘Nero playing fiddle while Rome burns” only interested in playing MCA politics despite mounting deaths from dengue and H1N1 epidemics”

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Dengue – shouldn’t Health DG be sacked?

Letters
by ABJ

Here we go again. DG Merican laments yet again that the source of Malaysia’s entire healthcare problems lie with private clinics and hospitals as reported by Annie Freeda Cruez, the New Straits Times’ healthcare correspondent “extraordinaire”.

Incredible as it may seem, DG Merican with all the healthcare resources of the Malaysian government at his beck and call, has chosen to blame, yet again, private clinics and hospitals as the main cause for the rising death toll of dengue in Malaysia. Why are we not surprised? What next? Blame the H1N1 on airlines or the virus itself?

Merican appears to have forgotten, that the government’s own understaffed, overcrowded health and rural clinics conveniently close their doors at 4.30pm on the dot driving the hapless population to private clinics, if there is still one that has not closed, in that locality. Continue reading “Dengue – shouldn’t Health DG be sacked?”

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Big Napoleons in MOH

Letters
by mnoria

Big Napoleons in MOH acting like mafia warlords to sabotage the Health Ministry’s official announcements

I hope the Malaysian public have not forgotten the plight of House Officers or young trainee doctors:
1. Forced to work non-stop 36 hours, on-call duty for 24 hours and need to continue with another 12-hour regular, routine duties.

2. Extension of the period of their houseman-ship into two-years from the previous one year only.

The voices of grouses and protests died down totally after:
1. Health Minister Datuk Liow Tiong Lai announced that trainee doctors would now get a day off after carrying out their 24-hour on-call duty.

2. Health Ministry director-general Tan Sri Dr Ismail Merican announced an automatic promotion to grade UD44 upon completion of their two-year houseman-ship.

Please refer to the following two news reports from the Star newspapers for the details: Continue reading “Big Napoleons in MOH”

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Engage Engineers, Not Doctors, To Control Dengue

by M. Bakri Musa

Florida in the summer has the same hot and humid climate as Malaysia. Its topography too is like Malaysia, with plenty of swamps and other stagnant bodies of water. Unlike Malaysians however, Floridians are not regularly threatened with outbreaks of dengue.

The secret is not that Florida has more and better doctors than Malaysia (although that is true) rather that Florida engages its civil engineers and not medical doctors to control vector-driven diseases like dengue. That is much more effective as well as cheaper, both in financial costs and human suffering.

While it is commendable that Dr. Ismail Merican, the Ministry of Health’s Director-General, is spearheading public awareness of dengue during this latest outbreak – the most severe – he is not the best person to do that. Neither his professional background nor his regular duties prepares him for this awesome responsibility. His ministry is not the most appropriate agency to undertake this monumental task.

Like Florida, we should engage civil engineers in local councils and the Ministry of Works, instead of medical doctors in local hospitals and the Ministry of Health. If those engineers could get away from their air-conditioned offices, they would notice those stagnant drains, silted ponds, and ditches with overgrown weeds. If those officers could brave the stench and examine closer, they would see mosquito larva luxuriating in the stagnant waters.

The solution is not to pour toxic chemicals into the water or fog them into the air. Yes, that would be effective, but those same chemicals could eventually leach into our water tables and poison us, that is, if we have not already inhaled them. Get rid of the stagnant water and you would kill off the larva. No larva, no adult mosquitoes, and no vectors to spread the dengue virus.

There is of course a major role for the Ministry of Health. The most obvious is to educate the public and health professionals in recognizing and treating the disease early. The other is in collaborative research with international agencies for prevention (as in vaccine development) as well as treatment. Its Public Health Division could develop sophisticated surveillance strategies using the Internet, GPS, cell phones, and traps laced with chemicals to attract pregnant mosquitoes so as to get real-time information so we could initiate effective and immediate interventions, as the Brazilians are doing. Continue reading “Engage Engineers, Not Doctors, To Control Dengue”

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Liow Tiong Lai – take leave from all MCA duties to spearhead war against dengue

Health Minister Datuk Liow Tiong Lai flew into a rage over my suggestion that the Prime Minister, Datuk Seri Abdullah Ahmad Badawi appoint a new Health Minister if Liow is incapable of being an effective commander-in-chief in an all-out war against the worsening dengue epidemic to check continuing avoidable loss of lives.

Liow descended to a very personal level, resorting to abuses and invective, such as calling me a “poisonous political mosquito”.

I will not go down to Liow’s puerile level as my priority concern is to puncture Liow’s phoney war against dengue which could only lead to more avoidable dengue deaths and sufferings, which had already reached an unprecedented level last year, so that the Health Minister can take full responsibility to mobilize the nation to wage an all-out and successful war against dengue.

Liow failed Malaysians as a Health Minister last year in failing to spearhead a war against dengue, which recorded the highest number of 49,335 dengue cases and 112 dengue deaths in the nation’s history. Continue reading “Liow Tiong Lai – take leave from all MCA duties to spearhead war against dengue”