Saturday, June 28, 2008

Eat, Drink, Be Merry and Die.

Like Ling Hee Leong, chronic alcoholics practice the principle of eat, drink and be merry. Engaging in loud and rowdy drinking sprees in an orgy of unlimited tobacco, casual sex, filthy swear words and an oversized self-esteem, they live life as though there is no tomorrow.

Sometimes, they happen to be spot on.

Eat, Drink, Be Merry and Die.

The whole country is still coming to terms with the recent fuel price increase. For the next six months, Malaysians in general would be in a state which psychiatrists term as adjustment disorder. The price of chicken rice in the neighbourhood would have most certainly increased by now. The size of its serving might also have shrunk somewhat, in tandem with the value of the Malaysian ringgit locally.

There are certain clusters of the population that are somehow unaffected by the rising cost of living. They are none other than the commercial sex workers, the chain smokers, the corrupted politicians, the reckless mat rempits and the binging alcoholics. Indeed, the earth may rumble beneath their feet, the storms may roar across the skies and the deputy prime minister may confess to murder, but life goes on as usual for these unique characters who more often than not happen to be the one and the same individual anyway.

Have you observed the mannerisms of drinkers in the ubiquitous pubs and karaokes in their routine binging session? Like Ling Hee Leong, chronic alcoholics practice the principle of eat, drink and be merry. Engaging in loud and rowdy drinking sprees in an orgy of unlimited tobacco, casual sex, filthy swear words and an oversized self-esteem, they live life as though there is no tomorrow.

Sometimes, they happen to be spot on.

A 40-year-old man was wheeled in at 4.00 am in the morning, reeking of what was most probably a lethal concoction of potent alcoholic brew. He was involved in a car crash after yet another late night out boozing into the wee hours of the day.

It was a surreal moment, watching the father of five lying there helplessly obtunded on the operating table with tubes and lines running out of his body orifices. His tummy was distended larger than a pregnant lady’s at term, suggesting massive internal injuries and bleeding. He was paler than Casper and must have lost at least three liters of blood by the time he was wheeled in for surgery. The torn spleen and bruised liver were expected and predictable. Brain and spinal injury were not excluded yet though. He might survive the surgery but if he might be spending the rest of his life in a wheelchair if there were brain and spinal injuries.

Over his chest and back were tatoos bearing images of fire-spewing dragons and the Kuan Yin goddess of mercy. They wouldn’t be of much aid to him at the moment. His wife and children waited impatiently outside the operating theatre, embracing each other in somber moment of knowing that head of the family was hanging precariously like a walk on a tightrope without safety netting.

I wonder what kind of life he led.

Was he another typical hard-laughing, smooth talking businessman who professes love for his wife in the morning and beds a Filipino guest relations officer at night?

Was he the irritating smoker who huffs and puffs at my face like a chimney when I am trying to have dinner in peace at a hawker stall?

Or was he the intolerant road bully driving his four-wheeled SUV and honking at every vehicle in front of his?

Maybe he was none of that kind. Maybe he was just a regular jock who has yet to discover his calling in life in a journey of self enlightenment. Maybe he was a loving father who comes home every night to cuddle with his wife in the marital bed every night. Maybe he was not even a drunkard or a smoker or an impatient road tyrant.

I will never know. Who am I to judge anyway?

Judge not, lest ye be judged by the same standards by which you have used to judge others.

I can’t help but feel sorry for the wife and kids though. Hers is yet another family destroyed by the consequences of driving under the influence. Hers was not the first and definitely won’t be the last.

Sad tales like this lends credence to PAS’s firm stand on regulating the consumption of alcoholic drinks. The Islamists falls short on another potent venom though. Their hypocrisy comes to full disclosure when it comes to cigarette smoking.

While drunkards with alcoholic liver cirrhosis succumb in an acute manner to sudden variceal bleeding, chronic smokers have a more protracted period of suffering and distress before moving on to the hereafter.

I am anti-smoking and anti-smokers and I am biased because I have allergic rhinitis that doesn’t gel well with cigarette smoke. Parents with an asthmatic child can relate to my strong sentiments on smokers.

