Archive for category Health
Unrecognised doctors
Letters
by Frustrated doctor
The Star article titled ‘Hope Yet For Med Grads’ (10th April 2008) claims to give the option to unrecognised doctors of transferring credits to local establishments to pursue their goal of becoming doctors . If this article is true , this is a misleading thing the new health minister is undertaking .
Firstly , the option to transfer credits has been there since 1998 when students in Indonesia were allowed to pay 60,000rm to an agent to transfer to Malaysian recognised Indonesian government universities . Many decided not to pursue this option as they didn’t have the money ; and the studies they were doing in other universities which were claimed to be unrecognised in Malaysia were actually on par with the recognised government universities there .
This whole credit transfer came about when 3 JPA sponsored students from Padang came back after only 4 years of theory claiming that they had finished their studies and were posted to do their housemanship . Not having any clinical experience , their peers and dept heads found them lacking and refused to accept them when it was found out that they didn’t do their 2 years of clinicals to be considered doctors in Indonesia . Thus , JPA and MMC tried asking the U in Padang to take them back but the U refused saying that they had ‘mencemarkan nama baik universitas’ . Thus , JPA had to pay hefty amounts to the govt U in Bandung who decided to allow them to continue their studies there . Using this case of credit transfer , an agent worked out with various other recognised Indonesia government universities to accept students . Even local Indonesian students were irritated with this as this smacked of double standards as the same option was denied even to them .
It is a known fact that wherever JPA is able to put students , the U is given recognition in a short time . Malay students were gathered and all placed in an Islamic private medical U to finish their studies . However , due to the large number of non-bumi students there , this U was not given recognition and the Malay students were placed in the govt U in Bandung . However , since they hadn’t finished their 4 years of theory , the Bandung U gave some problems . Then they were placed a 3rd time in the govt U in Medan . This U was not strict with the rules as hefty sums were paid to the rector’s office to close a blind eye . Each transfer involved a sum of about 60K . Three transfers and the JPA would have paid nearly 200K for each chap . This is how much the govt doesn’t mind paying for bumi students from all the Petronas money they have received . Read the rest of this entry »
Plight of JPA medical scholars
Letters
by Frustrated JPA scholar
I am a medical student sponsored by JPA to study in Ireland about to complete my studies. I write to you after reading your article on the rot of the Malaysian healthcare system. We JPA scholars here have been very frustrated with the JPA enforcing us to immediately return to the country upon graduation, barring us from continuing training as interns (equivalent of houseman) in the countries where we graduated from This would mean we cannot obtain the sufficient exposure that would make our training complete, and would off course, mean a waste of taxpayers money as there would have been no difference with studying locally.
JPA had announced recently that none of its medical scholars overseas will be allowed the opportunity to do further train overseas even at their own expanses, and are to return ASAP upon graduation. No scholar would be allowed to stay on regardless of the training posts they obtain upon graduation. To add to the spice of JPA’s foolishness, it seems that JPA gives priority to romantic relationships over the academic achievements of its scholars by giving exception to remain overseas to those who are married to a fellow JPA/MARA sponsored student who are still commencing studies in the foreign country concerned.
Till today, I have yet to comprehend the narrow minded policies set by the JPA. JPA seems to fail to understand that by allowing its scholars to stay on for postgraduate training, many will be offered positions in world-renowned healthcare institutions. The exposure and experience gained through these positions would be an invaluable asset to the country and the rakyat in the future. Unfortunately, JPA seems to be adamant in having fresh graduate doctors returning to receive Malaysian medical training, instead of allowing these fresh grads to further train themselves and one day return as first world specialists who will reform and infuse new uptodate skills in Malaysian Healthcare a few years down the road. Read the rest of this entry »
MCA to blame for marginalisation of foreign Malaysian specialists
Letters
by LTT
I refer to Dr. LMK’S letter “Eye specialist problem – another multiracial problem”, and sympathize with this ophthalmologist who wants to come home but is prevented as a result of bureaucracy pertaining to his postgraduate qualifications.
Some have commented that Dr. LMK should just go on to another country where his skills will be better appreciated, but this would be in essence giving in to racist policies that have now slithered into our professions. It would also mean that the change that all those Malaysians were yearning for when they took to the streets and turned up in massive numbers at all those ceramahs leading to the ruling party losing in five states and at the same time almost politically annihilating the previous government would have been for nothing. Further, all the efforts and sacrifices the DAP/PKR/PAS have made to seek a just Malaysia that practices equitable policies may come to naught. Malaysians must stand their ground and must unearth or hunt down the zealots and charlatans who prey on this country’s masses and in this case its medical institutions.
