Monday, December 22, 2008

A touching account from a West Malaysian doctor



Don't neglect Sabah, please.

I refer to the Malaysiakini article "Kota Marudu needs more than wireless Internet."

I read Dr Ham's letter and cannot help but agree with many of his observations. I worked in Sabah for over seven years as a house officer and medical officer. After my housemanship, I was sent to Ranau to serve in the district hospital. What Dr Ham described in Kota Marudu is not something isolated to that district alone in Sabah. It is an often repeated story in the whole of Sabah.

My first introduction to the poverty in Sabah came during my first months there, when a sweet 70- year-old lady from Kota Marudu was sent to the Queen Elizabeth Hospital with deep jaundice. She lived alone in a small village off Kota Marudu and noticed the jaundice about a month before.

She had no money for the taxi fare and so waited a month to sell off her chickens to have enough money to pay RM50 for the transport to Kota Marudu Hospital. She had to walk two miles to get to the road to get to the taxi.

Having been born, bred and educated in Peninsular Malaysia, I was shocked. When she arrived, she was septic and had a gallstone lodged in her common bile duct. The stone was duly removed but she was found to have a heart problem that required a pacemaker. We arranged for her to get a permanent pacemaker but she refused.

When I pressed her for her reason, she told me that she couldn't afford to buy batteries for the pacemaker, having sold off her chickens. Once I explained to her that the batteries would last for years and we would provide them, she agreed to the pacemaker.

Ranau town itself has roads and is on the main highway between Sandakan and Kota Kinabalu. It developed primarily as a result of the Mamut Copper Mines in the district. However, highway in this context means a two-lane road with frequent landslides and potholes, with a two-hour drive to Kota Kinabalu.

Outside Ranau, transportation becomes a problem as tarred roads disappear to become gravel or crudely marked logging trails. Anyone who has worked in Sabah would have the same stories to tell, of extreme poverty and poor transportation.

During my 2 years in Ranau, I've heard and seen it all, patients with cerebral malaria, a condition unheard of in Peninsular Malaysia, coming in after 48 hours to the hospital from places like Kaingaran and Karagasan, with relatives having to push the 'pirate taxi' through the mud, spending RM50 on fare during the monsoon season, the equivalent of 2 months income, this too when petrol was only around RM1.20 a litre in Ranau.

Patients having to delay treatment for life threatening conditions because a bridge washed away along the trail (I won't even call it a road) to Tambunan. Emergency surgery such as caesarian sections, appendectomies and even ectopic pregnancies had to be performed in our little district hospitals by Medical Officers with little more than 4 months housemanship experience.

Medical emergencies such as myocardial infarctions, which in Peninsular Malaysia would be managed in a Coronary Care Unit setting, had to be managed in the district hospital level. I'm grateful however, that my staff in that hospital were the best I've ever had the pleasure of working with and were dedicated enough to want to make a difference in their patients' lives.

But poor transportation does not only affect the access to healthcare. Having no roads to be able to transport their agricultural produce for sale means that these people are stuck in a never ending cycle of poverty.

At most, some of them get RM20 to RM50 by selling their produce to middlemen to be sold at the monthly tamu or market at prices that are perhaps only 10 percent of the value of the goods. These innocent people are also preyed upon by traveling cloth merchants, mostly foreigners, who offer them 'easy payment schemes' to buy cloth for clothes, and when they cannot pay for the cloth and the interest accumulates, they end up having to marry their daughters to these men, who often have wives back home in Pakistan.

One of the cases I could never forget was of the family who came to Ranau Hospital just as I was leaving, a family who had failed crops, were hungry and unable to get food. The father collected some toad eggs and fed them to the whole family in a desperate attempt to stave off hunger. When they arrived at our little emergency room, one of the children were dead and two passed away within 10 minutes of arrival in our casualty unit due to poisoning.

Education is a problem in parts of Sabah outside major towns like Kota Kinabalu at the moment. Many children would be lucky to be able to get to a school or even afford to get to one. Most of my patients outside Ranau were lucky to even have a primary school education and a vast number of women marry in their teens.

I've had 14 year olds delivering babies in Ranau, most of them have never ever stepped foot in a school. The education level is so poor that many women feed their children condensed milk thinking that it's better than breast milk.

But at the heart of it all, these mothers want the best for their children but are not empowered with the knowledge to help them. Major towns in Sabah have electricity courtesy of the Sabah Electricity Board, but smaller villages have either diesel generators or rely on candles or lamps when night falls.