It is outright irritating to have someone smoking into one’s face when one is trying to have dinner in peace and quiet after a long working day. So maybe smokers have a right to relax and chill out after their own long and tiresome working day, but they seem to have an additional privilege of doing so by denying others a hassle-free lunch and dinner. In a world that operates on violence and aggression, non-smokers cannot confront these walking chimneys lest they desire a bruised eye and a bloody nose. We end up penning our anger within, downing our meals in bitterness and walking off smelling like tobacco.

It is not the end of the story though.

The end comes eventually for the recalcitrant cigarette smoking person. Chronic obstructive lung disease sets in soon enough. There is only so much we can do to our bodies before nature takes its course. In the few months preceding overt respiratory failure, there will be multiple hospital admissions and nebulizer sessions. They are probably repentant by now but it is a little too late. They wheeze and labor for air until the very last breath, in a manner so dismal and beyond help.

Even so, there is no poetic justice or sweet vengeance at the sight of dying smokers.

After all, they receive subsidized healthcare just like the rest of us taxpayers. Difference is, they probably receive more than they have contributed. It doesn’t make any sense sometimes. Why should someone who chose to smoke one’s lungs away be given equal privileges to free healthcare as someone who actually took care of one’s health?

Are we promoting a sense of accountability to oneself or are we sowing a rent-seeking mentality of entitlement?

A gargantuan anti-fuel hike protest will be held on July 5th in the capital city of Kuala Lumpur. As much as I feel the pinch of inflation and downsized nasi ayam, I will not participate in any such demonstration unless all of the chest-thumping, placard-bearing protestors are innocent of squandering their ringgit on booze and tobacco.

Read more!

Exams and Self Examination

It wasn’t too long ago that 150 medical students graduated with Bachelor of Medicine, Bachelor of Surgery (MBBS) from University Malaya by feigning surprise in their practical examinations...

Exams and the futility of it all.

Allow me to let you all in on an open secret: examinations are a farce in Malaysia.

From pre-university to undergraduate to postgraduate, Malaysian examinations are a mockery of knowledge and academic pursuit.

The questions for my STPM Biology paper were partially leaked just a week before I sat for the examination. The similarity between the questions I practiced on and the ones in the real examination was beyond the logical explanation of logic and coincidence. So you see, I may not deserve the ‘A’ I scored after all. In fact, many who passed Biology in the STPM examination of that year could do so merely because of leaked official national secrets.

It is not something unique. It has been going on for years and probably will forevermore until the Lord Jesus returns to judge the living and the dead.

It is not limited to the STPM either. The privileged and brilliant students studying in their exclusive full hostel schools (sekolah asrama penuh) have been enjoying immeasurable assistance in exams for generations. When we the non-privileged folks needed some clues as to what might be forthcoming in the Fifth Form examinations, we would seek out our privileged friends in these elite institutions. The trial examinations in the Maktab Rendah Sains MARA (MRSM) colleges are usually uncannily similar to the real thing.

For this very reason, I am personally not impressed by the 100% excellence passes obtained by the all-Malay MRSM colleges and full hostel institutions. It is but a grand charade produced and directed by a political party saddled with inferiority complex but is also narcissistic and kiasu.

The practice of ‘assisted examinations’ extends all the way to tertiary educations.

It wasn’t too long ago that 150 medical students graduated with Bachelor of Medicine, Bachelor of Surgery (MBBS) from University Malaya by feigning surprise in their practical examinations. The MBBS finals were approaching faster than we could prepare ourselves for. We had two weeks to revise what we had learnt in five years. There were theory papers, clinical assessments and practical skills examination.

The relatively high passing rates of previous years were no consolation. When one is faced with a daunting task ahead, no hopeful hindsight is helpful.

It was Sunday, a day before the examinations were due to begin in the week ahead. There was a sudden mad stampede of medical students to the general clinic. Seemingly, we were to be tested on the techniques of using asthma inhalers and obtaining consent for a major surgery. The rumors surfaced after a prayer session in the college surau.

