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.

And if there is one in a rural setting that actually opens for 24 hours patients come in late as a result of costs. Patients who come late with all their attendant symptoms get referred to a government hospital quickly.

But Merican of all people should know that getting them to a government hospital that has the resources of a functioning 24-hour laboratory or platelets with a proper ambulance service and an ICU bed on standby is easier said then done.

Please come to Kota Kinabalu and we will take you through the mayhem some people term “makeshift government services” here. In fact no need to blame private clinics here because they have indeed become part and parcel of government service.

DG Merican needs to wake-up, stop his lowly politicking and move away from the blame culture so deeply embedded in his DNA. Dengue, like almost any other vector borne disease, is all about prevention, not treatment. Merican’s very statement gives him away for the incompetent fool that he is threatening to become. Any other country would have given him the sack instantly. But sigh, we are in Malaysia and so we must tolerate and unfortunately respect his idiosyncrasies too.

Merican. Where are all your health staff? Yes, all those makciks and kakaks who want a cushy 9 to 5 job and refuse to go to the kampongs, shoplots, factories, schools and housing estates to campaign, educate and enforce so that all breeding grounds for this deadly disease are eradicated, assuming of course you have moved away from the “blame the public” doctrine.

Or are they not there at all because, you have channeled all of them and the money the wrong direction into some useless program like halal vaccine or something like that. Is the whole southern region still sharing one useless fogging machine to kill these mosquitoes? And do you still not know that fogging is actually almost useless in today’s battle against dengue.

Private clinics and hospitals have always been the favorite bogeymen for anything and everything that goes wrong in the Ministry of Health ever since the Merican and Chua Soi Lek show began in 2004.

Even Parliament was scammed by these two clowns when MPs were misled into believing that private clinics and hospitals were the source of all Malaysia’s healthcare problems resulting in the passage of yet another new Act.

Perhaps, Merican should use the services of the almost 50 doctors doing their fault finding and blackmailing rounds of private clinics and deploy them instead to fight the mortal dengue menace.

Perhaps Malaysians should engage in a bit of fault finding themselves and ask how this country has descended to such horrific low standards in public healthcare. This Ministry of Hell, long run by a politically lost party which doesn’t have the confidence of the public compounded further now by an incompetent DG is being hit by one health disaster after another repeatedly.

There is a pattern here. And that pattern is – everytime a major health issue arises, please go raid a clinic or pharmacy and take the attention off the issue. It’s only a matter of time before H1N1, malaria, TB, yellow fever, cancer, diabetes, hypertension and ISS (Intellectual Stupidity Syndrome) is also blamed upon on private clinics.

It’s been 5 years running that DG Merican has fooled the public and the government including the cabinet that all is well at this disastrous Ministry tarnishing the government’s credibility in the process. Isn’t it time Najib or whoever is responsible in running this government put an end to this DG’s charade?

  1. #1 by monsterball on Sunday, 14 June 2009 - 7:50 pm

    Blaming others is a trademark of UMNO buggers.
    That’s one of the reason …why our country is heading BACKWARD!!
    Bad attitudes…bad mentality and in state of denials.
    You think he is going to admit..,he is sleeping on the job?

  2. #2 by ktteokt on Sunday, 14 June 2009 - 8:41 pm

    Just remember one thing – “The BN government can do NO WRONG”! Everyone else is a mortal, except these BN goons! Time to send BN into oblivion in the next GE!

  3. #3 by Keewildoo on Sunday, 14 June 2009 - 8:46 pm

    This DG very clever to blame.

    He ought not to blame private clinics and hospitals unless he’s got proof that they mis-diagnose or don’t report dengue cases. Have you proof?

    For decades, Malaysians 30 years have been bitten by Aedes Egypti mosquito and kena dengue.

    So what has he learnt in these decades. Has he collated data on how and where these mosquitoes breed and how to kill their larvae at source? Have effective prevention if it is common sense that prevention better than cure.

    Vector’s larvae breed partly in private properties, many owned by big companies, some abandoned housing projects. Others in blocked drains or stagnant pools.

    What about local authorities, do they take adequate enforcement action? Is there a will to go and inspect these places?

    The writer is right to sarcastically say that to blame private doctors on dengue is like “blaming H1N1 spread on airlines or the virus itself”.

  4. #4 by Keewildoo on Sunday, 14 June 2009 - 9:00 pm

    Director of the Disease Control Division of the Health Ministry, Datuk Dr Hasan Abdul Rahman already clarified that inspections by the Health Ministry and local authorities revealed that residences and shops were primary breeding grounds of the Aedes mosquito that spreads the dengue fever. “Inspections also show that notorious breeding grounds were construction sites, garbage dumps, playgrounds, empty land lots and schools,” he said. Fogging is just a stop gap measure. So much got to do with people’s attitude, so prevention is in direction of education, combined with enforcement, all within area of responsibility of Health Ministry DG and local authorities. If one can’t get govt depts and local authorities to act, its convenient to deflect to blame private practitioners. The later only come into picture when paytient already bitten by the aedes mosquito. DG is to prevent the aede from breeding in the beginning. Quite obvious who should bear main responsibility if there were blame game.

