"I believe in a country where hard work and merit, not privilege or background, determines success."
Tony Blair 2005

Saturday, May 29, 2004

Rape : Are we on the right track?

We have sadly seen a dramatic increase in the number of rape cases. Some are random victims while others are members of their own family. But what is the psychology behind such actions? On most occasions , only the rapist would know.

However, in most cases especially those involving family members , there are always warning signs. For example, unwanted advances etc. Some blame it on the provocative dressing by females. I believe that this is a spectrum of sexual dysfunction. We have to recognise it and treat it as a disease.

Most sex crimes are done by repeat offenders. This occurs due to the failure of the system to help these individuals. Most are only eager to banish them to lengthy prison terms. None would really offer them proper treatment and counselling especially after their jail term.

Of course, in such crimes, the individual that suffers most is the victim. Most are scarred for life, physically and emotionally. Only time will be the best healer under such circumstance. There is no word that could describe the pain that they have to endure.

There is no excuse to rape. It is a violent and despicable act. The inability to control ones hormones appears to the sole cause of such heinous crimes.

Once again, education plays an important role. Educating males to respect their female counterparts is essential. Chaunivinistic mentality should be discarded. Women should not be portrayed especially by the media as sex objects. But ultimately, the most important element is to educate males on how to cope with raging testosterone levels and the recognition of abnormal urges. They must know where to seek help. Help that guarantees confidentiality.

There is no easy answer. But we now have a problem in our hands and something needs to be done before more souls are hurt.

Friday, May 28, 2004


From Malaysiakini,

University intake: True meritocracy needed
4:40pm Fri May 28th, 2004

Opposition leader and DAP chairperson Lim Kit Siang today called on the Cabinet to decide on a common university entrance examination to ensure that genuine meritocracy is practised.

"Malaysia must get out of the ‘denial syndrome’ that we are practising a true and genuine form of meritocracy, which will continue to be a source of national disunity," he said in a statement.

"So long as there is the ‘Malaysian mould of meritocracy’, which is merely a reminder to all that there is only meritocracy in label but not in substance, the annual intake of students will be a source not only of individual disappointments and frustrations, but even more serious, national unity," he added.

The meritocracy system was implemented in 2002 to replace the quota system, which had set a 55:45 ratio for enrolment of bumiputeras and non-bumiputeras respectively.

Under this new system, entrance to public universities are by way of two examinations - matriculation and Sijil Tinggi Pelajaran Malaysia (STPM). Only 10 percent of Mara matriculation courses are open to non-bumiputeras.

Many have decried this system as being unfair as the one-year matriculation programme is deemed to be not on par with the more trying two-year STPM examination.

No exception

Lim said this year’s intake comprising 38,892 students into public universities was no exception because of the ‘differential and discriminatory’ application of two different entry examinations.

Of the total number of students admitted into public universities, 24, 837 (63.8%) were Bumiputera, 11,778 (30.3%) Chinese and 2,277 Indians (5.9%).

The opposition leader also noted that 1,774 students obtained the maximum Cumulative Grade Point Average (CGPA) of 4.0.

Among the STPM students, 527 obtained the maximum CGPA - Chinese (503), Indians (23) and Bumiputera (1). For matriculation, there were 1,247 students with the maximum CGPA - Bumiputera (789), Chinese (419) and Indians (39).

"As only 10 percent of the Mara matriculation courses are open to non-Bumiputeras, this means that non-Bumiputera students representing 10 percent of the matriculation candidates secured 36.73 percent of the candidates with CGPA score of 4.0 as compared to the 63.27 percent securing the top score by bumiputera students representing 90 percent of matriculation candidates," Lim said.

The DAP chairperson added that if Malaysia is serious and genuine about meritocracy, then it must be prepared to have a common university exam.

"No Malaysian will object to an intake policy based on ‘merit coupled with need’ to ensure other important considerations of proper ethnic and socio-economic representation are also taken into account.

"But these considerations should be kept completely separate and distinct from the system to establish and determine academic meritocracy in a common university entrance examination," he said.

Students’ plight

The Star today highlighted the plight of Murali Silvarajoo and other students, who despite scoring high CGPA scores, failed to gain admission into the courses of their choice.

Murali, who scored straight As in the STPM examination, was crestfallen when he discovered that he did not qualify to do medicine. He was instead offered Chemical Engineering.