Dr. LMK should be commended that he wants to return home to make this country a better Malaysia. All right thinking Malaysians who have helped transform the political landscape should help him and other Malaysian doctors who plan to come home, by ensuring that the doctors who have hijacked this country’s healthcare system are flushed out once and for all. Dr. LMK should rest assured that there is nothing wrong with his Fellowship qualifications. The problems are all here with the so called “Master’s programs” and the muddled policies at the Academy of Medicine and the Ministry of Health which have been put in place by self-serving specialists who suffer a serious dose of inferiority complex. Read the rest of this entry »
Eye specialist problem – another multiracial problem
Letters
by Dr. LMK
I am an eye specialist (ophthalmologist) currently practising in UK, I
cannot come home because of my specialist degree.
“FRCS(Glasgow) in Ophthalmology” (hereinafter refer as FRCS) is a
specialist degree recognised by the whole world, the eye specialist
must go through a proper training and exam in order to get this
degree. Many eye specialists in many are holding this degree
including our famous eye specialists in Tun Hussain Onn Eye Hospital.
FRCS was confered by 4 boards, ie, Edinburgh, London, Ireland and
Glasgow. In 1999, UK has decided to change its training service due
to the European Union. FRCS exam was be replaced by MRCS exam. For
your information, MRCS is not a recognised degree in Malaysia.
However, Glasgow board is STILL offering this exam for this degree
until NOW. Read the rest of this entry »
More bull by DG Merican
Letters
By EJB
13.2.08
It appears that there is no end to the spin of Annie Freeda Cruez for the yarn she creates for DG Merican. Today the NST highlighted an article, “Malaysia’s rural health service second to none”. They forgot to add that it was for the year 1965 when you had to worry essentially about cholera, typhoid, malaria and hookworms.
DG Merican, just fresh from conning doctors that the PHFSA (Private Health Care and Facilities Act) is not meant to penalize registered doctors but is there actually to weed out bogus ones, has seen to it that, Basmullah Yusom, a registered practitioner, still languishes in Kajang Prison. He shows no remorse for blatantly lying to doctors and to parliament. He appears not to have a conscience either as he goes on another PR jaunt with Annie Freeda Cruez. Today it appears that he is trying to win brownie points by highlighting to the largely gullible Malaysian public that our rural health service is well run and effective. He is, of course, now in danger of believing his own bull.
Merican’s ebullient statistics include a health clinic every five kilometers and that more than 95 per cent of the rural population have access to a doctor. There are also 2,965 clinics and 151 mobile clinics in rural areas and there is one health clinic or centre for every 20,000 people while there is one community or rural clinic for every 4,000 people.
Impressive statistics until one actually walks into one of these clinics and realizes that there is only a nurse or HA who is going to attend to today’s epidemic of hypertension, diabetes mellitus, heart disease and cancer. Their duties – check your BP, sugar, etc and dish out 30 year old medication for the next 6 months packed in two polystyrene bags with a “Kalau mau jumpa doctor…tunggu tiga bulan ya…”. If the patient returns alive on follow-up, repeat above. Any complications, refer to “Hospital Besar” and join the queue where the rest of Malaysia will also be waiting to see not a specialist..but a medical officer in the specialist clinic, who could have been just transferred from the same district the patient was seen. This is the modus operandi of the Malaysian Healthcare System for the last 50 years. Read the rest of this entry »
The Malaysia we live in today (case of Dr. Basmullah)
What a sight it must have been. A wheelchair bound ethnic Indian lawyer from a multi-racial (but predominantly ethnic Chinese) party together with an ethnic Malay doctor from an opposition party were in High court to make an application to get Dr. Basmullah out of jail.
This is the Malaysia I like to see. Where it’s not about race but about helping one another, especially when another fellow Malaysian has been dealt with unjustly.
It is most unfortunate that the MMA was not the one seen to apply to bail Dr. Basmullah out. Never mind if he was not a member of the MMA but the MMA must be seen to be a champion of Malaysian doctors’ rights. If not, who wants to join the MMA?
Perhaps there has been too much in-fighting in the MMA of late but now that there has been overwhelming votes cast for Dr. Quek as President perhaps once again the MMA will be of one voice and a stronger doctors’ association.
