Lawyer: Say no to child marriages

The Star

PETALING JAYA: United Nation’s Committee on the Rights of the Child member Yasmeen Shariff has urged the Syariah Court not to be too quick in granting consent for underage marriages.

Yasmeen, a child rights lawyer, said children’s groups rejected underage marriage as most teens were not mature enough for the responsibilities and it deprived them of education.

Yasmeen also urged the Women, Family and Community Development Ministry to provide support and proper counselling to parents on underage marriage.

Help for diabetics to prevent complications

the star

BY LOH FOON FONG

Taking precautions: Dr Jeyaindran launching the workshop on diabetes prevention and management by Diabetes Malaysia.

PETALING JAYA: The Health Ministry will soon kickstart a programme to educate diabetics about their condition to prevent the onset of complications.

Health deputy director-general Datuk Dr S. Jeyaindran said awareness on the complications such as kidney failure, blindness or limb amputation was still low.

“The main reason why many Malaysians suffer from those complications is the lack of awareness on the need to control the disease,” he said during the 2013 Diabetes and Management Workshop yesterday.

Dr Jeyaindran said the team of educators would include doctors, nurses, physiotherapists, occupational therapists, dieticians and pharmacists who would send out the same message to patients so they would get the message “loud and clear”.

“Patients need to be educated early on that diabetes is a slow killer,” he said.

He said diabetes cases were increasing at an alarming rate at 11% of the population in 2005 to 15% in 2011 and were likely to be one in four in the near future.

Dr Jeyaindran said the ministry was also working with the Community Development Depart­ment under the Rural and Regional Development Ministry to educate some 500,000 women on providing healthy food for their families.

Asked about a study by a Malaysian endocrinologist in Newcastle University who managed to get patients’ blood sugar levels back to normal through a diet of 600 calories per day for two months, Dr Jeyaindran advised caution.

He said the amount would not provide adequate energy for the day as people needed 1,500 to 2,000 calories per day. The diet, over a long term, could lead to starvation and even coma.

Dr Jeyaindran said that those at the pre-diabetic stage could control their condition through diet but once the disease was full blown, it would require diet, medicine and exercise.

Five groups to work on unity

the star

BY LOH FOON FONG

PETALING JAYA: Five working groups will be set up to address various unity-related issues when the National Unity Consultative Council members meet for the first time next month.

Its president Tan Sri Samsudin Osman said that the working groups comprise legal and the promotion of national harmonious policies, national building and cross-cultural understanding, inclusive development, youth and unity, and national integration.

“The members in the council are made up of a diverse group, with people of various backgrounds and age groups who are rich in experience,” he said yesterday.

Prime Minister Datuk Seri Najib Tun Razak announced the launch of the council on Monday to replace the National Unity Advisory Panel which ceased to function after the Emergency Ordinance was abolished.

Samsudin said that a lot of work had been done by the Prime Minister’s Department in collaboration with Institut Kajian Etnik of Universiti Kebangsaan Malaysia (UKM) and the council would work closely with them.

On critics doubting the council would have enough bite to carry through its recommendations, Samsudin said: “We are hopeful. The PM (Prime Minister) has given his assurance.

“The recommendations will be looked at by the Cabinet. We need to come up with policies that are pragmatic and can be implemented.”

Council member Associate Prof Dr Madeline Berma from the UKM’s Tun Fatimah Hashim Women’s Leadership Centre said she was glad the Government was putting a serious effort in uniting the various ethnic groups.

“I hope the work we do is not confined to consultative efforts. We want action,” said Dr Madeline, an Iban from Sarawak.

Another council member Audrey Goh, a life member of the Sarawak Federation of Women’s Institute said she saw her role in the council as a “bridge builder”.

She said she would use skills of advocacy and inquiry to engage and enlighten the community on unity and encourage participation and “bridge building” initiatives.

Another council member Zubedy (M) Sdn Bhd managing director Anas Zubedy said it was important for the council to create “bridge builders”, including people or system processes that bring people together.