"I cannot believe it. I am really shocked and disappointed," he said, adding that he would file an appeal on the matter.

Another high scorer, Jenifer Kua, who obtained a CGPA of 3.92, was not given any of the eight courses she had applied for. She was instead offered a course she had never heard of.

"I applied for medicine, pharmacy and dentistry but was offered some course called Pemulihan Biodiversiti (Biodiversity Rehabilitaion) at Kolej Universiti Sains dan Teknologi Malaysia. I have not even heard of this place," she lamented.

Meritocracy is still a hot topic for debates. There is certainly much controversy with regards to the selection of students. The discrepancy in standard between the matriculation and STPM appears evident despite vehement denials by the education authorities that they are of equivalent standard. But it is clear that these 2 systems are bound by different rules, curriculum and examination standards. If they are of the same standard, then why have 2 systems? Why can't all students be measured by the same examination?

I think the answers are pretty obvious. The quota system still exists but has been "discretely" disguised. Imagine a 5A STPM student cannot qualify to do medicine. I can almost bet you that there will be many matriculation students with inferior scores getting into medicine. The Government often laments on the brain drain occuring in Malaysia. Unfortunately , they are not doing the necessary things to stem this trend. I am sure a student of Murali's calibre will be quickly snared by other countries, in particular Singapore, which recognises talent.

Malaysia is still pretty much segregated racially and this divide is set to widen even further. We must not fool ourselves into believing that all is well. Media propagandas often paint a good picture of racial harmony but is it a true reflection of the current situation? If the basic tool for racial integration ie our education system, still appears racially segregated, how can we then expect future generations to forge a cohesive partnership between races in Malaysia?

The Government needs to be serious when implementing meritocracy. We only appear half-hearted, with certain quarters still reluctant to completely relinquish favouritism. The verdict for now is "No, there is no meritocracy as of yet". It appears that the Government has its own definition of meritocracy, similar to their re-defining of the word democracy.

Interesting statistics

Friday, May 21, 2004

Topsy turvy world

Featured on CNN
Singapore reality TV: 1st pregnant couple wins
Thursday, May 20, 2004 Posted: 11:15 PM EDT (0315 GMT)

SINGAPORE (AP) -- The prize: US$100,000 -- and a baby.

Ten couples from around the world could compete in a reality TV show in Singapore to see who can procreate first, the city-state's self-styled sex guru said Thursday.

What on earth is going on? These reality TV shows are really skirting the boundaries of sanity. Of course, we all know the objective of this ridiculous exercise. Profit making and nothing else.

It was mentioned that this idea was conceived due to the fact that Singaporeans registered a low frequency of sexual intercourse in a recent Durex survey. How would a game show increase sexual stimulus? The couples will be watched closely as they lead their normal lives.

Isn't this voyeurism? It could have unwanted repercussions on society. It is condoning voyeuristic tendencies.

I fail to see the benefit of this game show. It is a wonder how a progressive nation like Singapore could come up with a backward and distasteful idea like this.

Thursday, May 20, 2004

Bomb hoax at Hospital Mentakab

A bomb threat was received this morning at Hospital Mentakab. This caused the evacuation ,transfer of patients and the ensuing closure of the hospital for a thorough inspection by the police. After hours of searching, the threat was deemed a hoax!

However, such can be seen positively! It can expose weaknesses in the emergency procedures and similarly, remind the hospital management that drills are an important component of any hospital administration. When faced with a crisis situation , the staff have to function like a well-oiled machine. There is little room for errors under such dire circumstances. Are our hospitals able to perform well in Emergency situations? Perhaps this hoax was a test and a subtle reminder as to the work that needs to be done to improve existing protocols and procedures.

Bomb hoaxes have become increasingly frequent in Malaysia. Even the Twin Towers was not aparred from this attack. There is a need for a system that could reduce or discourage such mischief. Targetting hospitals is unwise and reflects a disturbed mind. It offers no strategic political points and the hospital itself poses no threat. A hospital is a sanctuary for the sick and thus should be respected as such. I believe that the perpetrator is mentally unstable and requires professional help. But can our police find him?

