Doctors Prescribe, Pharmacists Dispense, Patients Suffer
Real Life Scenario
Madam Ong is a 52-year-old lady with a twelve-year-history of hypertension and diabetes. She complained of generalised lethargy, lower limb weakness, swelling and pain. She brought along her cocktail of medications for my scrutiny. Her regular medications included the oral antidiabetics metformin and glicazide and the antihypertensives amlodipine and irbesatan. Madam Ong also had a few episodes of joint pains three months ago for which she had seen two other different doctors. The first doctor suspected rheumatoid arthritis and started her on a short course of the potent steroid prednisolone. Thereafter, she developed increasing lower limb swelling for which a third doctor prescribed the powerful diuretic frusemide.
Madam Ong was not on regular follow-up for hypertension and diabetes. Additionally, she has been re-filling her supply of steroids and diuretics at a pharmacy nearby with the purpose of saving up on the consultation charges.
I took a more complete medical history and performed a thorough physical examination. I concluded that this lady’s health was in a complete mess.
She was under sound management by the family physician until the day she defaulted follow up and was started on prednisolone by a doctor who was unaware she was diabetic. The steroid probably helped in relieving her arthritic pains though the suspicion of rheumatoid arthritis was never proven serologically.
However, it also worsened her sugar and blood pressure control and weakened her immune system.
Her legs swelled up because of the fluid retentive properties of the steroids. In addition, early signs of cellulitis were showing up around her legs due to a weakened immune function. The diuretic prescribed by the third doctor helped a little with the swollen limbs but she became weak from the side effects of diuretics.
Madam Ong’s problems escalated when she decided to forgo her doctors’ opinion altogether and decided to self-medicate simply by collecting all her medications from the pharmacist who supplied them indiscriminately. Unknowingly, the pharmacist had added to the lady’s problems in spite of the wealth of knowledge the pharmacist must have possessed.
The above scenario is a fairly common scene in the Malaysian healthcare. We see here an anthology of errors initiated by doctors, propagated by the patient’s health seeking behavior and perpetuated by a pharmacist. Read the rest of this entry »
Time for press freedom reform – although 8 years late
The Prime Minister, Datuk Seri Abdullah Ahmad Badawi, should embrace press freedom reform to ensure that the reform measures he has announced on the judiciary and anti-corruption are meaningful and sustainable.
Without a fair and independent media, no reform measures whether to restore public confidence in the independence, impartiality and quality of the judiciary or an all-out battle against corruption can succeed.
When Abdullah first became Home Minister eight years ago, he was presented with a memorandum by Malaysian journalists calling for press freedom reform. He had at that time promised to study the memorandum but nothing has come out of it so far.
The March 8 political tsunami should be a salutary lesson to the Prime Minister that it is time that he embrace press freedom reform although it is eight years late.
The latest press ranking for Malaysia being placed at 141 in the Freedom House survey report on Global Media is another adverse international verdict on the state of the media in Malaysia. Abdullah should use the World Press Freedom Day this year to announce bold measures on press freedom reform especially an end to the annual newspaper licensing requirement as well as the repeal of the Printing Presses and Publications Act.
Lee Hwa Beng to investigate RM4.6 billion PKFZ scandal?
Letters
by Albert Lim
I refer to YB blog posting dated April 11 regarding abovementioned.
I strongly believe and fear that YB predictions may come true with the appointment of former Subang Jaya state assemblyman, Lee Hwa Beng as Port Klang Chairman, reported today by China Press.
With Lee’s appointment, the transport minister gives an immediate instruction for him to appoint independent auditor to look into PKFZ scandal. Obviously, the transport minister’s instruction is a step in the wrong direction, a step towards a 3rd minister to be marred and tarred.
Again, BN minister has underrated the intelligence of all Malaysians, a lesson not learnt in the aftermath of March 8 political tsunami.
I hope YB Lim will look into the issue again, raise it in Parliament. A very simple action to show Ong Tee Keat’s sincerity in exposing this scandal is by appointing credible persons in the investigation,not Lee Hwa Beng known as ally to former transport minister Ling Liong Sik.
