50th Merdeka – nightmare of public health system

Our Pathetic Healthcare System
by “Product of the System”

Once upon a long time ago, I vowed as a naive medical student to serve fellow Malaysians with my utmost sincerity.

Despite much disappointment with the mediocrity of our local university, I was determined to repay the rakyat for the subsidy they have provided me with.

It has finally dawned on me that it is practically impossible to provide optimum healthcare in a pathetic healthcare system like Malaysia’s.

Indeed, ours is a system that is flawed at its very roots, and top.

An Obsession of Vanity

The shortcomings of Malaysia’s healthcare are anything but oblivious to the Ministry of Health (MOH).

Instead of putting in concrete efforts to overcome simple problems with simple solutions, the MOH has instead chosen to busy itself with efforts of vanity and exhibitionism.

Penning a rosy Piagam Pelanggan and a lofty “misi dan visi” for every single sub-department will not translate into better services.

Putting our healthcare personnel through time-wasting, brain-washing Kursus Induksi, Biro Tatanegara (BTN) and Penilaian Tahap Kecemerlangan (PTK) programs will not produce more skillful and knowledgeable staff.

Holding weekly perhimpunan pagi hospital and singing patriotic-sounding songs will not miraculously make anyone serve their fellow Malaysians with greater commitment and efficiency.

Forcing our doctors to don bacterial-laden white coats and equally lethal neck ties is the perfect example of style without substance.

Seeking and attaining MS ISO accreditation is far from reflective of the quality of services our patients are receiving.

These fanciful so-called recognitions have instead added unnecessary red tape and rigidity to a clumsy, obese system already burdened and bloated with excessive bureaucracy and paperwork.

The MOH’s misplaced obsession with ISO recognition and protocol is holding everybody back — doctors, nurses, lab technicians, radiographers and everyone else trying to fulfill their duties in a system that frustrates.

While healthcare in much of the rest of the modern world is cruising ahead, Malaysia’s is so very wedged in the medieval ages, with no signs of any prospective improvements under a greedy government more concerned about serving the interests of its cronies in the money-loaded field of medicine.

Arrested in Medieval Ages

The typical government hospital has no computer networking system to store and track patients’ records and investigation results. When a patient is readmitted, there is no inkling what was done in the previous admission. Crucial investigation results are rarely returned to the respective patients’ notes.

Almost everything is traced by phone in an age when people across the globe are downloading music, movies and any form of data at the click of a mouse. Doctors and nurses are kept crazily busy tracing investigations taken weeks and months ago, instead of seeing and attending to patients like they were trained for.

Elsewhere in the medical laboratory, lab technicians are answering relentless phone calls from their clinical colleagues stationed throughout the hospital instead of performing chemical tests and analyzing specimens like they were trained for. Sending specimens and collecting results are all done by foot, resulting in senseless delays in a field that requires a constant sense of exigency.

At a time and age where information transfer has never been much easier, our doctors, nurses and hospital attendants are still scurrying about like messenger pigeons chasing after scraps of paper that could be anywhere in a hospital of 600 beds.

Consequently, a simple two-minute test like a full blood count can be delayed up to hours. Receiving its results can take an eternity. Not uncommonly, some important investigations can never be successfully traced which in bulk, translates to wasted millions as tests are repeated merely because the first ones were nowhere to be found. All that is needed to address this crippling deficiency is a cheap, simple networking system any computer-savvy secondary school kid is capable of setting up.

Time is golden they say, and this is particularly true in cancer, where the difference between a week and a month may mean the difference between survival, morbidity and death. The histopathology services in our government system squirm along at a sluggish pace.

It is totally not uncommon for one to wait months for a tissue diagnosis of a suspected malignancy, by which time the cancer would probably have metastasized. Occasionally and not surprisingly, diagnostic reports disappear altogether, leaving the patient without a final diagnosis.

Frustrated with this gaping weakness of our healthcare system, most doctors choose instead to convince patients to perform their tests in private laboratories and hospitals – at a costly sum, needless to say.

The patients’ loss is the cronies’ gain, as friends of BN in healthcare businesses stroll gleefully on their way to the bank.

Medical wards or refugees camps?

Fifty years of merdeka and liberation from colonialists yet our medical wards are still very much like overrun, pre-war, post-disaster,refugee camps. Sixty patients with a spectrum of ailments are packed like solid popiah into a single ward no larger than a badminton court.