He said it was important for all of society to play a role in unity efforts so that the negative action by a few would be diluted by the good most people promote.

Another council member Lim Chee Wee said the hostile discourse on race and religion over the past few years required the participation of as many people as possible to reduce the tension.

“The biggest challenge is to reach a consensus on steps that would be effective for achieving national unity while the ultimate test is whether the Government and people will accept and carry them into effect,” added the former Bar Council chairman.

NGOs: Consultative council should be more open

PETALING JAYA: NGOs want the National Unity Consultative Council (NUCC) to be allowed to be more open and transparent in its approach.

Global Movement of Moderates Foundation chief executive officer Datuk Saifuddin Abdullah said the council needed to be more open and transparent if it wanted to get the public to buy in to their efforts.

Saifuddin, who is also a council member, said the council must also start with moving from race-based policies to needs-based policies.

“Proposals for unity goals must be based on this,” he said, adding that the council must be bold in taking on issues relating to equality in citizenship and good governance.

Malaysian Consultative Council of Buddhism, Christianity, Hinduism, Sikhism and Taoism president Sardar Jagir Singh said the council should be more open except for sensitive issues, where they could get the stakeholders to attend the closed-door meetings to provide feedback.

Jagir, who is also a council member, said its objectives were noble and if its efforts were to be carried out properly, it would bring about more harmonious living and greater peace.

Jaringan Melayu Malaysia president Azwanddin Hamzah welcomed the setting up of the council.

He said the council must engage NGOs as well, so that it could be effective.

“The disunity that has seeped into society has to be taken seriously and addressed. We need to educate the young to respect one another,” he said.

DPM: Nation must focus on human capital growth

The star

BY LOH FOON FONG AND MAZWIN NIK ANIS

KUALA LUMPUR: It is important for Malaysia to prioritise its human capital development and address income and wealth inequalities, Deputy Prime Minister Tan Sri Muhyiddin Yassin said.

He said the 21st century had been referred to as “The Asian Century” due to astounding growth and the Asian Development Bank had projected that by 2050, it could double its share to account for half of the global GDP.

However, the Asian era is not just one of economic success but also great political, cultural and civilisational influence, he said.

As such, he said, Malaysia must prioritise its human capital development, strengthen its governance institutions and address income and wealth inequalities, as well as arrest environmental degradation.

Muhyiddin said this during the launch of the MIDA Forum 2013 “Asian Era: Malaysian Perspective” yesterday.

“As the world economy recovers, Asia is set to lead the way in reforms and transformations towards higher income levels,” he said.

“Asia’s rise offers many opportunities that we must take, as well as significant challenges that we must overcome.”

Earlier yesterday, Muhyiddin said Umno members would be given greater freedom to raise issues of their concern during debates at the coming general assembly as the party leadership wanted to hear what was in their hearts and minds.

The Umno deputy president said that with the party polls over, delegates could shift their focus on debating issues that “are of concern to the nation and race”.

“We want to know if they are happy, satisfied, frustrated or otherwise. Allowing Umno members to speak is a good way to measure how they feel about what is happening in the party and Government.

“It is also a good opportunity for us to tap ideas and views on how we can progress and improve, be it in Umno or the Government,” he said after opening the International Palm Oil Congress 2013.

Muhyiddin said that among issues which he expected delegates to raise would be the recent party election and the outcome of the May 5 General Election.

The Umno general assembly will be held from Dec 2 to Dec 7 while the party elections, following amendment to its constitution, saw the participation of 150,000 members for the first time. The party elections concluded on Oct 21.

Don't attempt childbirth at home without medical supervision, says expert

The star

BY LOH FOON FONG
foonfong@thestar.com.my

PETALING JAYA: Childbirth is a serious and potentially dangerous matter and pregnant mothers must not attempt unsupervised birth at home, the Obstetrical & Gynaecological Society of Malaysia warns following the death of Ang Lay Chin who has opted for homebirth.