It was to be kept a secret – restricted to within a certain community. Our Muslim colleagues were of course not as selfish and racist as their lecturers who leaked the questions. We ended up discussing about asthma inhalers and pap smears and the important points in breaking bad news and obtaining consent for clinical procedures. It was a demonstration of racial unity and interfaith goodwill, albeit in an exercise of deceit and fraud.

On the day of the examination, we laughed to ourselves quietly within but feigned surprise and astonishment when faced before the examiners. The external examiners from Hong Kong and United Kingdom must have been so impressed with our apparent familiarity and smooth handling of an asthma metered dose inhaler. We handled most questions that were thrown at us coolly and calmly, an evidence that we were well-trained and diligent by nature.

We knew better, of course.

There is a third party in the midst of our stageshow. Along with the 160 of us then medical students were eight medical students from unrecognized universities. They too were sitting for the final MBBS examinations with us but without the aid and help that we received. They failed miserably, needless to say – all eight of them. Frankly speaking, there little possibility they could have passed the examination on sheer hard work alone.

So you see, perhaps I am not in a position to write about meritocracy and injustice. After all, I was an unintended beneficiary of the university’s biased lecturers.

In my previous articles on the sham academic program termed Skim Latihan Akademik Bumiputera (SLAB), an infuriated UM academic who christened himself Tengku Cougar remarked that the SLAB candidates have achieved impressive passing rates in their final postgraduate examinations. Such arguments are essentially witless, to say the least. If questions were leaked and candidates were given a leg-up, passing rates are then meaningless and of no relevance.

Now before anyone accuses me of degrading local graduates, allow me to clarify that whatever I wrote today and revealed in this article is based on my brief Malaysian experience.

This article is focused solely on the isolated topic of examinations and not on the final products of local universities, most of whom are comparable to foreign institutions regardless of ethnicity.

Read more!

Barking Dogs and Wagging Tails

Which part of Najib Razak and the UMNO/BN government as a whole is serious in clamping down on illegal immigrants in our country?

How can we believe a government who warns the enforcement officers and courts to be sympathetic and caring in deporting foreigners and the very next day announces a massive crackdown on illegal immigrants?

Barking Dogs and Wagging Tails

A young boy, John visited a friend’s house and was greeted by an aggressively barking alsatian.

“I’m afraid to enter. Your dog is barking” exclaimed John.

“But it’s also wagging its tail,” replied his friend, Tom.

“Then I don’t know which end to believe…”

The short conversation above was something I read in the Children’s Brittanica many years ago. It was supposed to be a joke.

I didn’t find it hilarious then. I still don’t. In fact, I can’t see how anyone can find any humor in that short and bland dialogue.

It does however bear some relevance to recent national events.

After the Sabah Progressive Party’s (SAPP) threatened motion of no confidence against Abdullah Badawi, the UMNO government has made significant moves in an attempt to placate the increasingly impatient Sabahans.

It was reported as headlines on June 26th that the UMNO Federal Government will be holding a massive crackdown on illegal immigrations in Sabah. The grand plan was announced by Deputy Prime Minister Najib Razak. It was reportedly greeted with joy and thanksgiving by the Sabah politicians, including SAPP president Yong Teck Lee.

Amazingly, just a day ago on June 25th, the Immigration Department in Peninsular Malaysia was reminded not to be ‘overzealous in deportation’. Seemingly, an Indonesian couple suspected to be in the terrorist outfit Jemaah Islamiyah was deported from Kuala Lumpur recently.

It brings us back to the brief exchange between two little boys over a barking canine.

Which end do we believe now?

Which part of Najib Razak and the UMNO/BN government as a whole is serious in clamping down on illegal immigrants in our country?

How can we believe a government who warns the enforcement officers and courts to be sympathetic and caring in deporting foreigners and the very next day announces a massive crackdown on illegal immigrants?

Perhaps there is no contradiction in the press statements. Maybe he’s implying that the illegals rounded up in Sabah will not be deported after all but merely sent to temporary detention centers where they’ll wait patiently for a Malaysian identification card. After all, a genuine Malaysian ID only costs RM 100 in Sabah. It even comes with the special privileges of Muslim bumiputeras as enshrined in the constitution of Malaysia.