The immunocompromised HIV patient lies beside the old man with active tuberculosis who, coughing towards the immunosuppressed cancer patient on chemotherapy just opposite his bed. There is hardly any observation of barrier nursing or isolation. It is far from surprising that our ill patients are succumbing to multiple infections.

There is zero room for privacy in the typical general ward. Screens are scarce and often impossible in an overcrowded ward. Clinical procedures are performed in full view of other patients and relatives, putting the patient through untold embarrassment and loss of confidentiality.

Unless the Health Minister desires to undergo a digital rectal examination with a strong, curious audience of 60, there is no reason why our mothers and fathers should be put through such ordeals.

The general appearance of our wards is a shame. Rusty beds with broken wheels, faulty drip stands held in place by cheap plaster, blinking fluorescent lamps, and noisy mini-wall fans are the norm of the day and make good for a scene in Dark Water.

Our febrile elderly patients become dehydrated, and literally fry in the seething heat that epitomizes the current state of our hospitals. Septic patients with high fever, chills and rigors waste away in crammy, stuffy, noisy general wards, while the crooks they elected as representatives recuperate from a simple ankle sprain in spacious, air-conditioned single bedded rooms, oblivious to the sufferings of the simple-minded folk who put them in power in the very first place.

As BN-putras plunder the nation even as one is reading this article, ill and sick Malaysians are wasting away in shoddy wards so deficient in so many aspects.

ECG machines so crucial in diagnosing acute cardiac events are sometimes shared between two wards of 80 patients. In times of emergencies, doctors and nurses run helter skelter hunting for elusive ECGs, pulse oximetries, ventilatory bags, oxygen tanks, arterial blood gas machines and heck, even blood pressure sets.

Not uncommonly, life-saving intubation sets are incomplete or faulty and cardiac monitors are so ancient that the readings cannot possibly be taken seriously.

Our patients wait months to undergo CT scans, ultrasounds and MRIs. Inevitably, some patients meet their Maker way before their appointment date.

In one large state in East Malaysia, there are merely two CT scans to serve 2 million people, one of which is low-grade and substandard. With the rise in vascular diseases, most government hospitals still do not offer CT angiography. In an oil-rich nation, is this beyond our means?

In our existing miserable state, doctors, nurses and attendants do not even have working counters of their own and are instead wrestling for limited space to do the ridiculous paperwork bestowed upon them, in stark contrast to the posh, cooling office that the Minister sits in.

Pitiable Corrective Measures

Some hospitals, in a vain attempt to deal with the overcrowded wards, transfer “stable” patients to so-called extension wards which are commonly separated from the main hospital. Not infrequently, these supposedly stable patients deteriorate and require urgent intervention — elusive help which would not arrive as there is usually no resident doctor on-call in these peripheral units located far away from the main hospital building. Many needless deaths occur due to delayed help in these “recovery units” and “extension wards”.

Our clinics are not any better, if not worse. With the massive wealth of Tanah Melayu, it is beyond belief that most of our wards and clinics are not equipped with a computer and printer. Referral letters are hand-written, resulting in unquantifiable confusion, communication errors and disastrous consequences. Specimen tubes have to be labeled manually instead of cheap and convenient printed stickers. Up to five patients undergo consultations simultaneously in a room no bigger than Proton Perdana.

Malaysia boleh?

Emergencies Bereft of Urgency

Government ambulance services are reasonably renowned by now — for the wrong reasons. While the public may decry the unnecessary deaths of Mohd Yusry and Yusnita Abas due to alleged ambulance delay, much more nonsense does not reach public knowledge.

Poorly equipped to begin with, most of our ambulances serve as nothing more than a modified human transporter, with no inbuilt oxygenation, no ready supply of emergency drugs, no intubation sets, no communication services save for the driver’s handphone. Patients’ running out of oxygen supply during an ambulance ride is a daily occurence.

Essentially, our ambulances serve only to transport an ill patient from one place to another in the shortest time possible. Whatever happens in along the way is solely left to God, and beyond the control of any medical personnel, who has few tools to work with.

The sad state of our ambulance services is seen beyond emergencies. In many rural districts, ambulances serve as perhaps the only form of transport for poor patients to travel to a general hospital.