Hitting out at pro-homebirth groups for advocating homebirth without medical supervision, president Dr Tang Boon Nee said that it was unfortunate that the advice often went unheeded.

“The seminars on various pro home-childbirths were often conducted by mothers themselves who had gone through homebirths and believe that every other births should be the same.

“As it is unfortunately evident, mothers can die from childbirth, especially one which is assisted by unqualified assistants who have only seen few births, and do not recognise the signs of problems,” she said in a press statement yesterday.

Dr Tang was commenting after the death of Ang, 40, who had suffered excessive blood loss after giving birth to her first child in her house in Sri Kembangan, Selangor, on Nov 13, the Kwong Wah Yit Poh reported.

She said that medical supervision in childbirth was needed as complications could arise, resulting in devastating outcomes.

“In the event of excessive bleeding after childbirth, we have a ‘window of opportunity’ to stop the bleeding, using intravenous drip, medication to contract the uterus and physical maneuvres to reduce bleeding,” she said.

In the event of vaginal tears causing bleeding, to bring the patient into operating theatre to repair tears and stem bleeding, she added.

“Unfortunately, if the bleeding has gone on for some time, that window of opportunity is lost, resulting in the loss of a life,” she said.

Dr Tang said that a lot of homebirth advocates were not qualified nurses or doctors, and had not seen the complications that can arise from childbirth.

She said that Malaysia was seen as a model as a forerunner in reducing maternal mortality.

The doctors and nurses in Malaysia had worked tirelessly to reduce maternal mortality from childbirth to 28 per 100,000 from hundreds per 100,000 many years ago and was saddened to hear of another maternal death, she said.

“One of the most important aspects of this effort is to make available safe environments for childbirths, be it in a district, state, general or private hospitals, supervised by qualified medical and nursing staff,” she said.

Dr Tang said that childbirth educators must have the necessary qualifications if they were to conduct homebirth classes.

NKF: Surplus needed in case funding is cut

The Star

BY LOH FOON FONG

PETALING JAYA: The National Kidney Foundation said it has been subsidising poor patients and that its reserves are just adequate for contingencies and expansion plans.

 

Its chairman Datuk Dr Zaki Morad (pic) said the cost of haemodialysis per session for NGOs was RM150, but patients were charged only RM100 at NKF as it absorbs RM50 of the cost.

He said some patients were subsidised by the Social Security Organisation or other government agencies but others who were not, also received RM50 subsidy from the Government.

However, he said, even after the RM50 subsidy, there were patients who were unable to fork out the remainder and the NKF would also absorb this payment, providing them free haemodialysis.

Apart from that, he said the foundation would also pick the tab for patients who were still waiting for the RM50 subsidy from the Government.

“The reserves that we have is being spent. It is true that we have a surplus, but we need to keep it in the event funding sources are cut,” he said.

Dr Zaki was responding to The Star’s report on Friday where a life member and a staff member of NKF had said that it had a surplus income of RM5.644mil and other savings as of January last year and hence, should pick up the haemodialysis tab for poor patients, even if the Health Ministry had not approved their subsidies.

This follows The Star’s front page report Thursday highlighting the plight of haemodialysis patients in NGO-run centres who had not received approvals for government subsidy.

The problem became acute since mid last year and approvals became negligible this year. Some applications have yet to be approved since 2011.

On NKF accumulated savings of more than RM50mil, Dr Zaki said its board of directors had decided to keep a financial reserve that would sustain two years of operations should all sources of income stop.

This is based on an estimation that it would take about two or more years for the foundation to place all its patients in other centres that would be willing to accept them should their funding be cut.

Dr Zaki also said that NKF had also kept the reserves for the setting up of new haemodialysis centres, maintaining current ones, carrying out kidney screenings as well as awareness campaigns.

It costs NKF RM2mil to set up a centre and they have been opening two to three centres a year, targeting states with low rates of treatment such as Sabah, Sarawak, Kelantan, Terengganu, Kedah, Perlis and Pahang.