Sometimes I feel that we’re too affixed in the exponential population bloom of the Filipinos and Indonesians and Pakistanis in Sabah under Project IC. We’ve forgotten that Indonesians, Burmese and Bangladeshis are infiltrating Kuala Lumpur at a rate similar or perhaps in excess to what is happening in Sabah. Malaysians do not need PAS to transform the nation into an Islamic state. The UMNO politicians have already been doing that for years now, welcoming Muslim immigrants with wagging tails and friendly barks.

Lastly, food for thought – if the government can make two contradicting announcements in 24 hours, how are we to perceive the politicians' repetitive denials in the murder of a Mongolian model?

Read more!

Sunday, June 22, 2008

Mismanagement, Mismanagement, Mismanagement!

....for twenty two years, Malaysia was under the stringent care of a medical doctor whose previous administrative experience was that of Klinik Maha in Alor Setar, Kedah.

Mismanagement, Mismanagement, Mismanagement!

An Ailing Malaysian
A graduate from Universiti Malaysia Sarawak (UNIMAS) shocked me recently with her pathetic knowledge in pharmacology. She was placed in charge of a patient with a fractured hip bone. The elderly man from Sandakan had been under her care for days already. I reviewed the patient and identified multiple acts of blatant neglect and implicit murder. The docile patient was simultaneously on three non-steroidal anti-inflammatory drugs – Celebrex, Arcoxia and Voltaren. As a result, his kidney function was deteriorating, a phenomena totally oblivious to the house officer concerned. He was probably having a slow upper gastrointestinal bleeding as well, for his red cell count was falling slowly but steadily.

As a house officer, she was to be in constant knowing of the patient’s latest condition and medications. She was not, obviously. In addition, a house officer is supposed to be working under the supervision of medical officers. This too, was not happening obviously. Her medical officers were either just as apathetic or equally unfamiliar with drugs and their adverse effects. The last question that begs an immediate answer will put to shame all ye pharmacist apologists. Drug charts are reviewed each day by the hospital pharmacists for approval and dispensing, so why did the wise and esteemed pharmacists dispense the medications knowing it is a case of overzealous polypharmacy? Perhaps they too, were as well-read as the house officer.

When confronted, the house officer became defensive and insisted that Arcoxia and Voltaren were not in the same group as Celebrex. In fact, she was even unable to provide me with the corresponding scientific names of all the drugs she was prescribing to the patient.

I can accept a doctor’s being fresh and uninformed. I can’t however, accept a doctor’s being clueless and arrogant. She incurred my wrath for more reasons than her outright ignorance. She downplayed my concerns and was unwilling to learn from her mistakes. In short, she was unteachable.

I ended up wasting thirty minutes of my youth trying to educate this young Malaysian Chinese lady in basic clinical pharmacology. I should have been paid by UNIMAS for doing the job of its lecturers.

I have acquired a notorious reputation of sorts among the junior doctors. They know they’re in for a fiery tongue lashing session when I discover a patient under their care is neglected and unacceptably mismanaged.

It’s really annoying when patients are mismanaged in the wards. It’s not as though I have never committed blunders of my own. Everyone screws up every once in a while but mostly inadvertently. Then there are those who are total screw-ups in life and are seemingly determined to make others meet the same fate.

From my own limited observation on which I have no evidence or random surveys to quote from, I find that patient mismanagement falls mostly into three categories: investigations, fluids and drugs. I can write endlessly about the mismanagement of patients but I don’t see how it can be edifying to anybody.

This is not to be another case write-up overflowing with incomprehensible verbose medical jargon.

An Ailing Malaysia
Rather, I wish to draw parallel of the daily bungling of an ill person to the half a century mismanagement of a nation. After all, for twenty two years, Malaysia was under the stringent care of a medical doctor whose previous administrative experience was that of Klinik Maha in Alor Setar, Kedah.

Malaysia is currently very, very ill. If the world had an Intensive Care Unit (ICU) for ailing nations, Malaysia is an ideal candidate for admission because despite being in a debilitated condition, there are chances that Malaysia can be restored to viability and stability. We can blame the Abdullah administration all we want but truth be told, he inherited a nation that was messed up by his predecessors for almost half a century.