Friday, May 14, 2004

Waiting Time Debate

In the NST today,

Complaints of long wait for treatment at hospital
Nurjehan Mohamed and Tony Teoh
If being sick is not enough, some have to wait for hours before they get treatment at the Universiti Malaya Medical Centre, complained patients
interviewed today.Met at the Emergency Unit and General Clinic of the hospital, it was evident that some patients had to wait for three hours.

Retiree Chua Kui, 58, who took his 90-year-old father for treatment at General Clinic said that he often had to endure a long waiting period averaging three to four hours, excluding the time taken to register, just to see the doctor. "Getting the medication from the pharmacy is another hour's wait, thirty minutes if I'm lucky," he said.

Mastura Jamil, 33, who brought her five-month-old son, said it was her third visit to the hospital and from past experience, seeing the staff nurse was easy but trying to see the doctor would take up to an hour................................

This is an unfair report and extremely one sided. I am pretty sure there will not be any patients voicing satisfaction. It is a biased news report. Even Mastura Jamil was only waiting up to an hour. That is pretty good. Even popular private hospitals like SJMC have long waiting lines. Why are people not complaining then?

Perhaps the answer lies in this letter in the NST,

How to make doctors stay in government service
May 14:
I AM a doctor working in the Emergency Department of a government hospital. Much has been said about the condition of our health system, mainly the treatment of patients in hospitals, waiting time and the hardship faced by doctors. I believe the root cause of the problems mentioned is the shortage of doctors. We churn out many doctors from our universities — local and overseas, as well as from medical colleges each year. The problem is that we fail to keep them in government service.

The main reason why we fail to keep them is because of the low pay, long working hours and bad working conditions. Fewer doctors wish to remain in government service, thus causing an increased burden to those who do stay. Fewer doctors means longer waiting time for patients. Tired and overworked doctors may give substandard care due to lethargy and poor judgment. It is a vicious cycle.

How do we break the cycle? Increase the pay of doctors and improve their working conditions. More doctors will stay and then the workload will be lessened which will in turn attract even more to stay. To increase their pay, we need to find the extra money. How can we do this? Government hospitals are not profit-oriented. All medication is free despite being expensive.

Treatment at outpatient clinics and emergency costs only RM1. For example, a patient with fever and cough treated at the outpatient clinic will at least be given paracetamol and a cough mixture for his RM1. In contrast, the same medication bought at a pharmacy may cost RM1 to RM2 for 10 tablets of paracetamol and RM5 to RM15 for a cough mixture. There is so much difference in cost even for such a simple case as the flu. Another example is when a patient comes to the Emergency Department and is rehydrated intravenously with some blood tests and X-rays done. CT scans are done if warranted, and these may cost from RM300 to RM1,000 in private hospitals. All this for RM1. I believe increasing the charge from RM1 to RM5 is logical and necessary.

Currently, because it is so cheap to see a government doctor, patients abuse the system. I have seen patients in my Emergency Department with trivial complaints such as body odour, bad breath and dandruff! The prescription for medication by doctors in government hospitals should also be checked. A big chunk of our hospital budget goes into purchasing medication. It is not uncommon for patients to be on 10 different types of medication, some being expensive. The cheapest, most effective medication should be given priority over more expensive, newer medication.

Let us think of logical solutions which target the root cause and not solve a problem by creating another problem.

Kuala Lumpur

I agree that sometimes patients abuse the system. I have worked in the Emergency and have seen many cases which are non-urgent but they insist on going to the Emergency. These patients will voice their displeasure when told to wait or to go somewhere else. I still remember as the only emergency doctor on call on a weekend and with many emergency cases, there is little time and hardly any patience to see trivial cough and cold cases. Are we to be blamed then for long waiting lines? I hardly think so.

Patients have become increasingly demanding. The unrelentless and at times unreasonable pressure from the press does no favours as well. I suggest that patients and the press look in a broader perspective not just measure efficiency in terms of waiting times. We need the press to educate the public on the reasons for such a long waiting line. We cannot do magic and we need help to solve this matter.

Ultimately the above letter spells it out, we need more doctors in government service. We need to seal the leak of doctors going into private practice. There is only one way, make doctors feel more appreciated.

Perhaps we need to celebrate Doctors' Day too!! Why not?

Thursday, May 13, 2004

The continuing misery of doctors

In the NST letter section,

Long wait to get into government medical service
May 13:
"COME to Malaysia. Being a doctor here is great," my parents-in-law persuaded me. They assured me a medical doctor is highly sought-after by the Government and I would have no problem getting employment and permanent residency in this country.