Ning Baizura’s encounter with Penang CM
My attention was drawn to the blog on Malaysian songstress Ning Baizura’s encounter with the Penang Chief Minister, “Have you seen a Chief Minister sit in Economy Class? I have”.
It was independent blogger Zainol Abideen who drew attention to the blog of Guan Eng’s meeting with Ning and her manager, Vernon Kedit Jolly at the KLIA on Wednesday in his blog Mahaguru58.
Liow Tiong Lai, the PHFSA …and warrior mosquitoes
Letters
by Suka Jaga Tepi Kain
Thus far the new health minister, Liow Tiong Lai has made two statements regarding the notorious PHFSA (Private Healthcare, Facilities and Services Act). One is that doctors should not own too many clinics as they will not be able to focus on seeing patients (that is if they are still seeing patients) and the other is that of private hospitals overcharging. In today’s Star, the DG, Ismail Merican wrote a letter about how the Ministry used its enforcement resources to track down a “bogus Burmese doctor” who worked with a private hospital following a complaint. Hopefully this complaint was genuine and not borne out of professional jealousy.
This doctor was apparently employed previously by the DG’s own alma mater, University Malaya but became “bogus” when he left their employment. Presumably he or she had MMC registration previously. Could this not have been solved by a simple phone call to the hospital asking them to make certain the doctor renews his registration? Or was this created by the MMC themselves by dilly dallying his registration or worse still being obstructive in not renewing his registration? Or perhaps, what is deemed proper by the University Malaya, is not being deemed proper by the MMC or the MOH?
It is no secret that a great many of the Ministry’s own doctors are treating patients without registration. But the DG has seen it fit to apply Section 31(1) (c) of Act 586 of the PHFSA fastidiously in going after a single doctor who apparently is a bona fide one but is now technically not because his registration was not renewed or perhaps pending renewal. Mercifully no one was prosecuted. Apparently three cases have been prosecuted. Two are awaiting trial and one pleaded guilty. And we all know what happened to that one doctor who pleaded guilty don’t we? Liow should ask this DG, who obviously is still obsessed with this Act, as to what happened to all the promised amendments that he and Chua Soi Lek agreed to? Another broken promise? Tak Tau? Not within his powers? Ask the AG? You see. This is why you lose elections. The MCA just cannot keep its promises simply because it has no control over the pathetic civil service that attempts to run this Ministry. You want to know more. Just ask Chua Jui Meng. Read the rest of this entry »
Police after RPK again
Posted by Kit in Human Rights, IT on Friday, 2 May 2008, 3:38 pm
Police going after Raja Petra Kamarudin again.
His computer was confiscated during a police search of his house in Sungai Buloh this morning connected to his recent posting on the Altantunya Shaariibuu murder case in his blog, “Let’s send the Altantunya murderers to hell”.
Malaysiakini has reported DSP Victor Sanjos of the cybercrimes division as saying that the police are investigating Raja Petra under the Sedition Act 1948 for incitement and also because he “commented on a case before the court made its decision”.
Any offence in the latter category would fall under “contempt of court” to be dealt with by the presiding judge for the Altantunya case. When did it become an offence under the Sedition Act?
The police action, coming immediately after the denial by Deputy Prime Minister Datuk Seri Najib Razak through his press secretary of having anything to do with the murder of Altantunya Shaariibuu, smacks of an orchestrated response to Raja Petra’s blog – and must be deplored in the strongest possible terms.
Abdullah could only think of seven priority reform measures…
Posted by Kit in Abdullah Ahmad Badawi, Parliament on Thursday, 1 May 2008, 2:29 pm
Yesterday, my parliamentary question (No. 5 on the Order Paper) asking the Prime Minister, Datuk Seri Abdullah Ahmad Badawi “to outline the top ten priority reform measures which his government will implement in the next 12 months to demonstrate that he has heard the voices of the people in the March 8, 2008 ‘political tsunami'” was not answered as only three got replied.