How can children study in these conditions? Like many doctors in the districts, I had to learn Dusun to communicate better with these patients who could speak little else.

Forty five years after the formation of Malaysia, the promise of a better life for these poor Dusun, Murut and Rungus patients in the districts of Sabah is a pipe dream at best. How can our politicians claim to have brought development to the state and have neglected these poor people, many of whom still wear the cheap t-shirts and caps given free by political parties from many elections ago.

How can I claim to be proud of Putrajaya with its beautiful bridges and lamp posts and the Petronas twin Towers when our fellow Malaysians in Sabah are so neglected?

The cycle of poverty and illiteracy one sees in the districts in Sabah brings despair to the heart. Eradication of poverty must tackle the real issues of education and transport and not just handouts to poor people.

By all means, declare Sept 16th a public holiday, but remember it in its real context, where we made a promise to our brethren in Sabah and Sarawak to treat them as equals in Malaysia, and give them the development they've been long denied.


Moderator: I read this in a forwarded e-mail, and thought everyone should read this. It's quite a long article, and very related to my field of job. My respect for the doctor who wrote this. One day I must take out my pen and start writing my own stories. Have to "korek" out the creative juices suppressed by years of pharmacy school. Enjoy!


Wednesday, December 03, 2008

How Baby Turtles Are FEd



Never realised they are fed with fish until these babies are released into the sea!

Thursday, November 27, 2008

Oops. It's Your Birthday!!





Happy Birthday Anson. Dont be so shocked to see this, although you graduated from Elite Team long, long time ago. =)

Bruce Lee Ping Pong



Been on YouTube a lot since i have internet access at home. What a change from my previous lifestyle. It's unhealthy though, but I cant help it! So many interesting stuff to see...

Anyway, here's something probably Desmond would be interested in. Enjoy!

Wednesday, November 26, 2008

London's Calling


Booking Period : Now - 30 Nov 2008
Travel Period : 11 Mar - 24 Oct 2009

Fly from/to LCC Terminal, KLIA, Kuala Lumpur to United Kingdom (London)

Economy Seats = RM 499 / £ 99*

XL Seats = RM 1999.00 / £ 549*

Finally! The much awaited and anticipated destination of the year is NOW OPEN FOR SALE! Grab your low fare seats to LONDON from as low as RM 499 or try our XL seats and enjoy premium comfort at an Xtraordinary fare from RM 1,999.

Tuesday, November 25, 2008

Learn Your ABCs Well :)





Casablanca




Used to listen to this song when I was young, as my parents were huge fans of this movie. They claim it's the best movie ever made! Lately, I've been fond of this song after stumbling in the internet. Anyone have the DVD/ VCD??

Friday, November 21, 2008

Where is the Lost Child?


Was browsing over old pics to choose a photo for Chee Yang. I just love this picture. It shows he's facial expression when he says "Dun be so GELI" or something sinis... And typically, he's always very gatal, in Malaysia or Scotland. Hence the constant scratching.
Anyway, HAPPY BIRTHDAY Mr Chin Chee Yang. Hope to see you again soon bro.

Wednesday, November 19, 2008

Malu-Malu


Who is that shy pharmacist?? It seems that he's the clinical pharmacist in HOSPITAL KUALA LUMPUR. Malu-malu la pulak... Super dim.

Saturday, November 15, 2008

Masai Warrior


The Masai are a very famous warrior tribe in Kenya (Africa) whose lives center around herding cattle. They live in small settlements of 8-15 huts. Their settlements are surrounded by acacia thornbush fence as an added form of protection. The two-inch long thorns of the acacia thornbush are as sharp as barbed wire and the men are responsible for tying branches together to form the fence. In the evening, the cattle, goats, and other domestic animals are brought inside the kraal for protection against wild animals.




The huts take seven months to build by the women of the village. They are built of branches, twigs, grass, and cow dung and urine formed into a plaster and applied to a branch frame. When the mixure dries in the sun it is as strong a cement and does not smell. Generally they cannot stand up inside and the only openings are that of the doorway and a small opening in the roof or wall which allows smoke from a continually smoldering fire inside to escape. The fire is used on which to cook and to keep the family warm during the rainy season. Dried cow dung is used as the fuel for the fire. Inside, the family sleeps on beds of woven branches cushioned with dry grasses and animal skins. In some huts, small animals are brought into the hut in the evening to help protect them from larger and more dangerous animals as well as the cold. They stay in an area close to the front door. The only evidence of western man in a Masai hut might be a iron cast fry pan, a tin drinking cup or a piece or two of western clothing. Masai women and girls have a variety of chores besides building the dung hut. They are expected to milk the cows and fetch water, however far that may be (perhaps 36 miles in some cases).