Life hasn’t been anywhere close to what they promised. My husband, a Malaysian, is currently working as a medical officer (MO) with a meagre salary compared to what he could have earned in developed countries.

Me? While the Malaysian Government was busy recruiting foreign doctors from Egypt, India, Pakistan and Myanmar, it has given me, an Australian with a medical degree from the University of Melbourne, less of a priority. As a result, I have been in this country for almost a year, still waiting for my application to reach the end of the very long red tape.

This reflects a sorry state of affairs involving our Health Ministry and the Jabatan Perkhidmatan Awam(JPA). Some policies just defies logic. It displays the haphazardness in the current administration. Welcome to Malaysia , I say.

Medical Officers here are poorly treated and the benefits does little justice to the profession. The compulsory service is, sad to say, not universally practised. The evidence of cronyism is abundant. The traces of racial devide still lingers. The writer of the letter was obviously deluded by the parents-in-law in saying, "being a doctor here is great". This is far from the truth especially if you have to deal with the Health Ministry.

Contract doctors in Malaysia have been known to perform poorly due to, in most instances ,the language barrier. On many occasions as well, the practices differ due to the differing disease demographics in their home country. What puzzles me is that we are recruiting these doctors without first subjecting them to a stringent standard. It seems that the Government would like to make their path as easy as possible,thus to make Malaysia a more attractive destination. I beg to differ. I think that if doctors from overseas would like to practice here, they should be subjected to a common standard. This is the pre requisite in many other countries eg US, Canada and UK. Why are we treating foreign doctors better than we treat our own? Why does the Government have money to splash on these doctors when they are reluctant to increase the salary and thus keep more doctors in the service and probably attract more Malaysians back from faraway countries?

Despite vehement denials, there is an obvious lack of transparency and meritocracy in the current administration in Malaysia. If I had known these , I would not have returned myself. And my advice to those overseas, stay there!

Wednesday, May 12, 2004

Leading by example?

In the star,

USM to screen for smokers

PENANG: About 5,000 freshies entering Universiti Sains Malaysia (USM) next month will have to undergo compulsory medical screening to detect smokers.

Those tested positive will be sent to the university’s “quit smoking” clinic where special programmes will be held for them to kick the habit. USM is believed to be the first public university to introduce the move.

The university would also conduct training for 50 staff members who would soon be empowered to fine students and staff who were caught smoking in the main campus here, said its vice-chancellor Prof Datuk Dzulkifli Abdul Razak.

A staunch tobacco-control activist, Prof Dzulkifli said he did not expect any public backlash as the move was aimed at promoting a healthy lifestyle and was in line with the government’s aim to discourage smoking.

Any anti-smoking initiative is commendable. However, how effective and reliable are these screening methods? Or will it be a futile exercise and a waste of university funds? As to my knowledge, there is no effective way of determining if a person is smoking or otherwise, except through a breathanalyzer which detects carbon in the breath of an individual. Even this will not be accurate as pollution can also result in a false positive test. Social smokers can hardly be detected. Even smokers that abstain prior to entry into the university will escape the net.

So what is the purpose? I strongly feel that it will be an absolute waste of money and manpower. I understand the intentions of Prof Datuk Dzulkifli but such methods just will not work. It will only create a greater sense of defiance among the student population. Moreover, I think he should first look into his faculty before enforcing such rules on students. I am quite sure there will be smokers among his current faculty members!

Education remains the main tool in our fight against tobacco smoking. Ultimately, the individual will have to decide what is best for himself. Using peer approach is underutilised and needs greater emphasis. I think even patients with coronary heart disease, chronic obstructive lung diseases and cancers caused by tobacco smoke should step forth to educate the young. This usually sends a powerful message that smoking tobacco does have real and dire consequences.

I do applaud the ongoing "TAK NAK" campaign. It is costly but necessary.

So to USM, I am sure there will be no public backlash but is this the best method?

PAS : A Path of Desperation

In the Straits Times,
PAS push for non-Muslim membership
KUALA LUMPUR - Some Parti Islam SeMalaysia officials believe PAS should throw caution to the wind and admit non-Muslims.

Otherwise, it will be difficult to expand the party's political influence and rebut claims that it is chauvinistic, they say.At the Federal Territory PAS convention on Sunday, they passed a resolution to let non-Muslims become members.