Our ambulances fail miserably even in this undemanding task. Recovering patients end up stranded for weeks awaiting ambulances from the district hospitals to send them home to their anxious families. Ward beds are occupied unnecessarily. Some patients waited so long that by the time an ambulance is actually available, they developed severe hospital-acquired infections due to an unnecessarily prolonged stay in the ward.

Here in Malaysia, the field of emergency medicine is one that lacks a sense of urgency. Uncannily however, such lackadaisical attitude is cleverly hidden during buy-elections – by-elections, I mean.

Unsupportive Support Services

Our sad state stretches far beyond the clinical scenario. Our hospital support services are equally, if not more pathetic.

Faulty elevators lie in ruins, unrepaired for months, causing delay in almost everything and to everyone. The elderly lady with severe osteoarthritis is forced to walk up seven flights of stairs to visit her ailing husband. Is this humane? Far from it.

Urgent phone calls lose their very adjective as doctors wait ten minutes for calls to be answered and a further ten minutes as operators flip through prehistoric, dog-eared antique phone books instead of an ultra-convenient computerized directory. What could have been achieved in minutes and seconds take hours and days instead.

Replacing a burnt bulb takes a mere four minutes but getting the personnel to actually do so may take up to four months. So much for privatization of hospital support services…

What is needed, What is not

Improvements to our healthcare do not require fanciful slogans so characteristic of the Badawi administration. We do not need more time-wasting, money-consuming kursus or more standard operating procedures (S.O.P) that make everything so rigid and methodical. As it is, everything is already moving at snail pace. With that statement, I am of course guilty of insulting the snail.

We need wisdom and sincerity if we are to improve our healthcare. Both unfortunately, are not synonymous with the Barisan Nasional regime.

  1. #1 by Godamn Singh on Saturday, 5 May 2007 - 7:29 am

    Public health system? What system??

  2. #2 by kurakura on Saturday, 5 May 2007 - 7:34 am

    Luckily my parents could just afford to send me to private hospital when I was young.

    Ok. This is another trickle down effect of the NEP. Stupid people become doctors. Stupid people become administrators. Stupid people become quality controllers. Where are the smart people? Mostly down south contributing to one of the best healthcare system in the world.

  3. #3 by kurakura on Saturday, 5 May 2007 - 7:43 am

    A sad story taken from Malaysiakini.com
    Hopefully we can do our part to prevent anotehr story like this.
    Last days of my aunt
    Lim Han Syn
    May 4, 07 4:42pm

    My life and the lives of my family changed for the worse just in the past month. In the 20 years I have been alive, I never knew that incompetence could be fatal to innocent people.

    When my aunt fell ill and upon checking into the Kota Bharu Medical Centre, we were advised to admit her into Universiti Sains Malaysia (USM) hospital in Kota Baru which was said to be better equipped. At USM, it took half-a-day to admit her during which she was made to wait at the registry counter.

    X-rays revealed that she suffered from an intestinal block, a case of hernia, the doctors said. We were told there would be a three-day waiting period before the operation. Blood samples were taken from her. n preparation for the operation, she was not allowed solid foods.

    The following morning, we were told by a doctor they were ‘not confident’ about performing the operation. My aunt started trembling the same morning. A doctor was called. He said an enema was required and told her daughter to administer it herself. He went off.

    My aunt vomited and complained of abdominal pains. Visits to the toilet became more frequent.
    My aunt was then told by a doctor to wait for a specialist to check on her. My family starting questioning the doctor how her abdominal pains became so serious.

    To our surprise, the doctor told us that they had to forgo a procedure whereby toxins were removed from her gastrointestinal tract through a pipe. He said my aunt complained that the procedure, where a pipe was placed down her throat, was uncomfortable.

    The doctor then turned to my aunt and scolded her: “Why didn’t you listen to me?” However, the procedure was then carried out. Some 100ml of mucus was removed. My aunt was hard of breath. Her blood pressure was taken by two trainee nurses. It took them ten minutes, switching from a manual machine to a digital one.

    She was then sent for x-rays the second time. My aunt, at this stage, was still conscious, and still was able to remove her own watch before the x-rays were taken. She then started having breathing difficulties. A small hole was made in her side, and the doctor confirmed that her lungs ‘contained water’ and that it had reached a dangerous level.

    More blood samples were taken. It took fifteen minutes.We were told the specialist had yet to arrive. My aunt was weak. She had no solid food for over a day.