Masai women also spend much time doing bead work. It makes their costumes more colourful.

Now... All hail the Masai Queen, working in Klinik Kesihatan Masai.... Wan sui wan sui...


Sunday, November 09, 2008

You're Elite Gathering 2009


This picture was taken in Sept 2006, the weekend before i left for Sabah. Location was in Kuantan (Soh+JouAnn+ZhiYong House). Because not wanting their faces to be missed out in the blogs (*ahem* from Ipoh *cough*), our team members came all the way from Perlis, Ipoh, Kuala Terengganu, Seremban, Batu Pahat and of course Kuantan. What a huge change from the times when we were carefree students, most of the time discussing about Dota, latest gossips, the latest movies, etc. Not that we were that excited watching "Money Not Enough 2"!!

How we all changed. Nowadays our conversations revolve around pharmacy-related topics. Initially I felt so strange. Hey, we were not like this, discussing which drug is better, how to reduce waiting time!! Shit! But when I thought about it, it's part and parcel of our journey as pharmacists. It's not that we do not have a life, but rather this is our life. For some people, his life involved insurance also lah.. Haha.

At least we still get to express CCB, lansi, tiu le lo mo, niama everytime we meet up. And the real difference now, we all have cars and spend our own money. Looks like we will not walk 15-20 minutes every night to Ajimal Razim anymore!

Hey let's plan another meet-up for next year. Let's plan this trip early, as I need to book my tickets home early. Also, so that Acrix will not be missing in Action and the girls can show up in full force as well. I would suggest:

(1) 22-23 May 2009
(2) 6-7 June 2009

Which date is better?? Any ideas for location??

Saturday, November 01, 2008

Extremely Drug-Resistant Tuberculosis (XDR-TB)


XDR-TB is the abbreviation for extremely drug-resistant tuberculosis, also called extensively drug-resistant tuberculosis. One in three people in the world is infected with dormant TB germs. Only when the bacteria become active do people become ill with TB. Bacteria become active as a result of anything that can reduce the person’s immunity, such as HIV, advancing age or some medical conditions.

TB can usually be treated with a course of four standard, or "first-line," anti-TB drugs. If these drugs are misused or mismanaged, multidrug-resistant TB (MDR-TB) can develop. MDR-TB takes longer to treat, and requires "second-line" drugs that are more expensive and have more side effects. XDR-TB can develop when these second-line drugs are also misused or mismanaged and become ineffective. Treatment options for XDR-TB are seriously limited.

Many people think of TB as a disease of the past, but in 2007 alone, TB killed 1.7 million people. That’s 4,660 deaths a day, or one death from TB every 20 seconds. TB is the leading killer of people with HIV: Individuals are able to live with HIV but are dying from TB. Without proper treatment, 90% of those living with HIV die within months of contracting TB.

The drugs to treat a standard TB case cost only $20 per patient in the developing world, and are almost always completely effective in curing a person of the disease when taken properly, even among people living with HIV.

XDR-TB and MDR-TB, the drug-resistant strains of TB, are much more difficult, and sometimes impossible, to cure. Cases of multidrug-resistant TB (MDR-TB) and extremely drug-resistant TB (XDR-TB) have been found in almost every country of the world. It is not clearly known how far these strains have spread.

Reversing the TB epidemic is a political issue as much as it is a health issue. The World Health Organization estimates that it will cost approximately $6.7 billion annually to reverse the TB epidemic. Currently, only slightly more than half of that is projected to be available at current funding levels. This gap is costing millions of lives.

You can learn more here.

Thursday, October 30, 2008

Datin's Big Day


A little belated birthday wish to Puah Ying Jia, the leng lui pharmacist in Kuala Pilah. Hope you're having a great time in Negeri Sembilan, may you find nine boyfriends. Wtf. Do visit Jempol off and on to keep Acrelaine's sanity alright.

Btw: Feli and JFC shared a boyfren in Edinburgh!