Is PAS getting that desperate? And how will allowing non-Muslims in the party rebut claims of chauvinism in the party?

PAS is fundamentally an Islamic party. Its fight politically is motivated by religious issues. Thus this latest move of allowing non Muslims to join the party, contradicts the very core of its beliefs. It makes a mockery of their constitution.

PAS lost heavily in the latest general election. The heavy defeat was unexpected. They are still finding it difficult to accept such heavy defeats, prefering instead to blame the Election Commission of election fraud. The voices of the people sent a clear message to PAS. Its policies are no longer acceptable. It is archaic and at times foolish.

So this latest move reflects a sense of desperation. The support of the party has eroded with its main support coming from Kelantan, which is also weakening. They are bleeding badly and they need to stop it fast. But are non Muslims going to be the answer?

Tuesday, May 11, 2004

Private Wing Debate Continues

In the Star
Chua: Private hospitals fear potential competition
KUALA BERANG: Private hospitals fear the competition that may arise from the proposed setting up of private wings in government hospitals, said Health Minister Datuk Dr Chua Soi Lek. He said some people were worried the move would affect the quality of service in government hospitals.

“We have to strike a balance between the profit-oriented private sector and the Government’s responsibility of providing services at minimal rates.

“These matters would be looked into by the special Health Ministry committee studying the proposal,” he said, after visiting the Hulu Terengganu Hospital here yesterday.

He said the private sector “will always come out with lots of reasons.”

He declined to elaborate.

The animosity between the government and private sector is evident from the above news report. I think the Government would fear more from losing doctors, than the private sector of competition arising from private wings in Government hospitals. The biggest worry from the setting up of such a private wing is whether patients that can ill afford the payment be given an equal quality of service from doctors especially the specialists. The fear is that the disparity between the quality of such services will widen the already worsening gap between the rich and the poor.

It will cause confusion. In the current system, there are many patients who can ill afford to pay even the lowest of charges. Will these patients now be neglected as the specialists concentrate more on making more money? Who will then attend to these patients? How much time will these specialists or doctors spend on poor patients? Will there be a difference in the quality of service ie better services for patients that pay?

I feel that we are heading in the wrong direction. The Government it seems is avoiding the responsibility of increasing the renumeration of doctors. Bottomline is doctors need a different and higher payscale. A payscale that reflects the sacrifice given in under graduate training, in active duty, in post graduate training and so forth. We need to feel a sense of appreciation from the Government. We are like any other employees. We need to know if we are being appreciated. One way is by means of a better payscale.

We need to set up a nationwide insurance scheme similar to Medicare in the United States. It will be a challenge but I think there is where the answer to better medical services lies. The setting up of private wings in Government run hospitals will only widen gaps in social stratas in Malaysia. At this moment, only the middle and upper groups can afford insurance schemes and thus the right to medical services in the private sector. Poor citizens should be afforded that right to choose as well.

We need to work as a team with better cohesiveness. Creating animosity between the same group of professionals does not augur well for the profession.

Saturday, May 08, 2004

MMA: Still toothless

In the NST
Government docs seek review of salary package
Tan Choe Choe

Government doctors are not seeking a complete revamp of their salary scale but rather, a review of their allowance scheme.They feel that their allowances should be incremental and not be fixed to their salary scale. "While our salaries are incremental, our allowances are not.

"If you do not get promoted to another salary level, you will not get any increase in allowance," said Malaysian Medical Association'schairman for Section Concerning House Officers, Medical Officers and Specialists Dr Kuljit Singh, today. This salary package, according to Dr Kuljit, is rather outdated because there are more patients today and doctors are doing more overtime to cater to their patients.

He added that doctors were also being increasingly recalled on weekends or public holidays.

Yesterday, Health Minister Datuk Dr Chua Soi Lek said the Government was considering a new salary scale for government doctors and specialists. He also said a committee had been established to review the salary package and allowances of doctors, which would also look into their frustrations in public service.

However, MMA president Datuk Dr N. Arumugam explained to the New Straits Times today that government doctors' salaries were tied to the salary scale of civil servants and could not be changed without approval from the Cabinet. "I believe what the minister meant was that the Government is considering reviewing the (allowance) benefits, not so much the salary scale," he said.