It also makes me wonder if you give some people too much power, they will become arrogant, they will abuse the power and they will think your, my, our opinions and voices do not matter.
The PHFSA is just one example of such a situation. This is a law which was passed in Parliament despite the reservations and objections of doctors who feared they would be criminalized. Read the rest of this entry »
Dr. Basmullah’s jailing – is Ka Ting the worst Acting Health Minister in nation’s history?
I am here with Norliza binti Hassan, 44, wife of Dr. Basmullah Yusoff – the first doctor be to criminalized and jailed under the Private Healthcare Facilities and Services Act (PHFSA) – her counsel Karpal Singh (DAP National Chairman) and Dr. Lo’Lo Mohd Gazali, Dr. Basmullah’s medical colleague (PAS Wanita leader) for an application to the High Court to get Dr. Basmullah out of Kajang Prison.
Two days ago, New Sunday Times quoted former Health Minister, Datuk Seri Dr. Chua Soi Lek as asking the medical fraternity not to blame him for the jailing of Dr. Basmullah who failed to register his clinic under the PHFSA 1998.
Chua said the PHFSA was never intended to criminalize doctors. He said PHFSA, which came into force on May 1, 2006 when he was Health Minister, was intended to weed out bogus doctors who posed a threat to public health and safety.
Now that a qualified doctor, who has an annual practicing certificate issued by the Malaysian Medical Council has been criminalized and sentenced to three months jail for his inability to pay RM120,000 fine, why has Chua failed to speak up firstly, to admit that the enforcement of the PHFSA should be suspended until there is iron-clad guarantee that there would not be another case of criminalizing of a doctor like that of Dr. Basmullah; and secondly, that it is grossly unjust for Dr. Basmullah to spend another day in jail.
Dr. Basmullah has been jailed for 18 days which is equivalent to paying a fine of over RM24,000 – which is already too hefty a fine for a technical offence committed by Dr. Basmullah.
Is Chua prepared to publicly state that as Dr. Basmullah has paid an equivalent of over RM24,000 fine in serving 18 day’s jail sentence, justice demand that he be released immediately without any extra day in Kajang Prison?
I am very disappointed that for more than two weeks, there has been deafening silence from the Acting Health Minister, Datuk Seri Ong Ka Ting on the Dr. Basmullah case – whether he is utterly indifferent about the sufferings imposed on the father of eight or whether he is totally lost as to how to rectify the injustice suffered by Dr. Basmullah. Read the rest of this entry »
Release Dr. Basmullah immediately as he has paid over RM21,000 fine with 16 days’ jail
Posted by Kit in Health, Human Rights on Sunday, 3 February 2008
In asking the medical fraternity not to blame him for the jailing of Dr. Basmullah Yusom who failed to register his clinic under the Private Healthcare Facilities and Services Act (PHFSA) 1998, former Health Minister, Datuk Seri Dr. Chua Soi Lek is guilty of a grave injustice to Dr. Baharom.
Chua said the PHFSA was never intended to criminalize doctors. He said PHFSA, which came into force on May 1, 2006 when he was Health Minister, was intended to weed out bogus doctors who posed a threat to public health and safety.
Now that a qualified doctor, who has an annual practicing certificate issued by the Malaysian Medical Council has been criminalized and sentenced to three months jail for his inability to pay RM120,000 fine, why has Chua failed to speak up firstly, to admit that the enforcement of the PHFSA should be suspended until there is iron-clad guarantee that there would not be another case of criminalizing of a doctor like that of Dr. Basmullah; and secondly, that it is grossly unjust for Dr. Basmullah to spend another day in jail. Read the rest of this entry »
Dr. Basmullah’s jailing – Ismail Merican inconsiderate, callous, heartless and unbecoming of top civil servant
The comment by the Director-General of Health Tan Sri Dr. Ismail Merican that Dr. Basmullah Yusom, the first doctor to be jailed under the Private Healthcare Facilities and Services Act 1998 preferred jail to paying the RM120,000 fine in instalments is most inconsiderate, callous, heartless and totally unbecoming of a top civil servant.
New Straits Times today quoted Dr. Ismail as saying that Dr. Basmullah “declined the Health Ministry’s offer to stay out of jail”.
He said the offer was made to the doctor by the ministry’s prosecuting officer.