    When another doctor came to make another hole in her side, my aunt lost consciousness. The doctor asked us to be patient. He said specialists were on the way to put her on a machine to help her breathing.

    My aunt passed away minutes later. The specialist never appeared. To the family, the doctors referred to their charts and did not say anything. We were never told exactly what she died of.
    I am very angry at the hospital.

    The staff there are entrusted with peoples’ lives. The doctors there were absolutely incompetent. The nurses were worse still. When the doctors were not around, there were not empowered to do anything. And when they did something, it was done absolutely incompetently.

    In her last moments, when my aunt wanted to be transferred to the Intensive Care Unit (ICU), she was told by nurses that the doctor’s permission needed to be asked first. She was also told that in her state, it was ‘useless’.

    My aunt would not have passed away if she wasn’t admitted into USM. If not for the delay after delay, she would be still alive. She was only 53.

  4. #4 by Unladen Swallow on Saturday, 5 May 2007 - 7:49 am

    …translates to wasted millions as tests are repeated merely because the first ones were nowhere to be found. All that is needed to address this crippling deficiency is a cheap, simple networking system any computer-savvy secondary school kid is capable of setting up.

    Easier said than done. And a simple networking system isn’t going to cover the needs of a hospital, especially where tests are concerned, and since I won’t go into computer terminology right now, I would say that it’s beyond the scope of a secondary school kid.

    Though I haven’t been involved with a local government hospital for a while, I can attest to the dying ICU patient who was placed in the same two-bed ward as I was, in which we were separated by a single layer of curtain. I didn’t catch any of what he was coughing out, so I’m okay with that.

    Maybe I went to a ‘good’ urban hospital, because I haven’t seen any wards with populations of more than perhaps ten, though I can’t really comment, since I have yet to see one, and a few other things that have been highlighted in this topic.

  5. #5 by Tai Lo Chin on Saturday, 5 May 2007 - 8:02 am

    Much of what writer says of our government hospitals is true. The public has experienced it. Though name of writer is not stated, I presume it is Dr Ahmad Sobri, who has been writing extensively and posting his comments in media and blogs. He should run for office in Malaysian Medical Council. It is a platform to lobby with Chua Soi Lek’s MOH. The problems afflicting public health care are those afflicting the entire public delivery system. Malaysia is Mediocrity personified because of rejection of Meritocracy in favour of the ideology of Ketuanan and NEP. This is the mother of all problems in this country. What reforms can one expect in such cultural and political milieu? The brain drain in Malaysia affects all sectors. It is and will be particularly acute for Medical sector. Doctors are a mobile lot. The good ones are wanted all over the world. Singapore recently allowed medical graduates from Universiti Malaya and Universiti Kebangsaan Malaysia to practise in the city-state. This is another door opened. The Singapore Medical Council currently has 86 Malaysian doctors on its register.

    [Clarification – the writer “Product of the System” is not Dr. Ahmad Sobri but another medical doctor. Kit]

  6. #6 by smeagroo on Saturday, 5 May 2007 - 9:32 am

    But dont these patients deserve the very services the recevied? Afterall, those who use these services are from the lower bracket and they are easily fooled by BN every 5 years (and sometimes everytime a SA dies and a buy-election is held). Though I may sound cruel but that’s a reality check for all of them. THis is one area where the opposition can gather evidence to show them how the “crooks” have neglected the very core of national duty ie to provide every citizen with a good health care system. These are the people who ill afford the bills and even if given rm500 every years during GE wont be enough to cover the rising costs of medication and simple diagnosis. Tell them it is time to think not for themselves but for their children’s children.

  7. #7 by Libra2 on Saturday, 5 May 2007 - 9:48 am

    The writer chose to remain anonymous for the simple reason that he would be hounded if his identity is revealed.
    This is Malaysia. The whistle blower is anti-national and traitor. He is never appreciated for public spiritedness. The blood-thirsty Dracula will come out in full force.
    The writer apparently knows the entire system and what is written is ALL true, not most of it as someone commented above.
    The government is famous for pump priming the economy but why is focus on the construction sector all the time. If only all this money is pumped into Health care and Education, this country will see marked changes for the better.
    The 600 million ringgit given to UMNO division should have used for Health Care.
    While the common folks suffer, the PM goes to Autralia for his sinus operation. Other VIPs go to UK even for a routine medical check up. I knew of one who made 2 trips a year to the UK for his check up.