He said that NKF’s annual operating expenditure was between RM32mil to RM35mil a year, of which the cost of the haemodialysis programme was RM25mil.

Doc: NFK’s surplus just isn’t enough to cope

the star

(no byline but follow-up exclusive by me)

PETALING JAYA: A nephrologist who volunteers at a haemodialysis centre has refuted claims that RM5mil is a huge surplus for the National Kidney Foundation (NKF).

Dr Liew Boon Seng, who has been providing his service to two NGO haemodialysis centres in Sabah, said the surplus reserve was not much in view of the foundation’s 1,557 patients.

He said if NKF picked up the Government’s tab of RM50 subsidy per session and 13 sessions per month for each of the 200 patients still waiting for the subsidy approvals, it would cost it RM1.56mil a year, not including the cost of Erythropoietin injection.

“How long should NKF fill the void while waiting for subsidy approvals? What if the approvals never come or the applications are rejected?”

Dr Liew was responding to The Star’s report on Friday where a life member of NKF had pointed out that the foundation had surplus income of RM5.644mil as of January last year and hence, should pick up the haemodialysis tab for their poor patients, even if the Health Ministry had not approved the subsidies.

This follows The Star’s front page report Thursday highlighting the plight of haemodialysis patients in NGO-run centres who had not received approvals for government subsidy.

The problem became acute since mid-last year and approvals became negligible this year. Some applications have yet to be approved since 2011.

On NKF’s accumulated savings, he said that NGO centres also faced increasing number of patients and to set up 20-chair hemodialysis centre in any cities would cost up to RM4mil.

Meanwhile, in response to the Ministry’s reply to the front page story that it had not stopped funding for the poor in NGO-run centres, MAA Medicare Kidney Charity Fund senior vice-president Aliyah Karen said it should respond to patients’ application forms quickly.

Health director-general Datuk Dr Noor Hisham said rejected and pending haemodialysis subsidy applications were mainly due to incomplete supporting documents relating to socio-economic status or that the NGO or private centre had not been approved by the ministry.

Ministry denies stopping subsidy

the star

BY LOH FOON FONG

PETALING JAYA: The Health Ministry has denied that it has stopped giving subsidy for haemodialysis treatment to poor patients seeking treatment at NGO-run centres.

Health director-general Datuk Dr Noor Hisham Abdullah said the rejected and pending cases were mainly due to incomplete supporting documents relating to socio-economic status or that the NGO or private centre had not been approved by the ministry.

“The Government has never stopped providing subsidy for haemodialysis treatment and injections provided by the NGOs,” he said in response to The Star’s front-page story on Thursday highlighting the plight of haemodialysis patients who said they had not received approvals for government subsidy.

NGO centres said that the problem became acute from mid-last year. They claimed that approvals were negligible this year and some had not been approved since 2011.

Dr Noor Hisham said that each year the Government spends RM31mil on dialysis treatment and Erythropoietin injection subsidies at RM1,040 per month or RM12,480 a year for each patient.

This year, the ministry received 458 subsidy applications; 141 were approved, 81 rejected and 236 pending approval, compared with a total of 824 applications last year when 488 of them were approved, 102 rejected and 234 still pend-ing.

In 2011, of the 954 applications, 730 applications were approved and 61 rejected.

Since 2001, the ministry had spent RM231.2mil in subsidy on haemodialysis patients and another RM41.6mil on Erythropoietin injection which has benefited 3,048 patients since 2009.

Dr Noor Hisham said that the ministry was reviewing the status of dialysis centres and might close down those that did not meet the standards to ensure patients’ safety.

“But before such action is taken, the ministry will take proactive measures to ensure the affected patients will continue to receive dialysis treatment at other licensed centres located near their house or at the ministry’s facilities,” he said.