Dr. Ismail said: “It’s not that we do not care for doctors or are unsympathetic to them.”
If Dr. Ismail really “care” or sympathetic to doctors, how could he use language which is so inconsiderate, callous and heartless?
From Dr. Ismail’s account, it would appear that Dr. Basmullah is a pervert who prefers to go to jail instead of enjoying his personal freedom outside prison!
Dr. Ismail went on to say that if Dr. Basmullah feels he has been harshly sentenced by the Sessions Court, he has the right to appeal to a higher court.
I am just shocked and outraged beyond belief that even up till now, Dr. Ismail does not see or accept that Dr. Basmullah just do not have the means to hire counsel to appeal against the sentence of RM120,000 fine or three months’ jail – when he had not been able to afford the expenses to retain counsel to represent him at the Sessions Court or to take up the “offer” to pay the hefty RM120,000 fine by instalments.
This is why Dr. Basmullah is in jail in Kajang Prison for the past two weeks – creating outrage to the extent that a online “Don’t Jail Doctors Blog Campaign” has been launched.
Many are asking why is the system of justice in Malaysia is so perverted that a doctor could be jailed for not registering his clinic although he has the annual practicing certificate of a medical practitioner, while criminals whether the corrupt or those guilty of heinous crimes can get away scot-free, moving freely in society! Read the rest of this entry »
Dr. Basmullah in Kajang Prison – Karpal takes up case pro bono publico
DAP National Chairman Karpal Singh will take up the case of Dr. Basmullah Yusom, 44, the first doctor to be jailed under a technicality under the Private Health Facilities and Services Act (PHFSA) 1998 as pro bono publico to get him released from Kajang Prison.
As reported by New Straits Times on 19th November 2008, Dr. Basmullah has earned the dubious reputation of being the first person to be convicted under the PHFSA for not registering his 10-year-old clinic in Desa Pandan, Kuala Lumpur.
Fined RM120,000 or three months jail, Dr. Basmullah had been languishing in Kajang Prison for the past fortnight as he does not have the money to pay the fine.
In Penang on Sunday, I had called on the Attorney-General, Tan Sri Gani Patail to intervene in this case of grave injustice and to invoke the revisionary powers inherent in his office to call up Dr. Basmullah’s case to get the Univeristi Sains Malaysia (USM)-trained doctor and father of eight out of jail without any moment of delay.
Alternatively, I had also called on the Chief Judge of Malaya or the Chief Justice of Malaysia to invoke their revisionary powers to call up the case to quash the jail sentence imposed on Dr. Basmullah.
Unfortunately, there has been no response whatsoever from the Attorney-General’s Office or the judiciary.
This was why DAP MP for Ipoh Barat, M. Kulasegaran and I visited Kajang Prisons two days ago where we received confirmation that Dr. Basmullah was serving his jail sentence although we did not get to see him.
I have since been in contact with Dr. Basmullah’s wife, Nurlizah Hassan, who also met Karpal over Dr. Basmullah’s jail term. Read the rest of this entry »
Dr.Basmullah paying RM1,333 for every day in jail
Together with DAP MP for Ipoh Barat, M. Kulasegaran, I visited the Kajang Prison and the authorities have confirmed that Dr. Basmullah Yusom is serving three-month jail term for failing to pay RM120,000 fine for operating a clinic without registering it under the Private Health Facilities and Services Act (PHFSA) 1998.
Every day of jail by Dr. Basmullah is equivalent to paying RM1,333 of the fine. He has been jailed for 12 days or equivalent to paying RM15,996 of the RM120,000 fine!
We were unable to see Dr. Basmullah and will try to contact his family members to see how we can be of help to ensure that he could be speedily freed from jail.
I find it most regrettable that there has been no response from the Attorney-General Tan Sri Gani Patail in the past three days to my appeal for his intervention by invoking his revisionary powers to call up the case to quash the most unfair and unjust three-month jail sentence – the first doctor to be jailed under the PHFSA despite assurances by both the Health Minister and Director-General of Health Services that private practitioners would not be jailed over a technicality.
