Climate change raises dengue risk

The Star
BY LOH FOON FONG

PETALING JAYA: Half of the world’s seven billion people will be at risk of getting dengue if minimum temperatures in certain regions continue to rise, warned the first ever global mapping report on dengue vulnerability.

According to Mapping Global Vulnerability to Dengue using the Water Associated Disease Index, while South-East Asia and South Asia already faced the highest levels of vulnerability to dengue, western and central Africa, as well as parts of Europe and the mountainous regions of South America would be affected if minimum temperatures there continue to rise.

“The increase due to climate change alone would more than double the number of those at risk to an estimated 3.5 billion,” said the report published by the United Nations University’s Canadian-based Institute for Water, Environment and Health (Unu-Inweh) on the university’s website yesterday.

Vulnerability in this case is determined by exposure and susceptibility, the latter influenced by access to healthcare, clean water, decent housing, dengue control measures and government policies.

Aedes mosquito eggs are rendered non-viable at temperatures below -2°C. But should minimum temperatures rise by a few degrees, the eggs could survive, putting large populations at risk of exposure to the mosquito.

While the authors noted that a rise in temperatures could make the environment too hot for mosquitoes in some places, overall warmer climates were expected to facilitate the spread of dengue both northwards and southwards of the equator.

The report also noted that Brazil reported the largest number of dengue cases – about 450,000 from 2004 to 2010.

It also listed Indonesia, Vietnam, Mexico, Venezuela, Thailand, the Philippines, Colombia, Malaysia and Honduras as among the top 10 countries where dengue is endemic.

“Climate change is increasing dengue vulnerability in some regions and there is a pressing need for improved waste management and sanitation in urban areas as part of a wider public health response,” said Dr Anthony Capon, director of Unu’s Malaysia-based International Institute for Global Health at the UKM Medical Centre in Kuala Lumpur.

Close to 400 million people today are infected by the virus, causing between 250,000 and 500,000 severe cases annually and some 20,000 deaths.

CIJ calls on MCMC to rethink fine decision over BFM radio interview

The STar
BY LOH FOON FONG

KUALA LUMPUR: The Centre for Independent Journalism (CIJ) wants the Malaysian Communications and Multimedia Commission (MCMC) to rescind the fine imposed on BFM radio over an interview with an Islamic scholar.

Its director Sonia Randhawa claimed the RM10,000 fine had been wrongly imposed on BFM radio as it was onerous to require broadcasters to submit all their content for pre-approval by the regulator.

“This is an infringement on the freedom of expression and damaging to media freedom, in particular,” she said in a statement issued together with CIJ co-director Jac SM Kee yesterday.

BFM’s interview with Islamic scholar Reza Aslan was aired on Oct 21 last year and the latter made comments disputing the Court of Appeal’s decision which barred Catholic newsletter Herald from using the word “Allah” to refer to God.

On Tuesday, the Malaysian Insider reported that MCMC had deemed it to be in breach of the conditions under their Individual Content Applications Service Provider (CASP-I) broadcast license, which required the regulator’s approval before any live or delayed telecast.

CIJ urged the MCMC to ensure that any such conditions imposed be subjected to the Federal Constitution, in particular Article 10, which guarantees freedom of expression.

Sonia said discussions on ethnicity or religion should not be curbed simply on the notion that the feelings of a particular religion’s adherents might be hurt, as it was harmful to a proper discourse.

She maintained that the government and the MCMC should have made their own arguments against them, rather than shut a down healthy debate.

She said MCMC should review the conditions imposed on broadcasters and remove any requirement for the pre-approval of all content.

MMA: ‘90-hour week impossible’

The Star
BY LOH FOON FONG

PETALING JAYA: It is not possible for house officers (HOs) to work 90 hours in a week with the current housemanship system, the Malaysian Medical Association (MMA) said yesterday.

Its president, Dr H. Krishna Kumar, said they would usually work 60 to 70 hours per week and get a compulsory day off.

“However, it is known that some doctors do change their shifts to get a longer period off after working for prolonged periods of time.

“This practice is usually curtailed when the head of department or specialist in charge finds out,” he said.

Dr Krishna was responding to a letter published in The Star on Monday where the writer had urged the ministry to investigate cases of HOs being threatened and made to work up to 90 hours a week.

On a statement posted on his Facebook page yesterday, Health Director-General Datuk Dr Noor Hisham Abdullah said a flexible working system implemented in 2011 required HOs to work an average 65-75 hours a week.

“Housemen are entitled to a day off per week but it is not necessary for it to fall on weekends,” he said .

Dr Krishna reminded HOs that a doctor’s life was not easy and there would be no shift duties when they became a medical officer or specialist.