Political analysts have write theses after theses about how Malaysia became as ill as she is today. The problem list is long but can be generally summarized to three main areas of mismanagement: Wealth, Human Resource and Time.

At risk of sounding like an overplayed, outdated Vanilla Ice track, it really isn’t too far fetched to reiterate that Malaysia is a land blessed with abundant wealth.

Malaysia has almost everything mother earth has to offer except for real snow, chubby pandas and an intelligent deputy prime minister. Malaysia has the resources to provide almost anything for her citizens – delicious multicultural delicacies, natural places of interests and potent C4 explosives.

Had the richness of the nation been fully utilized prudently and honestly, Malaysia can today be more generous than Cuba, more flamboyant than Brunei and more peaceful than Switzerland.

Yet the solemn fact is that the fat of the land has been squandered and stashed away in the private Swiss bank accounts of those who call themselves ambassadors of the nation and defenders of race, religion and culture.

We have ended up therefore instead with trunk roads littered with potholes and hospital mortuaries stocked with fallen motorcyclists, even as our limestone mountains are indiscriminately chiseled away on a daily basis.

Our oil reserves have almost run out after decades of drilling with bountiful profits reaped in the process, but still we have districts without schools, schools without teachers, teachers without money and now, money without value.

It is not too late for Malaysia to undo the wastages of her wealth on white elephant mega projects and salvage the residual assets of our land. UMNO has proven itself incapable of keeping its hands out of the cookie jar. Perhaps Anwar Ibrahim, Lim Kit Siang and PAS can do better job?

Human Resource
A Singapore-based hospital came to Sabah recently on a small-scaled roadshow. The institution is in the process of expanding its services and is thus somewhat short on manpower. The Human Resources team came on a recruiting tour, hoping to employ medical officers and registrars with the prospect of further training and sub-specialization. The employment terms and conditions were moderately attractive although the salary scheme will not make one rich in view of Singapore’s high living cost.

Yet the team of headhunters emphasized one crucial characteristic that has hitherto been sorely absent from our Malaysian civil service. It is none other than the factor of and emphasis on meritocracy in consideration for future remuneration and promotion. All this while, the Malaysian Ministry of Health proclaims that our doctors are leaving solely because of monetary reasons.

I must admit that I am extremely tempted to send in my curriculum vitae to a foreign institution. I am not alone, apparently.

What the Malaysian Ministry of Health is trying hard to oust and discard, their counterpart at the south of the peninsular border is waiting impatiently to receive.

In the Singaporean hospital’s own admission, up to 40% of doctors in the Lion City are Malaysians.

Some quarters estimate that between one to two million Malaysians are currently serving a foreign country. Every family I know seems to have a relative or a child working overseas. Therefore, a Malaysian diaspora in the scale of a million or two isn’t really incredulous.

Only God knows how many talented and skilled Malaysians have left the country since BN’s discriminative policies came into effect. It’ is not entirely an issue of race or ethnicity. It is very much the question of political affiliation and personal ideals as well. Great thinkers like Azly Rahman and M Bakri Musa are Malays by the most rigid definitions yet they have chosen to serve a foreign land in spite of the promises of a privileged life back here in Tanah Melayu. Enlightened individuals with enormous talent can never gel with an authoritarian regime that tolerates no dissenting view.

Indeed, we have lost doctors and engineers, economists and artists, thinkers and writers and even P. Waytha Moothy and Sufiah Yusof.

In short, the Malaysian government since 1957 has failed to safeguard our collective resources as well as resourceful individuals.

Only time will tell whether a Pakatan Rakyat administration will adopt a new stance in employment and promotion - the axiom that human resource is the greatest asset to any corporation. After all, such a working principle has worked well for our southern neighbours thus far.

Time and tide waits for no man. Time and tide waits for no country too, especially one that doesn’t appreciate the value of time and the consequences of wasting time.

The Malaysian government and the civil servants it employs are experts in time wasting.

Our civil servants did not acquire their fame for unproductivity for nothing. On second thoughts, perhaps I’m contradicting myself. Maybe they did after all - by doing nothing.