Why is the Acting Health Minister, Datuk Seri Ong Ka Ting keeping quiet about this gross injustice in the implementation of the PHFSA? Read the rest of this entry »
Botched PHFSA – why the Director-General of Health must resign
Letters
by EJB
It is with regret that medical practitioners learn of a doctor being jailed under the Private Healthcare Facilities and Services Act 1998 (PHFSA) for not registering his clinic. This is clearly not what was promised to doctors when both the current Director General of Health, Ismail Merican and the previous Health Minister Chua Soi Lek were all gung ho about implementing an Act that was clearly poorly drafted. When the PHFSA came into effect on Nov 1, 2006, there was great resentment and distrust among private doctors. The PHFSA was regarded as an insult to their integrity and demeaning the profession. Many were distrustful about the implementation of a haphazardly written law by a ministry known primarily for its incompetence.
Despite the misgivings of senior GPs, specialists, ex-DGs, ex-MMA chairmen and even a senior judge such as Datuk Mahadev Shankar who was an authority on medico-legal proceedings, both the Minister and the DG ran roughshod over their objections in implementing this law. Doctors still recall how Chua and the DG quickly convened a meeting when medical practitioners threatened to march to parliament. At the meeting, they promised various amendments to the Act. The Malaysian Medical Association (MMA) and other medical associations trusted the word of both the Minister and the Director General and did not even push for all the changes to be in writing before the law was passed.
But today it is clear that the word and the credibility of the Director-General means nothing as the regulation has now claimed its first victim, Dr. Basmullah Yusom, a USM graduate, registered with the Malaysian Medical Council with a valid Annual Practicing Certificate. He was fined an unbelievable RM120,000 and jailed subsequently for three months when he could not afford to pay this fine. He couldn’t even afford counsel. Anyone, long enough in the profession will tell you that there are many medical practitioners who serve their communities quietly without expecting too much in financial returns. Read the rest of this entry »
Quash 3-month jail for Dr. Basmullah – AG/CJ/CJM should act
I call on the Attorney-General Tan Sri Gani Patail to uphold justice and intervene to quash the three-month jailing of a private practitioner Dr. Basmullah Yusom for being unable to pay RM120,000 fine for operating a clinic without registering it under the Private Health Facilities and Services Act 1998.
Yesterday, my blog received and put up a letter on the jailing of Dr. Basmullah on 18th January 2008, drawing my attention to this gross injustice for the first time.
I checked the press and found this New Straits Times report “Doctor fined RM120,000 for not registering clinic” dated 19th November 2008.
I call on the Attorney-General to make swift amends of such travesty of justice and invoke the revisionary powers inherent in his office to call up Dr. Baharum’s case to get him out of jail without any moment of delay.
Alternatively, I call on the Chief Judge of Malaya or the Chief Justice of Malaysia to invoke their revisionary powers to call up the case to quash the jail sentence imposed to Dr. Baharum.
DAP MPs and leaders will contact Dr. Baharum’s family to see how we can help to get him out of jail.
Will Ong Ka Ting review the PHFSA?
Letters
by RS
With reference to media reports of a doctor being convicted for not registering his clinic, (Jan 19th 2008), it is incomprehensible that this registered doctor was fined a whopping RM120,000 for not registering his clinic. And since he couldn’t come up with the fine, he was sent off to serve a three month jail term at Kajang Prison.
In April of last year the DG of Health, asserted that the Private Healthcare Facilities and Services Act 1998 (PHFSA) was enacted to direct private hospitals to carry out their social responsibilities and was not meant to be punitive or detrimental in nature.
He and the previous Health Minister, Chua Soi Lek, further assured the medical community that since the Act was outdated, changes would be made and ratified by the Attorney-General’s chambers.
These changes have yet to be agreed upon or ratified but the Act has already been applied leading now to a doctor being convicted on a technicality.
Will the DG now tell the judge, that she should not have passed this type of sentence? Of course not, because that is not how the law works once an Act is passed. Read the rest of this entry »
Ka Ting doubling up as Acting Health Minister – ridiculous, shameful and unacceptable
The proposal that the post of Health Minister left vacant by the resignation of Datuk Seri Dr. Chua Soi Lek should be left unfilled with the MCA President, Datuk Seri Ong Ka Ting doubling up as Acting Health Minister is most ridiculous, shameful and unacceptable – subordinating the rights and interests of 26 million Malaysians to a world-class medical and health system to the rot and factional infighting in MCA.
It is a reflection of the advanced marginalization, irrelevance and rot of MCA that it has found itself in a dilemma over the appointment of a fourth MCA Minister to the extent there could be the serious suggestion that the post be left vacant until the next general election and that the MCA President double up as Acting Health Minister apart from his portfolio as Local Government and Housing Minister.