From the answer Abdullah would have given (reproduced below), the Prime Minister could only think of seven priority reform measures (many of which are quite unsatisfactory) although he had promised Malaysians wide-ranging reforms since he took over from Tun Dr. Mahathir Mahathir more than four years ago.
May be you can outline more reform measures which deserve Abdullah’s top priority in the next 12 months.
Abdullah’s answer: Read the rest of this entry »
Bad start for 12th Parliament
Posted by Kit in Parliament on Wednesday, 30 April 2008, 12:52 pm
Its a bad start for the 12th Parliament, with Parliament setting the bad example of breaking and bending laws and rules to fit the whims and fancies of the Barisan Nasional government, whether during question time or in the first debate on the Royal Address.
Those who have seen the live telecast may want to give their views for the benefit of MPs.
After the apology over the keris
Posted by Kit in Azly Rahman, nation building, UMNO on Wednesday, 30 April 2008, 8:12 am
by Azly Rahman
We must resolve the keris controversy generated by Umno Youth chief Hishammuddin Hussein, who has brandished the keris at the party’s annual assembly twice now.
At last year’s meeting, Umno Perlis delegate Hashim Suboh said at the end of the debate on economy and education issues: “Datuk Hisham has unsheathed his keris, waved his keris, kissed his keris. We want to ask Datuk Hisham, when is he going to use it? […] Force must be used against those who refused to abide by the social contract.”
This was in relation to Hishammuddin’s alleged weakness in dealing with demands from Chinese schools.
We live in a world in which signs and symbols of violence colonise our consciousness. From cave walls inscribed with images of Neanderthals clobbering a baby dinosaur, to production of images disseminated worldwide via the electronic media and Internet, we are confronted with violence.
We are creatures of signs and symbols manipulated by those who own the means of producing static and moving images. Objects of violence – of deaths and mega-deaths, of decimation and of demolition, and of the demonstration of defiance and destruction – all these, throughout history, have become symbols of choice for those in power. Read the rest of this entry »
Urgent Parliament motion on Wednesday for release of Hindraf 5 and 60 other ISA detainees
Posted by Kit in Hindraf, Human Rights on Monday, 28 April 2008, 4:43 pm
I have given notice to Parliament to have an urgent debate on Wednesday for the release of the Hindraf Five – M Manoharan, DAP Selangor Assemblyman for Kota Alam Shah, P. Uthayakumar, V. Ganabatirau, R. Kenghadharan dan T. Vasantha Kumar – and over 60 other detainees currently held in Kamunting Detention Centre under the Internal Security Act (ISA), including some who had been incarcerated for over six years.
In calling on Parliament to urge the Abdullah administration to respect and comply with the wishes of the people as demonstrated in the March 8 “political tsunami” for a more democratic, accountable and progressive Malaysia, the government is reminded that the ISA detainees should not be denied their fundamental rights to an open trial if they are deemed to be threats to national security.
The refusal of the government to release the Hindraf 5 and the scores of other ISA detainees is proof that the Abdullah administration is not prepared to heed the people’s aspirations clearly articulated in the March 8 “political tsunami” to end its arrogant governance and to revoke its high-handed and undemocratic policies and laws.
Freedom From An Oppressive Government
Posted by Kit in Bakri Musa on Monday, 28 April 2008, 3:54 pm
by M. Bakri Musa
The greatest legacy the leader of a nation could bequeath would be freedom from an oppressive government. This realization comes to me when I compare Malaysia’s experience during the 1997 economic crisis to America’s current struggle with its massive debt mess.
The differences in reactions and consequences are attributable to one salient factor: Unlike Malaysians, Americans do not fear and are not dependent upon their government. Americans have a healthy skepticism towards their leaders and government, an attribute generally lacking among Malaysians.
With Malaysia in 1997 there was a general crisis of confidence, with widespread gloom and doom permeating the skyscrapers in Kuala Lumpur as well as the suraus in Ulu Kelantan, and from the Prime Minister to the village penghulu. It also precipitated a deep and ugly split in the leadership that resulted in riots and ugly street demonstrations. The very symbol of our sovereignty – the ringgit – was devalued.