  8. #8 by Libra2 on Saturday, 5 May 2007 - 9:53 am

    “This is one area where the opposition can gather evidence…”
    The evidence is all there for us to see. It is the poor who go to government hospitals and they have no inking what the ideal health care should be.
    The rich go to private hospitals.
    As always it is the poor who suffer.

  9. #9 by vovo on Saturday, 5 May 2007 - 10:04 am

    Many of my family and friends were top scorers in their respective classes and schools and many were from some of the best schools in the Malaysia country. But when my eldest brother and his friends applied to local universities, almost none of them got their choice of courses.

    When it came to my turn in the mid 1980s, I was already prepared to go overseas and did not even attempt to apply to local varsities. But many top scorers I knew not only did not get the courses of their choice, they were given courses that was beneath their intelligence.

    A person capable of being a doctor was asked to go into agriculture. A person who wanted to do economics was asked to do education. A person who wanted to do law was asked to study social science.

    In a number of cases I am personally aware of, those who also had appealed against not being given their choice of course were scolded by officers of the education ministry for ‘being ungrateful’.

    This is the hidden story that has not been told supposedly due to our ‘social bargain’. There is no doubt in my mind there was near-fascist thinking within the education ministry for a number of years. My own personal guess is that it is still happening.

    How is it possible that given the expansion of the number of hospitals in this country – both public and private – there has been not anything even near a corresponding increase in medical students intake?

    My family and friends have almost all moved overseas and have not looked back since our school days. Many of us ended becoming IT engineers and doctors.

    When we tell our growing children of the things we went through, they are aghast. As much as they suffer discrimination in our adopted countries, they are horrified when they discover the things that went on in Malaysia – and are still going on.

  10. #10 by Jan on Saturday, 5 May 2007 - 10:41 am

    As long as this country do not suscribe to meritocracy it will continue to slide backwards. Education and healthcare will be among the first to suffer and it looks like the decades of moddlecoddling and misplaced social engineering is manifesting itself for all to see.
    It’s so plain that NEP policies are no longer relevant but the ruling party is bent on continuing it in the name of Ketuanaan and let the rakyat suffer than to lose perceived political support.
    BN’s type of political strategies are no longer relevant in this day and age but unfortunately for this country the bulk of it’s people are unable to see beyond tarred roads, sewing machines and kain pelekat.
    Quality of the civil services have yet to hit rock bottom and when the time comes the people will suffer so much that there will be a revolution.

  11. #11 by HJ Angus on Saturday, 5 May 2007 - 12:47 pm

    I think my class of 1966 (Sixth Form) was one of the batches that was not affected by the NEP policies.

    But it was a class with only one non-Chinese – that was me.
    We had something like 8 doctors/dentists, 6 engineers and 3 pharmacists.

    But of course after that, we had careers that were also subject to NEP manipulations.

  12. #12 by raven77 on Saturday, 5 May 2007 - 4:48 pm

    Dear LKS

    Chua is a politician who is surrounded by idiots. Only 3 people need to be questioned, Datin Rosnah and Datuk Noorimi who are directly responsible for the above state of affairs and of course the DG Ismail Merican, who should be told to go as well. Health is no laughing matter in many developed countries and hopefully LKS, PKR, etc will go after these people who probably by now killed hundreds of patients.

  13. #13 by Educator on Saturday, 5 May 2007 - 5:41 pm

    Any one of you knows who owns the private hospitals in Malaysia?
    Is it a plot to get more people to go to these private hospitals so that the owners can increase more?

  14. #14 by Educator on Saturday, 5 May 2007 - 5:42 pm

    Sorry, should have been “the owners can increase their earnings”?

  15. #15 by tc on Saturday, 5 May 2007 - 11:06 pm

    I personally had a bad encounter on last Monday .I stopped to help an accident victim in SS2 PJ.She was lying on her back motionless but alive.It was raining then.I shielded her with an umbrella.Her left leg was practically broken into two parts.Her shin bone or tibia was detached from her leg together with all the muscles and arteries.She was really suffering in great pains.I called for an ambulance and provided the details.To my relief, the voice on the other end said that an earlier call had already been made.40 minutes later a fire engine arrived instead.About 5 firemen came down with a stretcher( the one they use in carrying an injured footballer out of the field).One wise fireman said to carry the victim to a nearby petrol kiosk without knowing whether she could be moved or not.To my utter shock they were all wearing very dirty and soiled firemen’s glove.This could cause infections to the existing wounds.What can I say to them then?
    An ambulance finally arrived 50 minutes later.Question is why did it take so long for the ambulance to arrive at the scene?Why aren’t the firemen trained with proper paramedic techniques.In a modern city like PJ,and from University Hospital in Jalan University to SS2 which is about say 3KM, should it take 50 minutes to reach the scene?
    It is cruel for me to wish that the victims should be the loved ones of those on the top and whether they can tolerate such bad services after that.God Bless!