The Malaysian public are entitled to know whether the MCA Presidential Council has reached such a decision and whether the MCA President had formally forwarded such a proposal to the Prime Minister – as whether the country has a full-time Health Minister or just a half-time Acting Health Minister is a matter of grave public importance which concerns all Malaysians and not just MCA. Read the rest of this entry »
Zero-negligence in hospitals and not Chua Soi Lek’s “medical mistakes inevitable”
Posted by Kit in Health, Parliament on Monday, 3 December 2007
The Health Minister, Datuk Seri Dr. Chua Soi Lek’s statement in the press yesterday that “medical mistakes are inevitable” however careful the doctors are is most regrettable and must be deplored by all MPs as it is tantamount to giving a blank cheque for hospital negligence endangering lives and welfare of the people seeking medical treatment.
We claim to want to be a first-world developed nation which is not matched by a first-world mentality and mindset, such as making an important distinction between mistakes and negligence in hospital. The former is understandable and acceptable but the latter, i.e. negligence, is totally unacceptable and unforgivable.
Tragic cases like the baby girl Lai Yok Shan who lost her left forearm because of a chain of negligence at the Tengku Ampuan Rahimah Hospital in Klang or a private hospital nurse Kalaiyarasi Perumal, 44, who went through the nightmare of a pair of forceps left in her abdomen after an operation at the Sultan Aminah Hospital in Johor Baru cannot be accepted as unavoidable incidents. Read the rest of this entry »
Exercise best preventive medicine and as important as eating and sleeping
by Dr Chen Man Hin
It is commonly known that exercise has beneficial effects on the human body, especially the heart, lungs, kidneys, bones and muscles.
It also help patients to control their hypertension, diabetes, and mood disorders like stress and depression.
There is increasing evidence that exercise is also beneficial for mental health. Many discoveries have been made
Professor Arthur Krammer from the Beckman Institute in Illinois, USA found clear evidence that aerobic exercise boost performance in key areas of the brain and that exercise could improve ‘decision making’. The research team scanned thousands of rains of voluneers using the magnetic resonance imaging (MRI).
Next, a neuroscientist, Professor Comon at University of California Irvine has found that during exercise, the nerve cells release chemicals (neurotrophic factors) which protect nerve cells from injury and prompt nerve cells to multiply and grow. The frontal lobes have shown to increase in size by MRI scanning.
Other neuroscientists also claim that exercises delay the onset of dementia and Alzheimer disease, prevent Parkinsonism and help spinal cord injuries. Read the rest of this entry »
Organ transplantation…brain death and financial implications (3)
Letters
by FK-506
In reply to Carpe Diem’s cherry picked quotes to the letter, ‘Organ transplant: Are we on the right track?’, the writer’s attempts to endorse this country’s nascent transplant program by trying to downplay key issues in any transplant program — financial implications and controversies surrounding brain death is reprehensible.
Quote : “… … … ..it isn’t quite right to place patients on VADs which have a limited life of their own into patients, not knowing if they are ever going to get a heart. This cannot be ethically correct.”
“Is it more ethical to deny me this option, based on not knowing whether I will get a heart in time, if the expertise is available and I am more than willing?”
For how long and at whose cost? Is Carpe going to pay this out from his or her own pocket? Clearly this person doesn’t realize the economic costs of such programs on government expenditure, unless of course, Carpe thinks that it is the state’s moral duty to transplant everyone with end-stage heart failure, liver failure, renal failure, etc. Chua Soi Lek moaned only last year that the MOH couldn’t afford to pay the RM900 million pharmaceutical bill for patients being treated by the Ministry. But miraculously he today is quoted to have said that the Cabinet, which has never shown respect for tax-payers money, is willing to provide even up to a billion ringgit for a transplant program. Incredible. Where is the set of priorities? Why don’t the cabinet approve the billion ringgit so that patients get better care, better follow-ups, better education programs, home nursing and of course better medicines, so that less patients end up in heart failure, renal or liver failures.