Like Malaysia then, America is today plagued with a mountain of debt on a scale a universe beyond what Malaysia suffered. The American dollar is also being debased, not by the government however as with Malaysia, but by the more powerful force of the marketplace.
The American tribulation is even greater, as the leadership – in particular President Bush – is viewed as ineffective and irrelevant. America is additionally burdened with an expensive and bloody war. Yet for all that, there are no riots or widespread doom and gloom. When Americans are disenchanted with their president or government, they throng the voting booths in record numbers to vote for a change. Read the rest of this entry »
12th Parliament Opens Today
Posted by Kit in Parliament on Monday, 28 April 2008, 8:21 am
The “political tsunami” 12th Parliament elected on March 8, 2008 convenes today for the swearing-in of the 222 elected Members of Parliament and the election of the Speaker and two Deputy Speakers.
Tomorrow, the Yang di Pertuan Agong will officially declare open the 12th Parliament with a royal address which represents the policy speech of the government.
On Wednesday, question time and debate will begin.
There are great expectations of the new Parliament. Let its curtain rise.
Hishammuddin’s apology – Malay keris-wielding antics laid to rest?
Posted by Kit in nation building, UMNO on Sunday, 27 April 2008, 12:23 pm
Two weeks ago, when speaking at the first public ceramah/consultation with DAP MPs, Excos, State Assembly representatives in Ipoh, I broached the subject when the UMNO Youth leader and Education Minister, Datuk Seri Hishammuddin Hussin will publicly apologise for his offensive, irresponsible and provocative “Malay keris” antics which MCA, Gerakan and even Umno leaders had blamed as one of the causes of the Barisan Nasional’s debacle in the March 8, 2008 general election “political tsunami”.
I said:
Hishammuddin should publicly apologise for his “Malay keris” antics and MCA, Gerakan and other Barisan Nasional leaders should demand in unison for such an apology and assurance of no repetition in Cabinet and Parliament.
Unless Hishammuddin is prepared to make a public apology and MCA, Gerakan and other BN leaders in Cabinet and Parliament take a public position demanding that Hishammuddin publicly apologise for his offensive, irresponsible and provocative “Malay keris” antics, it could not be said that Umno, MCA, Gerakan and BN leaders have learnt anything from the March 8 “political tsunami”.
The questions I want to pose tonight is whether Hishammuddin is prepared to publicly apologise for his irresponsible and provocative “Malay keris” antics and whether MCA, Gerakan and other BN leaders are prepared to demand in unison for such an apology and assurance of no repetition in Cabinet and Parliament as proof that they have taken seriously the voice of Malaysian voters in the March 8 “political tsunami”.
Now Hishammuddin has made his apology, although quite an ambivalent one. Read the rest of this entry »
Lee Kah Choon saga – opportunity lost for BN leaders after March 8 “political tsunami”
Posted by Kit in Election, nation building on Friday, 25 April 2008, 3:00 pm
The Lee Kah Choon saga is an opportunity lost for Malaysian leaders to emulate the Malaysian voters in the March 8 “political tsunami” to rise above race, religion and political differences to work single-mindedly for the good of the people, state and country.
In the last Parliament, in keeping with the perverse notion of “Support Barisan Nasional, right or wrong”, a new rule was formulated for all Barisan Nasional MPs that they cannot support Opposition motions whether right or wrong and cannot vote according to their conscience but must toe the party line.
As a result, the then Chairman of the Barisan Nasional BackBenchers Club, Datuk Shahrir Abdul Samad (now Domestic Trade and Consumer Affairs Minister) was forced in May 2006 to resign from his post to avoid disciplinary action against him for speaking up in favour of my privilege motion in Parliament to refer the then MP for Jasin, Mohd Said Yusuf to the Committee of Privileges over the impropriety of an MP asking the Customs and Excise Department to “close one eye” in a case involving the import of sawn timber in Malacca.