Nevertheless, he said each complaint should be evaluated independently.

“If housemen have issues with work, they can always complain to the specialist in charge or department head or hospital director,” he said.

Moreover, most hospitals had HOs leaders to channel their complaints and they were also invited to the ministry to provide feedback, he said.

“Therefore, it is unfair to claim that there is no feedback or complaint mechanism,” he said.

Dr Krishna also said the intention of young people becoming doctors should also be scrutinised.

“If they are forced into it and they do not have interest in the profession, they will leave no matter what the reason is given,” he said.

List of price-controlled drugs may be introduced soon

The star
BY LOH FOON FONG

PUTRAJAYA: A list of price-controlled drugs may be introduced in view of the soaring medicine prices that have burdened many Malaysians.

The National Pharmaceutical Control Bureau is looking into the feasibility of such a list, especially since drugs are currently not controlled price items, said Health Minister Datuk Seri Dr S. Subramaniam.

“We are studying different models in different parts of the world and whether certain essential drugs can be subjected to the control, and the discussion is being done at the industry level,” he told reporters yesterday after launching the Malaysian International Healthcare Innovation Conference and Exhibition themedGlobal Healthcare Challenges.

Sunday Star carried a front page report that medicine prices had risen by up to 50% this year and were continuing to rise, leaving many in fear that the drugs they need might soon be out of their reach.

Dr Subramaniam said the bureau would have to study how prices could be enforced and what drugs should be listed.

Asked if high drug prices would hamper health tourism as Malaysia would need to compete with Thailand and Singapore, Dr Subramaniam said the cost of healthcare in Malaysia was lower (than in the two countries) but that was not the determining factor for foreigners as they look for overall improvement on healthcare delivery.

“We are trying to restructure the concept of health tourism to ensure that it is more sensitive to their needs,” he said.

On retirees and pensioners still struggling to pay for disposables and needles despite receiving highly subsidised medical treatment, he said the ministry would like to give everyone free treatment but that would have to depend on the ability to do so.

Dr Subramaniam said the public healthcare system in Malaysia was funded by only one source – the Federal Government.

This was unlike many other countries which received funding from several sources for their healthcare system, he added.

In his speech, Dr Subramaniam said that innovation was the way to making healthcare better, accessible and affordable.

Man with elephantiasis unable to undergo surgery because of his 241kg weight

The star

BY LOH FOON FONG

Massive problem: Sheikh Nafiq (second from left) discussing Ahmad Khalid’s condition with Dr Pok (right) at UMMC.

 

KUALA LUMPUR: Ahmad Khalid Salleh, 39, could not seek treatment for elephantiasis on his right leg because he is unable to get his 241kg weight down to a safe level for surgery.

No doctor dares to carry out the conventional stomach bypass (Roux-En-Y gastric bypass) to enable him to reduce food intake and hence, weight loss, because it is deemed too risky for an obese person.

However, a relatively new method called single anastomosis gastric bypass or mini-gastric bypass, which has fewer complications than the conventional method, is available at Universiti Malaya Medical Centre (UMMC).

UMMC consultant surgeon Dr Pok Eng Hong said the mini-gastric bypass would address Ahmad Khalid’s weight problem and they could ultimately treat the parasitic infection that caused the extreme swelling (lymphatic filariasis).

“Ahmad Khalid needs to reduce more than 100kg before we can treat his leg,” he said yesterday, following Umno Youth community complaint bureau’s highlight of the case.

Ahmad Khalid, who quit working as a telecommunications salesman due to his condition, lost 23kg following a low-calorie diet at UMMC.

Dr Pok said a mini-gastric bypass would be carried out on Jan 9.

“We will create a small tube in the stomach to reduce food intake. The food will go straight into the small bowels,” said Dr Pok, who learned the technique from Taiwan.

UMMC, the pioneer of the method in this country, has carried out the procedure on seven severely obese patients this year.

Dr Pok said patients must follow a special diet and take multivitamins their entire life as their food intake and nutrition would be limited after the bypass.

If patients adhere to the diet and exercise programme, they could achieve almost all of the weight they need to lose within one-and-a-half years to be close to their ideal weight, he said.

Ahmad Khalid said he had difficulty walking because too much tissue would cover his foot.

He said it all began two months after a jungle trek in 2009. He had fever for a month and from then on, his leg began to swell and he was diagnosed withlymphatic filariasis.

Ahmad Khalid said he would need RM10,000 for the surgery despite having some welfare funds and aid from the Subang Jaya Zakat Centre.

Umno Youth community complaint bureau chairman Sheikh Nafiq Alfirdaous said they had been highlighting Ahmad Khalid’s problem but no hospital had taken up the case until UMMC came along.