Every half hour or so, is a protracted coffee break in the typical bureaucratic office. The culture of ‘minum teh’ is too entrenched in the system. In fact, the one who does not participate in this orgy of sluggishness might end up alienated and ostracized for being pretentiously diligent. The working ethics might have improved a little over the years but mostly, an administrative officer in civil service is more likely to have Solitaire on one’s computer screen than a window of backlogged records and documentation.

Every other day meanwhile, there seems to be a reason to organize a lunch function of sorts. It’s either the welcoming of a new department head or the farewell to a retiring director. It’s either the officiating of a Toilet Cleanliness week or the formal closing ceremony to the Service-with-a-Smile campaign. If 100 personnel attend these two-hour functions every other day of the week, it’s a loss of 100x2x3 = 600 working hours each week, or the loss of 2 months productivity per week.

Every other week or so thereof is an inescapably lame workshop or nonsensical seminar. These are programs that supposedly improve the skills, knowledge and public relations of our bureaucratic staff. More often than not however, they are delivered by untalented souls who would otherwise not find employment in the private sector. The mother of all these courses is none other than the Induksi and Biro Tatanegara Program (BTN) that serve only to brainwash any dissenting views and convert opposing voices into all-hail-UMNO-and-BN zombies. Each Induksi session lasts two and a half weeks.

Do the maths and one will arrive at a horrifying figure of unpardonably wasted time. Suddenly it all makes sense why our general hospitals never to seem to have enough nurses, medical assistants, dentists, pharmacists and doctors. They are all busy feasting away in a hotel ballroom listening to speakers spreading pro-UMNO propaganda.

Most people will welcome a paid holiday to while their lives away. I’d rather earn my keep and make the most of my time treating ill people just as I was trained to, so thank you very much.

A Priceless Trinity

Like the Father, Son and Holy Ghost unified in their Holy Trinity, Wealth, Human Resource and Time is essentially one and the same.

Time is money and human resource equals wealth.

Is that a concept too complex and beyond the understanding of our pea-brain politicians? Or are they as recalcitrant as the obstinate house officer from UNIMAS, the arcetypal of 'bodoh, sombong?

Read more!

Thursday, June 19, 2008

Stale, Boring, Anti-climax

SAPP's sudden outrage over the presence of Filipinos, Indonesian, East Timorese and Pakistanis is therefore amusing at best and a blatant bluff at worst. Illegal immigration is an issue as fresh as stale bread here in Sabah, so why has SAPP suddenly run of patience with prime minister famed for his indifference and ignorance?

After a much publicized and anticipated press conference, the Sabah Progressive Party (SAPP) announced that it is moving a motion of no-confidence against Prime Minister Abdullah Ahmad Badawi when Parliament resumes session on Monday, June 23rd 2008.

The main reason cited behind the party’s proposed move was the Barisan Nasional’s failure to sincerely tackle the issue of illegal immigration in Sabah.

For a party that has been part of BN/UMNO coalition ever since its existence, the cited reason for SAPP’s sudden, radical plan is at best hypocritical, stale, boring and anti-climatic.

Former Sabah Chief Minister Yong Teck Lee was himself a beneficiary of votes cast by Project IC citizens, a fact that was proven and authenticated by the courts in the 1999 Likas election petition.

The party’s sudden outrage over the presence of Filipinos, Indonesian, East Timorese and Pakistanis is therefore amusing at best and a blatant bluff at worst. Illegal immigration is an issue as fresh as stale bread here in Sabah, so why has SAPP suddenly run of patience with prime minister famed for his indifference and ignorance?

Politics is very much about making the right friends at the right time and setting sail to where the wind is blowing. SAPP is but just another Malaysian political party that knows fairly well where the pot of gold lies.

There is sufficient reason to suspect that SAPP is anything but sincere over the well being of Sabah-land. It took them – a self-proclaimed Sabahan organization – fifty years to find a voice over the long-standing issue of illegal immigration. Lim Kit Siang, a true-blue Peninsular Malaysian has been writing and yelling about illegal immigration in Sabah for decades already.