The age old idiom “prevention is better then cure” must hold true for this country based on the economy that we have unless Carpe is advocating American style healthcare, in which case, I would like to suggest that the technology be kept going but all transplants be borne by private funds. And I do hope Carpe fathoms the economic consequences of transplant programs. I hope he/she realized what happened to Barnard’s pioneering transplant work at Groote-Schur in South Africa. Transplant programs were immediately shut down by incoming President Nelson Mandela in 1994 when he realized that precious and limited health resources that could be used for Soweto’s populace suffering from cholera, typhoid, malaria and an AIDs incidence of almost 14% in some provinces, were being channeled to a glamorous transplant program. Are we in Malaysia any different if the startling statistics provided by our own MOH are anything to go by? In Sabah alone, even decades after independence, we have still not eradicated malaria and TB.
Quote: “Merican howled that what SJMC and Tan did were improper as ignorant patients may “not have been briefed about complications”. Tan, who pioneered liver transplant techniques at King’s College, London, of course left, preferring to base himself in “less ethical” Singapore, leaving Merican to focus on traditional medicine back here in Malaysia.”
That Merican howled is a fact. It is also a fact that K.C. Tan announced in the media that he was not willing to work in the ethical environment imposed on him. But the end result of this entire episode was clear. Malaysia’s liver transplant program in the private sector, supported quite earnestly by the media even then, was dead in the water. No RM30 million, 100 million or 1 billion ringgit boost to this program, although it was led by a Malaysian surgeon and the incidence of patients requiring liver transplants were equally a concern. Even private donations collected to help patients in this program were ultimately taken over by the Ministry. Why the double standards? Was it because K.C.Tan was a private surgeon working at a private hospital? Or was it due to something else? Yes the insinuation is direct. I am sure readers can make their own conclusions. Read the rest of this entry »
Reply to ‘Organ transplant: Are we on the right track?’ by FK-506
Letters
by Carpe Diem
I would like to comment on the letter by FK-506. However I will try to focus on rebutting factual inaccuracies in his letter, rather than comment on his insinuations and innuendos as my interpretations of his statements may be flawed.
Quote : “………..it isn’t quite right to place patients on VADs which have a limited life of their own into patients, not knowing if they are ever going to get a heart. This cannot be ethically correct.”
Whether this is ethically correct or not depends on the patient’s wishes, the facilities available and expert opinion. Unfortunately this is one area where opinions matter. An individual may consider it mental and physical torture to be hooked to a machine with no definite end in sight, but another may consider it a lifeline to a possibly better future. Is it more ethical to deny me this option, based on not knowing whether I will get a heart in time, if the expertise is available and I am more than willing?
Quote : “Merican howled that what SJMC and Tan did were improper as ignorant patients may “not have been briefed about complications”. Tan, who pioneered liver transplant techniques at King’s College, London, of course left, preferring to base himself in “less ethical” Singapore, leaving Merican to focus on traditional medicine back here in Malaysia.”
Well I have no love for traditional medicine, but I don’t see how this case affects the current scenario. Anyway, if I am not mistaken the issue against KC Tan then was on unrelated living donors. Please correct me if I am wrong. Read the rest of this entry »
Transplantation in Malaysia – are we on the right track?
Letters
by FK-506
As motorists on the NKVE scrambled to let pass the police outriders followed by a Perdana with an IJN logo with a host of other ambulances heading towards Subang Airport on Wednesday afternoon, many suspected the heart that 14 year old Tee Hui Yi so badly required after being placed on an ventricular assist device (VAD) for almost 12 months may have finally arrived. And indeed it had as she had her transplant done almost the same night courtesy of an unfortunate 15 year old accident victim who was declared brain dead at Ipoh General Hospital.
The miracle was all the more phenomenal as Tee Hui Yi’s predicament was highlighted only the day before on the front pages of the New Straits Times. Sadly she is said to have suffered a “hyperacute rejection” of her transplanted heart and had a second one put in which IJN happened to get from a patient from JB. Two hearts all in a day for one patient when none was available for almost a year. Miracles and coincidences do happen just like the statue of Virgin Mary crying blood sporadically in various churches around the world on Christmas. Hopefully Tee Hui Yi’s saga will finally end with her recovering fully.
Tee Hui Yi apparently developed viral myocarditis at the age of two and progressed to end stage heart failure. The indication for the expensive bridge to a natural heart in the form of the artificial ventricular assist device was presumably the failure of medical therapy in not being able to maintain her circulation optimally anymore on conservative therapy. In simple terms, for a future, she would need a heart. The VAD was just a stop gap. But in Malaysia this bridge to a heart or for that matter any other organ can be exceptionally long, arduous and occasionally a bridge just too far, leaving in its trail thousands dead on waiting lists. Read the rest of this entry »
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