It was in disgust at such obtuse and petty-minded mentality where individual and party interests were placed above parliamentary, public and national interests that the Malaysian voters rose as one to teach the Barisan Nasional a salutary lesson in the March 8 “political tsunami”, depriving the BN of its hitherto unbroken two-thirds majority in Parliament and power in five states. Read the rest of this entry »
Renewal of Makkal Osai welcomed – now for immediate release of Hindraf 5
The government’s about-turn to renew the publishing permit of Tamil daily Makkal Osai which it banned last week is welcome as it would have otherwise destroyed the credibility of all reform pledges of Prime Minister, Datuk Seri Abdullah Ahmad Badawi on the judiciary and the anti-corruption agency.
The Home Minister, Datuk Seri Hamid Albar should learn the lesson of the Makkal Osai faux pax and not repeat the same mistake of complying obediently and blindly the dictates of the “Little Napoleons” in the bureaucracy and to bring to bear his higher duties and responsibilities as the Minister ultimately responsible for all decisions made by his ministry.
Now, it is for Hamid to order the immediate and unconditional release of the Hindraf 5 from Internal Security Act (ISA) detention in Kamunting.
Hamid cannot again pass the responsibility of the continued detention of the Hindraf 5 to the civil servants as he must bear full and final responsibility for the government’s refusal to heed the voices of the people in the March 8 “political tsunami” that the Malaysian Indians have legitimate grievances about their long-standing marginalization of their citizenship rights in the country, and the Hindraf 5 should be rewarded instead of being incarcerated for bringing the plight of the Malaysian Indians finally to the attention of the government and nation. Read the rest of this entry »
Rustam Sani – Patriot and Intellectual (1944-2008)
Posted by Kit in Bakri Musa on Thursday, 24 April 2008, 7:31 am
by Bakri Musa
I am saddened to hear of the sudden death of Rustam Sani. In Rustam we had a true patriot, one whose love for the country is pure. It is so because it came from the head as well as the heart. It is patriotism unadulterated by the pursuit of material wealth, public adulation, or political power. A genuine intellectual, he was not one to fit his ideas to the fashion of the day.
He recognized early the heavy duty and responsibility of being a patriot. His was not one consumed with endless exhortations. As the son of a renown nationalist, Rustam must have been immersed in the patriotic fervor and fiery speeches of his late father, Ahmad Boestaman. Yet at a very young age he knew that the new independent Malaysia would need leaders who not only love the country but also be well equipped with the necessary skills and intellect to lead it.
Consequently he focused on his school work fully aware that he was among the fortunate few among the youngsters to have the privilege of attending school. From his local sekolah attap (village school) in Behrang Ulu and the Methodist School Tanjong Malim, he went on to the University of Malaya via Victoria Institution. From there it was on to graduate work at Kent and Reading in Britain, and later, Yale.
He was a scholar as well as a practitioner of politics. His intellectual accomplishment was never diminished by his political involvement. He had penned more academic papers and popular commentaries as well as books than many fulltime academics. It was only yesterday that I read his latest (and alas his last) posting on his blog. Rustam was in his usual sharp element; that posting was a trenchant commentary on Mahathir’s interview on BBC’s Hard Talk. Rustam was also to have launched his latest books, Failed Nation? Concerns of a Malaysian Nationalist, and Social Roots of the Malay Left, later this month. Imagine two books! Read the rest of this entry »
China-Bashing Season Has Begun
Posted by Kit in Farish Noor on Wednesday, 23 April 2008, 9:45 pm
By Farish A. Noor
While the simplistic thesis put forward by Samuel Huntington in his work ‘The Clash of Civilisations’ reads like a paltry script from a bad movie, it has to be said that bad scripts are often the most believable and effective. It was Huntington who predicted that in the wake of the Cold War a new sort of conflict would arise, namely one configured along cultural-civilisational differences between the developed Western world and the mysterious, exotic and threatening East.