He said that in view of the challenges arising from dialysis treatment as a form of renal replacement therapy, the ministry had moved towards Continuous Ambulatory Peritoneal Dialysis (CAPD) as the preferred choice of therapy.

Recently, Prime Minister Datuk Seri Najib Tun Razak announced that CAPD would be provided to about 1,000 patients beginning next year.

Pick up dialysis tab of the poor, NKF urged

The Star

BY LOH FOON FONG

PETALING JAYA: New kidney patients will be given priority for the RM600 monthly subsidy for haemodialysis treatment, the Health Ministry said.

“Our pool of funds is focused towards new patients as they have never had treatment and may require dialysis urgently,” said Health director general Datuk Dr Noor Hisham Abdullah.

However, he added, patients already undergoing haemodialysis would not be neglected and would be given assistance as announced in Budget 2014.

Prime Minister Datuk Seri Najib Tun Razak had announced free treatment kits, or Continuous Ambulatory Peritoneal Dialysis costing RM19,000 each for patients with end stage kidney failure to enable them to do the treatment at their own home.

An estimated 5,000 new kidney patients were diagnosed with end-stage kidney failure each year over the last three years, with 26.9% likely to be seeking treatment from 53 NGO centres. On average, half the patients needed subsidy from the Government.

Dr Noor Hisham told The Star that the ministry was reviewing its funding for haemodialysis treatment to make it more cost effective, among other reasons.

“Although our budget allocation increased this year, emoluments are taking up the bulk of it.

“Our development allocation has decreased from RM1.6bil last year to RM1.3bil this year to make way for the emoluments, such as employing more doctors,” he added.

Dialysis subsidy drying up

The Star

BY LOH FOON FONG

Published: Thursday November 7, 2013 MYT 12:00:00 AM
Updated: Friday November 8, 2013 MYT 9:37:24 AM

Saving lives: The Fo Yi-NKF Dialysis Centre in George Town, Penang. There is an estimated 5,000 new kidney patients each year requiring haemodialysis.

KUALA LUMPUR: Thousands of kidney patients are facing a tough time as the Health Ministry has not approved subsidies for haemodialysis treatment thus far this year. Some are reported to have waited for as long as three years for the nod.

The number of approvals for the RM600 monthly subsidy began to decrease in 2011, and became minimal from mid-2012.

NGO-run haemodialysis centres said they were told by the Health Minitry to source for funds elsewhere as it was focusing on new patients.

They also said that some patients had waited for the subsidy approval for as long as three years, instead of the usual one to three months.

 In Malaysia, the poor receive heavily subsidised dialysis treatment but due to the shortage of government-run centres many turned to those managed by non-profit NGOs.

Through these NGO-run centres they could apply for RM600 dialysis subsidy (RM50 per dialysis) per month and free injections.

A random check revealed that the National Kidney Foundation had 200 patients still waiting for subsidy, 50 patients in St John’s Pt Selangor in Klang, 40 in dialysis centres run by a religious body that declined to be named, 22 at Pontian Rotary Haemodialysis Centre, and five patients in KL Lions Renal Centre.

The actual number of the affected poor was not known but it could be in the thousands going by the estimated 5,000 new kidney patients diagnosed with end-stage kidney failure each year in the last three years.

Patients affected appear to be from NGO haemodialysis centres as those in private and government dialysis centres did not have to deal with subsidy applications.

According to the National Kidney Foundation, treatment for a patient who undergoes haemodialysis at an NGO or a private clinic costs between RM150 and RM250 per session.

The Malaysian Registry of Dialysis and Transplants said that as many as 7,088 (26.9%) end-stage renal failure patients had haemodialysis treatment at NGO centres out of 26,404 patients receiving dialysis treatment last year.

The remaining 13,159 patients (49.8%) sought treatment at private dialysis centres and 6,157 patients (23.3%) at public facilities under the Health Ministry, university hospitals and Defence Ministry hospitals.

A nurse who declined to be named said that Muslims had less issues with getting the subsidy as they could apply for aid from the Baitumal or zakat foundation.