It appears that the MMA is backpeddling. Why are they not seeking an increase in the salary scale in addition to allowances? It is the salary scale that does no justice to the profession. By the above statement, the MMA is suggesting that they are satisfied with the salary scale. Moreover, how can the president of the MMA correct what the Health Minister was trying to say?

This reflects the chaotic natiure of the MMA. It is a body riddled with politics and internal rife. It remains directionless with lack of leadership qualities. It remains meek when it has to stand firm. Ultimately , they fight not for the welfare of all doctors but a select few.

I am deeply disappointed with this recent turn of events. It only displays confusion in the ranks of the MMA. I believe this occurs because those holding positions in the MMA are no longer with the government service and thus are no longer subjected to hard labour. This reflects in their reluctance to go all the way in their fight to improve the renumeration of doctors.

The MMA is paralyzing itself. I can only sigh in disgust!

Friday, May 07, 2004

A Breakthrough?

In the NST,
Panel to review doctors’ salaries
Annie Freeda Cruez

The Government is considering a new salary scale for its doctors and specialists. Health Minister Datuk Dr Chua Soi Lek has established a committee to review their salary packages and allowances, while also looking into their frustrations. The findings, together with recommendations for higher pay, will then be submitted to the Cabinet Committee on Salary Adjustment, chaired by Prime Minister Datuk Seri Abdullah Ahmad Badawi. This was decided at a dialogue between Dr Chua, the Malaysian Medical Association (MMA) and the Section Concerning House Officers Medical Officers and Specialists (SCHOMOS) at the Legend Hotel here today.

"The low salary and allowances, their selfless service for years with no promotion in sight and long hours of work in hospitals were discussed at great length," Dr Chua told reporters after an almost four-hour closed-door meeting. He said he understood and sympathised with the doctors and specialists as they served in a challenging and difficult environment, with rewards that were not attractive when compared with those enjoyed by their peers in private hospitals. The special committee, he added, would compile all the data on the current salaries and allowances of doctors and specialists, get feedback from the MMA, and make recommendations. Dr Chua said it would also look into the facilities for medical officers and specialists, including houseman's quarters, on-call food, and safety and communication.

"I want close interaction between doctors and the ministry so that there is a two-way free flow of information," he added.

Chua said he would hold dialogues with the MMA from time to time to improve relations, understand the problems of Government and private doctors, and ensure a better health delivery system.

"A special committee will also be set up to discuss how to assess and promote doctors faster," he added. Last year some 1,800 doctors and specialists were promoted. At present, Dr Chua said, there were 10,000 posts for medical officers, with 25 per cent still not filled, and 1,200 posts for specialists, with 40 per cent vacant.

A special committee, headed by Deputy Health Minister Datuk Dr Abd Latiff Ahmad, has also been set up to study the proposed private wing in government hospitals. Dr Chua said the MMA had also submitted its views and proposals to be evaluated by the committee, besides looking into issues such as legislation, human resources and fees.

Dr Chua expects a working module to be ready within two months.

Asked if the proposed private wing would be implemented in all government hospitals, Dr Chua said: "We have to study whether the proposal is feasible, whether we have to build separate wings, manpower and how it is to be implemented. If it is not feasible, then what are the other alternatives to attract doctors to work in Government hospitals?" The minister said the MMA had also expressed its concerns over the increasing number of unregistered traditional and complementary medicine practitioners in the country. ..................

Good news at last. Looks like things are finally moving in the right direction. Let us pray that there will be a continuing momentum towards the implementation of an adjusted salary scale and better working environments. Kudos to our Health Minister for finally standing up for doctors in Malaysia.

Thursday, May 06, 2004

Doctors' misery

Silent agonies suffered by overworked doctors
May 05:

PLENTY has been said about the misery patients undergo in public hospitals.
I would like to share our silent agonies as house officers (HO).

HOs in most hospitals work Monday to Sunday, 7am to 9pm, including public holidays. If and when we need a break, we are allowed to take leave, from the nine days provided every four months (a total of 30 days per year). And if we fall sick and require medical leave, it is deducted from our nine days of leave.

When we are on call, we work throughout the night, clocking up to 38 hours continuously. In some cases, HOs have worked two calls in a row, totalling 62 hours non-stop.