That seems to be the usual case with Sabah and Sabahans anyway. They don’t seem to have a voice of their own. They don’t seem to have the guts to right the wrongs in their land without an inherent fear of angering their UMNO political warlords. They seem to have an innate inability to take the initiative and inspire a change for a better Sabah.

Up till now, the most pressing issues about Sabah are mostly brought to surface by West Malaysian leaders who have little to gain from a better Sabah.

Even in restless political times as these, the SAPP has only raised the increasingly stale issue of illegal immigration and Project IC. It only shows how shallow and out of touch these self-professed patriotic Sabahans are.

I have lived in Sabah for less than five years and can effortlessly compile a list of urgent issues affecting the common man (and woman) this very moment.

The electricity supply went kaput in the hospital last week – Monday and Tuesday. The sun sets at by 6.00 pm here in Sabah. By 6.30 pm, the damned hospital was mostly lingering in eerie darkness, except for the scattered areas where the emergency lighting was powered by a backup generator.

My nosy and busy-body traits got the better hold of me. I took a relaxing stroll around the hospital, from the flooded casualty to the leaking basement, from the foul-smelling third class wards to the relatively comfortable V.I.P wards.

A 16-year-old boy from Kudat with a broken femur blocked my course upstairs. He was carried on a stretcher all three floors up to the orthopaedic ward.

A local lady living in the nearby squatter settlement followed not far behind me. She was having dinner when the landslide buried her home. She was extricated and sent to hospital with the hope of receiving medical care. Instead, she was sent on a bumpy journey by stretcher to the wards – all six floors up.

An elderly couple was on their way to visit their ill son. Their backs were hunched from osteoporosis and their knees bent by the deformity of longstanding osteoarthritis. A walking stick in the left hand and a clumsy fruit basket souvenir in the other, they painstakingly made their ascent up the lightless, treacherous flight of stairs, their occupied right hand barely able to grasp the sidebars of the staircase.

The staff of the operation theatre meanwhile had a day off – all non-urgent surgeries were postponed till a later date while only the most life-threatening emergency surgeries were permitted to proceed.

In the wards, the utility of power was kept to a bare minimum. It means that the patient on a ventilator might not get his regular suction of chest secretions. It means that warm and cooked drinking water might be temporarily unavailable. It means that if a patient dies unnecessarily, doctors can declare the cause of death as power failure.

Power blackout and infrastructure failure are not once-in-a-blue-moon events for Sabahans or the hospital. The Sabah Electrical Sdn Bhd (SESB) monopolizes power supply in the state of Sabah and knows fully well that the people have no alternative utility company. It is the reason why SESB, a subsidiary of the equally incompetent Tenaga Nasional Berhad (TNB) is so utterly arrogant and pompous beyond redemption. The referral hospital of Sabah Borneo languishes in semi-darkness while the SESB headquarters stands adorn with sparkling neon lightbulbs from roof to basement. SESB goes after bona fide consumers who are late with their monthly payment while power theft by the ingenious illegal immigrants goes unheeded.

I’m surprised that the BN political parties of Sabah have yet to pressure SESB to improve its services. After all, a more consistent supply of electricity augurs well not only for the local Sabahans but UMNO’s prized Project IC citizens as well.

Roads and Transportation
I’ve driven from Kota Kinabalu to Kota Marudu, Kudat, Kota Belud and Kuala Penyu. The roads are anything but safe. It’s not because there are Mat Rempits or stampede buffalo crossings. They are hazardous because they are unlit and un-tarred along many stretches. Coupled with the omnipresent potholes and acute angles, a young child traveling in the humble family car in the form of a Perodua Kancil will be lucky if she escapes with Shaken Baby Syndrome.

Sabahans are really pleased to tell West Malaysians that there are no toll booths in Sabah. I wonder what is there to so proud of when the roads are in miserable condition, upgraded every five years in time to canvass for votes from the gullible local folk.

SAPP and other Sabah political parties do not need to be heroes by demanding for Badawi’s resignation. They can prove much more by simply constructing better roads for the rural folks to travel on.