Some NGO haemodialysis centres were not happy that the Government had pushed patients to them without providing the needed subsidy.

The halt in subsidy was also depleting the rolling fund of the centres since some NGOs help to pay for their patients’ dialysis treatments, a dialysis centre manager said.

“If they make it difficult for patients to get the subsidy, they should just get the patients to do it at government dialysis centres,” she said, adding that such centres were limited.

Related stories:

BY LOH FOON FONG

I'm afraid I'll die without the money, says kidney patient

PETALING JAYA: Former tombstone engraver Foo Kwai Wah, whose kidneys failed early this year, has exhausted all his savings and is worried about whether he can continue with dialysis treatment.

Foo, 57, whose wife died in 1999 during child delivery, said he had been waiting for government subsidy for dialysis treatment, which included RM600 per month plus free injections, since March 21 and sought aid from NGOs.

“I am afraid that without government subsidy, I will die because I have no more funds,” he said, adding that he had to support two teenage children who were still studying.

At RM100 per session at the Nat­ional Kidney Foundation, Foo said the dialysis cost him RM1,300 per month while injections cost RM325.

Although an NGO gave him RM500 a month, he still has to pay RM1,125.

He hoped the Government would use the funds from abolishing the sugar subsidy to help patients like him.

Foo also appealed to corporations to contribute funds to poor patients.

Housewife Ng Lai Leng, 44, from Selayang, has been on dialysis since July last year and has been waiting for government subsidy since Nov 8 last year.

Her husband Wong Kok Chai, a vegetable seller, said he earned RM2,500 a month and it was difficult to make ends meet especially now that his business was not doing well.

“My wife feels sad about the long wait,” said Wong who spoke on behalf of Ng, who cannot speak Malay or English.

A dialysis centre manager, who declined to be named, said the extra medical costs were a burden to the lower income group and some couples had got into heated arguments over the lack of funds.

Selangor state commander of St John Ambulance Malaysia Datuk Burnard Yeo said SJAM had persuaded some donors to sponsor poor patients while waiting for government subsidy to be approved.

“Some of these patients are jobless and cannot even pay for their rentals,” he said adding that the Health Ministry had informed them that it did not have enough funds.

“Some patients even wanted to cut the treatment to only once a week, but we discourage them from doing so as it could lead to complications or death,” he said.

By  LOSHANA K. SHAGAR

(Please note that the average cost for each NGO dialysis is RM150. For private sector is RM250. In the usual scenario for NGO-run haemodialysis centre, RM50 for each treatment is absorbed by NGO, RM100 paid by patients and if they could not afford it, they could get RM50 subsidy from the Government, hence, they only pay RM50)

New kidney patients get priority for the RM600 aid

PETALING JAYA: New kidney patients will be given priority for the RM600 monthly subsidy for haemodialysis treatment, the Health Ministry said.

“Our pool of funds is focused towards new patients as they have never had treatment and may require dialysis urgently,” said Health director general Datuk Dr Noor Hisham Abdullah.

However, he added, patients already undergoing haemodialysis would not be neglected and would be given assistance as announced in Budget 2014.

Prime Minister Datuk Seri Najib Tun Razak had announced free treatment kits, or Continuous Ambulatory Peritoneal Dialysis costing RM19,000 each for patients with end stage kidney failure to enable them to do the treatment at their own home.

An estimated 5,000 new kidney patients were diagnosed with end-stage kidney failure each year over the last three years, with 26.9% likely to be seeking treatment from 53 NGO centres. On average, half the patients needed subsidy from the Government.

Dr Noor Hisham told The Star that the ministry was reviewing its funding for haemodialysis treatment to make it more cost effective, among other reasons.

“Although our budget allocation increased this year, emoluments are taking up the bulk of it.

“Our development allocation has decreased from RM1.6bil last year to RM1.3bil this year to make way for the emoluments, such as employing more doctors,” he added.