HOs are the front-liners. We see patients first when they are admitted. We see them first when they need assistance in the ward. And most importantly, we see them first when they collapse. Now, wouldn't you want a person fully awake and capable of sound judgment when trying to resuscitate your loved one? Why do we lament? Lack of manpower is no longer a problem as housemanship is for two years, compared to one year previously. Has anyone thought of shifts? Could it be considered for doctors?


Housemanship has always been a time of intense stress. It is a time when all previous perceptions of what a doctor is, becomes rapidly extinguished. It is the lowest hieriachy in the medical field. It is a time when one can start doubting if medicine was indeed the right choice.

Housemans are expected to go through busy night calls without sleep and yet having to perform well the following day. There is also hardly any camaraderie at times between the specialists, registrars,medical officers and housemans. Thus, housemans can be ridiculed in full view of patients. It takes away all self esteem.

It is a process that can be humbling. No doubt , some may argue that it is a necessary process for training good doctors. However, working conditions are pathetic. Call rooms are poorly furnished and the beds uncomfortable. Food is usually not provided and even if it is, they taste horrible. Long working hours which defies humanity is common.

Starting pay is $1713. This surely does not commensurate with the working hours put in and the sacrifices that have been made during this period. It is during this time that most doctors decide that public service is not for them. The Government it seems have forgotten their plight.

It probably does not end there either. After your housemanship, doctors still cannot decide where they would like to go. On most occasions, it seems that placement of doctors are done solely to frustrate them. Any attempts at asking for a reconsideration will be given a cold shoulder. You are still pretty much on your own.

It is a journey that i am still going through. It remains an unfinished chapter. The ending in the distant horizon. Some say doctors are a priviledged lot in society. Perhaps only for those not in government service.

Wednesday, May 05, 2004

Spinal Cord Injuries : The Life After

I was surfing through the internet when I stumbled on a website that I found to be truly inspirational. It is maintained by Peter Tan, a spinal cord injury victim. Being a tetraplegic can be devastating both for the victim and his family. Nevertheless, Peter Tan managed to garner the courage with the help of his late mother and cousin, sturdied his life and move on. This site is relevant in light of a recent news report of a man with similar problems in Hong Kong requesting permission from the Government to end his life. Perhaps this site could be a source of inspiration to many others in a similar predicament. I salute your courage, Peter Tan.

His Blog

Tuesday, May 04, 2004

Educational flaws

In Malaysiakini letter section,

The 'insurmountable' STPM

Artemis Tower
1:50pm Fri Apr 30th, 2004

I agree with most points put forth by Casper, especially the part about the Sijil Tinggi Pelajaran Malaysia (STPM) examination. It is indeed rather insurmountable, or at least, near- insurmountable. For the sceptics out there, let me illustrate how.

I was a candidate for the 1997 STPM examinations. That meant that I had to start preparing for it in 1996 since two years is the prescribed period of schooling for most STPM candidates.

Everyday, I studied for eight hours solid excluding school hours. That meant waking up at 5am everyday and going to bed at 1am the next day. Saturdays and Sundays were a 16 to 17 hour marathon.

I must say those two years were very hard on me. Although I was always a high achiever in school, partly due to parental pressure, I was never really prepared to undertake a lot of hardship to secure a certain kind of results in exams.

Even now, I give a lot of priority to happiness and enjoyment, and I doubt I will ever voluntarily undertake hardships like that of examinations. But the STPM was totally different. Like it or not, I had to force myself to endure that hardship and give up life temporarily. Why?

Because I wanted to be enrolled in the University of Malaya (UM) to do law. And for that, I had to achieve at least 4As and 1B in the STPM to be safe. Even then, one is not guaranteed a place to do law in UM. Happily, at the end of the day, I achieved a full 5As and went on to read law.

So what’s my commotion all about? You see, there were 197 5A-achievers that year in the whole country, out of the 40,000 plus candidates who sat for STPM that year. Does ‘insurmountable’ begin to make some sense now?

And when I first joined law school, there were a few students from the law matriculation programme who were my classmates. They were all a year younger than me because they only had to do one year of studying.

And what did they have to do for the one year? According to them, they attended a few classes a week, studied a bit before exams, and partied most of the time. Lucky them? Not really, considering they matched up poorly to their counterparts who went through the STPM.

I do not blame these seemingly ‘privileged’ students. It is not their fault that our education system is what it is today, divided by racial quotas and dubious policies.