  5. #5 by PureMalaysian on Sunday, 14 June 2009 - 9:15 pm

    If only u guys know the true story on how Merican became the DG, and not the other Deputy DG back then!

  6. #6 by Ken G on Sunday, 14 June 2009 - 9:26 pm

    Din Merican should spend more time doing his job and less time politicking. His handling of the Kugan case was a case of pure politicking and a waste of govt’s resources. Why did he take it upon himself to protect the guilty?

    Unfortunately it is useless twits like him who get promoted. No wonder the country is going to the dogs.

  7. #7 by albert308 on Sunday, 14 June 2009 - 9:34 pm

    Our health ministers has changed hand three times, Chua JM to Chua SL to Liow TL. But, DG still the same. No improvement in public health care, replaced another new DG.

  8. #8 by Taxidriver on Sunday, 14 June 2009 - 9:44 pm

    DG Merican needs to be humble and go to the Little Red Dot to learn from its MOH on how to contain the dengue problem. In the past 2 weeks I visited the Red Dot three times, and on two ocassions I saw their health officers going round checking on HDB flats for potential mosquito breeding grounds. Can we say same about our KKM officers?

    Stop the blame game. Learn from the Little Red Dot.

  9. #9 by limkamput on Sunday, 14 June 2009 - 11:25 pm

    You are DG of Health long enough. Time for you to go. Nobody appreciates and knows what you do. Hello, dengue is beyond your ministry’s ability to solve. Dengue is created by more than one hundred local authorities countrywide. Got it? But I doubt it.

  10. #10 by ekans on Sunday, 14 June 2009 - 11:40 pm

    With all these controversies/scandals which involve the mismanagement/misappropriation of government funds/taxpayers’ money, it’s no surprise that the government run healthcare system would be one of the first casualties resulting from the depletion of financial resources…

  11. #11 by drngsc on Sunday, 14 June 2009 - 11:40 pm

    I wrote in for Bernama on Friday, and carried in Star today, 14th June, that this Dengue epidermic, has been with us from 1970, when I was a medical student, together with DG/MOH. He knows, as well as I do that to eradicate an infectious disease, or any disease, is prevention. The old cliche is true. “Prevention is better then cure “. Blaming GPs for misdiagnosis ( both DG and YB MOH ), in the early stages of dengue is totally unfair. In hindsight, everything is so obvious. But when confronted with a patient with high fever, aches and pains for 1-2 days, the diagnosis is not so obvious.
    Please also note that at a function organised by Guardian Pharmacy and attended by YB MOH, the President of the Malaysian Pharmaceutical Society asked MOH to allow pharmacist to do consultation.
    We in medical NGO feels that this is a orchestrated, organise campaign to bring more regulations upon GPs and private practitioners, like the “need for a National Health Financing Mechanism “.
    Yes, DG’s term has been extended. He is now on contract, awaiting a “golden handshake ” for being a good boy. Guess what is the “golden present “?
    You guess right. Could it be to oversee the National Health Financing Mechanism?

  12. #12 by dranony on Sunday, 14 June 2009 - 11:43 pm

    In the Dengue Clinical Practice Guidelines available from MOH,, it is reported:

    “In 2007, 98.4% of dengue cases were notifed by public and private hospitals
    with only 1.6% from the government and private clinics.”

    (DO check it up yourself, don’t just take my word for it)

    In the NST article 2009/06/10, DG was reported to have said,

    “…of the 22,426 cases reported, only nine per cent were notified by private practitioners.”

    Let’s see…

    2007
    48,836 cases
    98 deaths

    1.6% (or 731 cases) were reported by Govt PLUS GP clinics.

    in 2009, jan1-june6,

    22,426 cases reported in total,
    57 deaths
    9% cases reported by private practitioners.
    9% of 22,426 cases meant 2018 cases were reported by GPs.

    What does that mean?

    When there were more cases reported by GPs, ie 2018 cases in 2009H1, more patients died!
    In 2007, when there were fewer cases reported by GPs, there were fewer deaths.

    So, is there a correlation between GP reporting and dengue deaths, or not?

  13. #13 by kcb on Monday, 15 June 2009 - 12:25 am

    Chk Chk Chk
    This so-called DG is really pathetic!!!
    Other than blaming others, what is he good at???

  14. #14 by batuputeh on Monday, 15 June 2009 - 1:50 am

    Lim,
    You dont hv other fresh idea ka? everyone want to be sacked, resigned, removed etc.

    tired of hearing.