The two cultural blocs that were said to be the future adversaries to the West were the Muslim world and China, respectively. In the case of the former, it was opined by Huntington that with the demise of Communism the potential threat of Islam would be realised sooner or later for the simple reason that Islam and the West shared ‘bloody frontiers’ that were marked by centuries of conflict. This thesis, however, is patently false to anyone who has even the slightest idea of the history of Islam and the non-Muslim world, for the fact is that the frontiers of the Muslim world are not marked by violence nor stained by blood, but rather remain porous horizons marked by the eclectic culture of Islamic mysticism or Sufism: From Southeast Asia to China, from Africa to Europe, the furthest frontiers of the Muslim world are precisely where mysticism and the Muslim practice of inter-cultural dialogue and cultural cross-fertilisation flourished the most.
Related to Huntington’s fear of Islam was his fear of China, dubbed the ‘sleeping giant’ by Napoleon more than a century ago and which till today has yet to truly realise and demonstrate its full economic potential. Huntington’s crude thesis argued that in time the West would have to realise that non-negotiable cultural differences exist between the Western world and the Orient, and that these cultural differences would ultimately serve as the catalyst for an all-out confrontation between the West and China. Read the rest of this entry »
Passing of a great Malaysian patriot
Posted by Kit in nation building on Wednesday, 23 April 2008, 3:01 pm
Shocked this morning to hear of the passing away of a great Malaysian patriot, Rustam A. Sani, 63, academician, scholar and political activist suddenly at about 2.30am at his home in Gombak.
Deepest condolences to his wife, Rohani, his children Azrani and Ariani and grandaughter, Arissa.
Together with Fong Kui Lun, DAP National Treasurer and MP for Bukit Bintang, I paid my last respects to Rustam at his Gombak home.
Rustam is one of the great Malaysian sons and daughters who have made incomparable contributions to Malaysian nation-building but who have not been given proper national recognition and yet who continued to give his best for the betterment of the country through his writings and ideas till his last breath.
Rustam’s passing is an irreparable loss to Malaysia.
ACA director-general finally admitting “interference” in anti-corruption investigations?
Posted by Kit in Corruption on Tuesday, 22 April 2008, 11:43 am
“This is what the public wants. We want the same, too…What we want is to be independent in carrying out investigations with no interference.” – Director-General Ahmad Said Hamdan, ACA director-general.
Is this response by the ACA director-general to the proposed revamp of the Anti-Corruption Agency into the Malaysian Commission on Anti-Corruption, announced by the Prime Minister yesterday, an admission that there had been interference all this while into the ACA investigations, resulting in its inability to nab the 18 “big fishes” targeted at the beginning of the Abdullah premiership four years ago and the country’s plunge in the Transparency International Corruption Perception Index rankings from No. 37 in 2003 to No. 43 last year?
If so, the time has come for the ACA to open its books to fully account for all cases of interferences into all past corruption investigations into high-profile personalities, political or otherwise.
Anti-Corruption reform – Abdullah pre-empting parliamary question directed to him next week
Posted by Kit in Corruption on Monday, 21 April 2008, 1:23 pm
It has become the practice for Cabinet Ministers to pre-empt questions which MPs have given notice in the forthcoming parliamentary meeting by giving answers before the questions are actually asked on the dates they are listed.
The Prime Minister, Datuk Seri Abdullah Ahmad Badawi, has proved that he is no exception and is beginning to answer my first question for question time in the 12th Parliament beginning next Wednesday, which asked him “to outline the top ten priority reform measures which his government will implement in the next 12 months to demonstrate that he has heard the voices of the people in the March 8, 2008 ‘political tsunami’”.
This morning, Abdullah announced that the Anti-Corruption Agency (ACA) will be made a full-fledged commission by year-end and will be answerable to Parliament.
He said said this was one of the four key reform initiatives that would be carried out by the government in the move to address the public concerns on corruption in the country.
The commission’s workforce would be increased to 5,000 officers over a period of five years and the government would also introduce legislation to provide a comprehensive protection for whistle blowers and witnesess in corruption cases.
Furthermore, the government would also take immediate steps to improve the public procurement process through measures targeted at addressing specific problems in the system. Read the rest of this entry »