Tuesday, October 28, 2008

Sayang Kinabalu







My favourite song at the moment. The tune is so catchy!! Ada karaoke summore!! Shiok giler. =) Why Siau Yong never introduce this song to us earlier?? Ha ha.

Thursday, October 23, 2008

J Co-ed

Once upon a time, there was a "curious person from Perlis". He was wondering what the 'crazy J Co queue' was all about. Last August, he just found that out. He was exposed to civilization!!



This person is now "not-so-curious person" in Sabah. You can always spot a contented man when u seen one! =)

Monday, October 20, 2008

Kampung Mumiang, Kinabatangan


I'm back in action! Being in Sabah, there are various activities organized by the hospital, and one of it includes the Medical Camps. Last weekend, I was fortunate enough to join the medical camp to Kg Mumiang, Kinabatangan. It was an awesome experience.


We got a lift from the Maritim Malaysia. It was so cool man! The boat journey took roughly 1 hour from Sandakan port. I was reminded about the Taman Negara trip N-years ago!


This is how Kg Mumiang looks like from far. It's a small kampung with a population of just over 300 people. Most villagers are from the Suluk tribe. They speak reasonably good Malay, with heavy Sabahan accent. Most of the men here are fisherman.



Imagine a hospital setting... This is the registration.



The MOPD cum Peads Clinic.



Even have ENT there... Dun play play...



Klinik Pergigian. Check dan cabut sahaja. Kalau nak tampal, kena naik boat 1 jam bah.

The Pharmacy. =)


The cacing buster, Albendazole Man. Haha, basically I was making sure all the children underwent the de-worming process... It was a cool job. Haha.


The villagers in Kg Mumiang live a simpleton life. This photos shows the diesel generator, the only one in the kampung. The generator is only switched on from 6PM -11 PM every night. Imagine this, only 5 hours of electricity every day. There was no fridge or television in the kampung. Yet, they seemed happy.


I'll end with the happy faces of children. This trip was simply surreal.

Happy Working everyone!!!

Sunday, October 19, 2008

Woon Chin on Expedition!


Farm Woon Chin is currently on expedition!! It was quite a surprise for me that this shy girl has taken such a brave step into the jungle to participate in community, environmental and adventure projects! I just met Miss Farm today at the Sepilok Orang Utan Rehabilitation Centre (yes, I was there ZY). Gosh her hands and feet are really a mosquitos' favourite.

If you wanna write a letter/postcard to her, you can do so at:

FARM WOON CHIN
EXPEDITION MALAYSIA AUTUMN 2008
RI MALAYSIA
PO BOX 14182
88848 KOTA KINABALU
SABAH

I'm sure she'll be very happy to hear from someone familiar.

To find out what she's up to, some of the expedition updates are at the Expedition Blog. All the best to her, on expedition and beyond!


*How she sleeps*


Wednesday, October 15, 2008

Platform-ed!



Kenny Sia: Speaking of Harry Potter, there IS actually a Platform 9 3/4 at King's Cross Station.

Joe: Haha. Did u find it??

Ewen: we DID.....muahahaha, but gotta korek the pic out tho kekeke dunno hilang mana :p

Pei Sung: As a matter of fact, yes we found it.
only that it does NOT have any unbreakable glasses worth million of dollars surrounding the platform to protect it.
lol.. i bet u dun even rmber what u said when u tipu us.
bad la u.. hehe

Friday, October 10, 2008

You're A Hottie, Pei Sung!


Okok. Not closing down this blog. Not now, bcos there's something to blog about. (Haha, sounds familiar??)

Our fellow elite pharmacist in Hospital Teluk Intan, Happy Birthday (clap clap clap)!!!
Hope you are taking care of the health of people in Perak while I'm away.
Wish you all the best in your challenging career, and happiness wherever you are ok.

Looking great in that photo Miss Gan (not Puan).

Saturday, September 20, 2008

Sandakan-ed



If you are tired of seeing the big orang utan on AhFooPhoto, here's a baby one for you. It's cuter right?? Lolz..

A big hello from Sandakan, Sabah. I'm now working the the Duchess of Kent Hospital (HDOK). Will probably be in charge of MTAC Warfarin, and also OPD.

Sandakan is the second-largest city in Sabah. Sandakan is known as the gateway for ecotourism destinations in Sabah, such as the Sepilok Orang Utan Sanctuary, Turtle Islands Park, Kinabatangan River and Gomantong Caves.