  15. #15 by ttc on Monday, 15 June 2009 - 2:56 am

    :P Recommendation to the poor rakyat – who is not perchance now, but really this time for sure getting poorer everyday from that very monstrously scary costly PKFZ-place – to give a demanding ultimatum to the :( sinking PMship and its non-performing rotten and useless crew:

    If you can do, then okay, stay now and take your pay.

    If you cannot do, don’t stay or take pay, just go away.

    Hmm.

    You see, there are very many zillions of :| sad people all over the world now with no job to do and no pay to get who will be surely :P verily ready to jump over the moon to come there and help the poor rakyat to get some value for their toil and hard-earned money, and who surely can all do very, very easily what the :( rotten useless stateship’s crew cannot now do, and who can also surely guarantee to do much, much better for the rakyat what the rotten useless lot now can do, but perchance very uselessly and also perchance very sneakily :( and cunningly at extortionate cost and even more bad value. See?

    WE SAY YEAH! AND NO TO ISA! :P AND HARIS FOR AG & RPK FOR IGP! AND GO FOR DSAI FOR PM & LKS FOR DPM & KIND WAN AZIZAH FOR HOME MINISTER.

    2009 Resolution: Seek out all garbage and recycle or dispose post haste for a healthier life and planet!

    Addendum: Protect coral reefs and save the fishies in the seas!

  16. #17 by ekin on Monday, 15 June 2009 - 1:32 pm

    DG? or DOG?

    Leaders’ conversation to cronies…

    …..: “Hey boy boy, dengue is on the rise, the people will bising again..Do something will ya?

    Cronies: “Ok boss ok boss!”

    …..: “Hey boy boy! The people now bising to me why so much dengue cases all around the country? Did you guys go round pumping gas to kill the mosquitoes? If not better be doing it now or my head will be chopped off!

    Cronies: “We did papa, we went round pumping gas even into he drains and sub drains but papa, ‘tak cukup makan’ papa, mana ada luit beli ubat cukup? Thats why we diluted the content and pump it. It cannot kill the mosquitoes lo but managed to chase them away la…

    …..: “Oh ya, gua tarak bagi cukup funds…Oh can drive them away ya? Also ok la cause don’t need to use so much money…But…Drove them away?…Where did they go?

    Cronies: “To the neighbors lo papa, cause they can’t fly so far…”

    …..: “WHAT?! Aiyo…no wonder neighbor kena dengue la!…So now what am i going to tell the public? Drove them away from their house but to their neighbors? Like that my head lagi will kena chop!

    Cronies: “Aiyo papa, don’t need to worry la, just say the hospital tarak guna tak boleh cure the dengue patients lo…”

    …..: “Oh ya…OK! Settle!”

  17. #18 by monsterball on Monday, 15 June 2009 - 4:30 pm

    Your script describe the MAN at work well…spoken and his character pooped out from your script.
    Well done…ekin.
    You chased hantus out…all gone hiding….leaving one that can apologizes to me and next moment…very sarcastic can insult. … Same ..he is doing to LKS.
    This Limbo rock specialist .. well educated….young fut..thinks he is such a clever fella.
    Watch his moves…now playing agree to disagree.
    I don’t trust he will vote for change of government.

  18. #19 by kontiki on Monday, 15 June 2009 - 5:19 pm

    # monsterball Says:
    Today at 16: 30.13 (45 minutes ago)

    [deleted]

    [Time for moratorium for the spat involving monsterball, ekin, kontiki, tom thumb, limkamput etc or all will be placed on the moderation list without further notice. – Adm]

  19. #20 by ctc537 on Monday, 15 June 2009 - 6:14 pm

    Heard that this DG of Health Merican is a very strict doctor trainer. Many doctors were trained under him. So, I’m a bit surprised that he’s now under fire from the public for uttering some irresponsible statements. He must be better than many bumi (mamak) doctors in the country, or he can’t have stayed as DG of Health for so long, and a doctor trainer,too.
    Taxidriver, M’sia is so much larger than S’pore, and keeping our country dengue-free is always a monumental task. Still, it is unbecoming of Dr Merican to blame the problems on private clinics and hospitals for the MOH’s failure to check the spread of dengue to the minimum.

  20. #21 by carcinoma on Wednesday, 17 June 2009 - 7:51 pm

    malaysians, dont be too surprised that dengue is still within us. even doctors who stayed in hospital compound also were warded for dengue fever. how can we protect ourselves? simple, keep our compound always clean. to depend on the MOH? dont dream! the fogging will be done when the public make complaints or when the doctors are down with the fever! so help ourselves please!
    again, dont put too much hope on others espcially the “authorised angels” that suppose to take care of us!

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