  16. #16 by ihavesomethingtosay on Saturday, 5 May 2007 - 11:08 pm

    “misi dan visi” for every single sub-department will not translate into better services.” – Product of the System

    Aiyo…….. don’t you see, we have PM and DPM that don’t walk the talk? so, what do you expect the rest of the kakis to do? follow lah….

    want change, kick BN out!

  17. #17 by DarkHorse on Saturday, 5 May 2007 - 11:30 pm

    tc, welcome to the world of the underdeveloped and the developing – except that we do not know which was it is developing if it is developing at all!

  18. #18 by goldenscreen on Sunday, 6 May 2007 - 12:06 am

    Public hospitals are pathetic. I remembered a long time ago my brother was involved in a car accident and broke his leg. He was sent to the GH and when we went there found him groaning in pain in the middle of a ward packed with at least 30 people, with nobody attending to him. It was a nightmare. Crowded, hot, noisy, unhygienic. That’s the sad state of our public hospitals and this was 10 years ago. Now it’s still more of the same I guess.

  19. #19 by kurakura on Sunday, 6 May 2007 - 5:07 am

    Wawasan 2020……….a utopialah

    The aim of any decent country is to settle the fundamentals first before buidling te tallest this, the longest that and the biggest what.

  20. #20 by Donald on Sunday, 6 May 2007 - 8:27 am

    It looks like bureaucracy and red tape in MOH / public health is getting worse especially when you look at its’ restructured organisation chart and its’ very long chain of command, and all the paper works when somebody once talked about a paperless working environment. Some of the people sitting in the throne of power have been around for ages and these are the very people who have the most experience and yet did they contribute to any decision making or they themselves are only following orders. Mobile phones and SMS are strongly condemned but then again you find new commers going straight to the top to report on their latest spying stories. Is this an order from the top or is this the distrust shown in the immediate management who are promoted with little or no experience and have to be manipulated by the more experienced ones ? Egoism is very strong among many of the workers in MOH / public health. Some in power are literally afraid of certain people. For those who know how to dance to the music, they of course find favour and their career life is a bed of roses. For those who know that something is not right somewhere, they have to walk the fiery ground in their career life. There are so many contradictions to all the preachings heard during meetings, seminars, workshop and courses on creating a good working environment. Only nice to know preachings. But the need to know and do things are not there.

  21. #21 by k1980 on Sunday, 6 May 2007 - 10:20 am

    At the way things are going in this underdeveloped country with 4th world management, police outriders should be assigned to ambulances to and from hospitals. After all, whose lives are more important– accident victims in need of medical attention or VIPs in their aircon mercs?

  22. #22 by smeagroo on Sunday, 6 May 2007 - 1:30 pm

    some are in the developing stages and some are in the developed stage. but most of us are still under developed. I am talking about our pockets and money in our bank accounts. Guess who are in the developed stage and developing stages?

    Bravo! The ministers of bolehland. PLunder while u can.

  23. #23 by accountability on Monday, 7 May 2007 - 1:00 am

    we MUST educate our fellow countrymen with the truth of BN’s failings…

    …most are just too unaware of the excesses, failure and collapse of our public delivery system

    the rot is already very deep, we must act fast if malaysia is to have any chance of returning to decency…

  24. #24 by ahkok1982 on Monday, 7 May 2007 - 5:43 pm

    hey, who said tt e ministers were lying when they said tt we r a developing country… well, it is us who misinterpreted them really… we r developing into a 4th world country.
    Now who says tt we r not a developing country?
    Selangor is a developed state? yes, it is… developed into a crime infested state with lots of corruption. yes… it is a developed state.

  25. #25 by palmdoc on Friday, 13 July 2007 - 4:10 pm

    I think there’s still hope as we celebrate our 50th Merdeka and 50 years of Medicine in Malaysia

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