Come over for a visit someday alright. All Elite members are welcomed. =)

Friday, September 12, 2008

Happy belated birthday to Ewen!



Elite team would like to wish 'Ms Loo Yee Wen' a happy belated birthday. May your life be blessed with loads of sushi!

Friday, September 05, 2008

We're Growing!


After a long selection process, the Elite Team finally recruited its latest member. This is a wonderful girl, so I wonder why the hell she did not join Elite Team earlier!! She is now good friends with our Secretary, and pulled some strings to get in.

Among her specialties include singing Karaoke and shopping at Forever 21!!

Elite Team presents to you....... (drumrolls) Miss Melanie (clap clap clap)!!!

Welcome welcome,,, =)

PS: This is Elite Team reporting live from Kuantan, Pahang. Using the cun Toshiba laptop. A mini-gathering of sorts. We miss the Secretary!!

Monday, August 18, 2008

Team Building in Perlis

Sukaneka 2008 in Kangar, Perlis.





Sunday, August 10, 2008

Staying Young Forever

exercise

The best and safest method for face lifts is through facial exercising, by tightening elongated muscles, thereby producing face lifts, a firming up where the face appears flabby, and a filling out by rebuilding atrophying muscle tissues. Such face lifts are done in a natural and healthy way without invasive surgery, at no expense and in the privacy of your own home. The resulting face lifts result in youthful faces, which may be retained throughout life.
No wonder our Datin Puah looking younger and cuter each time we saw her!!! so jealous!!!

p/s: thanks for giving the chance to the secretary to blog this week.

Wednesday, August 06, 2008

Belated Birthday Wish to kelvin


This photo represents what I remember of Kelvin. Carefree, with his guitar, entertainment to all of us.. I'm sure people change, and I'm not sure if he's still the same. The thing is... Nutrilite passed USD 3 billion in annual sales!!!

Successful man, dun forget us after all that success. Haha, enjoy the moment bro. Cheers!

Saturday, August 02, 2008

Diving


I'm looking forward to scuba diving. Lots and lots of it!! The sea is calling me. =)

Wednesday, July 30, 2008

Warfarin


Why are we using different brands with different bioavailability for anticoagulation therapy?? In the UK, patients are either assigned to Coumadin or Marevan, and therapies are seldom interchanged. Wtf are we doing here??

OMG. I have no life. I'm a pharmacist!! =)

Friday, July 25, 2008

Back To Reality


I'm back in the land of paddy fields, but it was a fantastic weekend in KL. Something to keep my sanity. Looking forward to more outing with you all alright.
Finally, the curoius person from Perlis joined the crazy JCo queue in Pavillion KL!!
PS: Pei Sung, please dun close your blog!!

Sunday, July 13, 2008

Run Bulls Run!!

This is the time of the year. The time when my heart beats faster and pumps blood harder. I can remember vividly the adrenaline rush when Ah Foo and myself were at Pamplona (northern Spain) last year (07.07.07) to participate in the San Fermin Festival. It is also commonly known as the "Running of the Bulls". The experience was amazing and we never knew what to expect. Did we mention that we could not run with the bulls on our first attempt?? Paiseh.. we tot we wanna "curi ayam" by starting at the middle point. We ended up being chases out by the "Policia", as they did not want too many people to crowd the streets during this event. How pissed off we were!!

We both made sure that we woke up early the next day, and gathered right in front of the Mayor's Hall. When the cannons went off, it was time to run!! I ran and ran not even stopping for anything. How silly because I did not even see the bulls. Foo waiting to see some of the small bulls (the crazy ones!!) before running "with" the bulls. How brave, but the bulls ran really fast!!

By the time I reached the finishing line (a door into the arena), the bulls were literally 2 metres behind me!! People kept pushing this small Asian dude to the middle. I was lucky to have entered the arena, in one piece. As insurance, Foo and myself did buy tickets into the stadium the night before, just in case we could not enter the arena. Typical 'kiasu' Malaysians!! =)

It was an amazing experience, and I have to thank TopDeck for a job well done in bringing us there. If I ever have the chance, I would run with the bulls again in a heartbeat!!

The crazy opening ceremony:



Morning of the run:



Balcony view (you'll need to pay some money, while the run is free):


Ah Foo's view:




My view:



One for the album!!



Vive San Fermin!