As for me, I do not regret or hold a grudge against anyone for me having to sit for the STPM. If not for the STPM, I still may not know how far I can be pushed to achieve something important and near impossible. Having done it, I obtained a sense of confidence and a new level of maturity.

And I do not think it is fair to generalise that those at the receiving end of racial quotas and dubious policies are lazy, unmotivated and other such stereotypes. I know many who are determined to prove that they, too, are hardworking and capable.

For those who are keen on taking unfair advantage of the situation, I can only offer my sympathy for their self-induced mediocrity and eventual downfall.

I trust that our leaders and many in the government are painfully aware of the crippling effects these policies can bring on those who are taught to live off them like depending on opium.

However, as always, political considerations come first. Lack of political will is the mother of most ills suffered by us Malaysians.

The Education Ministry must be de-politicised. De-what?

Bullseye! There is such a compromise of quality in education in the name of uplifting the standards of a race. Will it backfire? The quality of local graduates have long been questioned by employers and this continuing trend will only tarnish the image of local graduates even further. There is no substitute for hard work in order to achieve success. This has to be taught to all young students.

Sadly, such protectionist policies will only serve to isolate a race and potentially dampen its competitive spirit. It has to be realised that competing will have long term benefits. Such foresight will enable the government to formulate an education system that is fair and based on merit.

Strength lies in accepting ones weaknesses and correcting it. Hiding or denying that such a weakness exist will fool no one. Ignoring it will prove disastrous.

Monday, May 03, 2004

Movie Magic

Based on the popular 1970's TV series, the story follows the titular pair of bachelor undercover cops (Ben Stiller as Dave Starsky, Owen Wilson as Ken "Hutch" Hutchinson), focusing on how the duo first meet and the first time they team up for their first big case: uncovering a cocaine operation run by a big-time drug dealer named Reese (Vince Vaughn). The two zoom around town in a red and white 1974 Ford Torino, solving crimes with the help of Huggy Bear (Snoop Dogg), their street informant, and annoying their boss, Captain Dobey (Fred Williamson).

A hilarious movie, something we expect from Ben Stiller and Owen Wilson. An odd couple. However their acting appear strikingly familiar with their previous roles. It was indeed a sharp contrast to the original cast of serious crime fighting. Nevertheless , it is an entertaining movie and i would give it a 6.5 out of 10.

Sunday, May 02, 2004

Cancer Research : Are we really serious?

IN the NST

Cancer research blueprint a critical need
Annie Freeda Cruez

One in every four Malaysians will die of cancer. This sobering statistic is the reason behind the soon-to-be drafted Cancer Research Blueprint.

There are also plans to set up a National Cancer Institute which will oversee the prevention of the disease, and the treatment and rehabilitation of patients.

The research blueprint will not only detail available information on cancer in the country but also look at making research more relevant and accessible to everyone.

At last, a progressive idea. Startling statistics have now alerted our policy makers that cancer is becoming a threat to Malaysian society. A cancer research blueprint will be a good first step towards formulating an effective battleplan to reduce cancer cases or to improve the survival rates of cancer in Malaysia.

Research in medicine should form the backbone in this blueprint. At this moment, quality research in Malaysia is sorely lacking. This is due to limited funds for such ventures. Our budgetary priorities still do not lie in research and development despite claims from higher authorities that it is an important area. Our Government it seems are a little more concerned about physical structural prowess rather than quality academic and scientific research.

If the Government is serious about fighting this scourge of cancer, they have to be prepared to pour in the cash to fund research projects in this area. There is no room to be stingy.

There is also a need to equip hospital with important diagnostic tools and equipments to aid doctors in making a diagnosis without troubling patients with the hassle of expenses with transportation. Take for example, in the state of Pahang, there is only one center with mammographic facilities that is in Kuantan. Despite having numerous hospitals in the state, only one center possesses the ability to do a mammogram. Patients from faraway places have to travel to Kuantan just to undergo a mammogram. How on earth are we going to diagnose cancers earlier if Malaysian doctors are still expected to perform 1st World miracles with 3rd World facilities?

There are no shortcuts in research. We need the expertise and the funds. Both are sorely lacking in the current environment. This blueprint should also look into areas where current procedures can be improved and should highlight the importance of adequate funding and the continuing encouragement for researchers in this country.

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