Drainage and Irrigation
A mother of six brought her eldest daughter after a whole week of high, spiking fever. The young girl had been deteriorating by the day at home. The doctors were furious and annoyed with the mother’s obvious delay in seeking medical help for an ailing child. The young child died with a diagnosis of rheumatic fever.

That’s not the point however. The reason behind the apparent delay is.

You see, the child was ill and the experienced mother was fully aware of it. It had been raining heavily however and they have not stepped foot out of their stilt house for days. The flood waters were receding to level just enough for the family to travel to the nearest district hospital. An unexpected guest was awaiting their exit however. It was a hungry six-foot crocodile that had been washed inland by the rising river just behind their home. It was more delay and an increasingly intense battle against limited time. In the end, death won and a mother lost her eldest daughter.

We can ascribe such calamities to divine fate and a mere series of unfortunate events; or we can own up to manmade chaos.

If there is one thing both urban and rural Sabah shares in common very regularly, it is none other than floods. One does not need to be an environmental scientist to comprehend the cascade of overzealous logging and unchecked development culminate in soil erosion and flash floods.

We should blame God when God is responsible but spare Him when He is not. Heaven does not have a Department of Irrigation and Drainage or policies dubbed as Environmental Impact Assessment (EIA). The Sabah state government has both however, and it is doing a lousy job in both.

The UMNO cronies harvest logs and build mansions on higher grounds, the commoner stays grounded and wade regularly in a cocktail of rain and sewage flood waters. It’s that simple, actually.

Education, Employment and Sabah’s Lost Generation
There will be a time in every student’s life when they will just “sit at home” and do nothing. The exams are over and there is yet to be an attractive part time job offer. In times like these, one is idle true to its very meaning, reading the same news daily repeatedly in attempt to pass the day more quickly. School will resume soon enough though and the routine cycle of classes and homework and exams will set in.

Young Sabahans are unique in this sense though. The state of being idle has no foreseeable end and this is especially true for the youngsters in the rural areas. They received little or no formal education. They have no marketable skills. They were not raised to be tough and buff like their Filipino counterparts clamoring for every minuscule job opening. The world as they know it is a world of simplicity – a daily habit of just sitting around and doing nothing.

It was reported recently that one third of schools in Malaysia have no power supply. Perhaps we should isolate the statistics for Sabah. It wouldn’t be shocking if half the schools in the districts of Sabah have no power, no water supply, no furniture, no books and no classrooms. After all, it is adverse circumstances like these that allow the exhibitionistic politicians to demonstrate their generous deeds and goody two shoe acts of community services for the front pages of local dailies.

The young Sabahans in Kota Kinabalu are of course better off in some ways, but they are hardly representative of a state with 2.5 million residents.

There are dire consequences should the young people of Sabah continue to stay out of sight and out of mind of the federal government. There will soon be farms without owners, harvest without labourers, homes without tenants and job vacancies without suitable candidates. The possibility of the indigenous folks ending up marginalized in their own birth place is real and palpable.

Sabahans can never lead Sabah efficiently by themselves
A common theme after the 12th Malaysian general elections went along the lines of Deng Xiaoping's "No matter whether it's a white cat or black cat. It's a good cat so long as it catches mice".

Sabahans have been far too close-knit among themselves in order to be capable stewards of their land in an age of globalization. Their chief ministers, one after another, have failed them miserable although these kingpins were all local Sabahans. From Osu Sukam to Musa Aman, Bernard Dompok to Joseph Pairin Kitingan, the lot of the less endowed Sabahans have changed little over the years.

Rather than demanding for greater autonomy, perhaps it is time they take a break from being Sabahan to being Malaysian.

Sabahans may never be capable of leading Sabah effectively and efficiently by themselves.

And I hope I'm totally wrong about this.

Read more!

Wednesday, June 18, 2008

Sleepless, as usual

Heaven bent to take my hand,
And lead me through the fire,
Be the long awaited answer,
To a long and painful fight...

Sarah Mclachlan’s Fallen plays softly in the background. Her ghostly voice and a matching rhythm complements the prevailing pensive mood hovering above me. The gloomy lyrics are mostly drowned out by the ageing ceiling fan pleading for repairs in a decible more squeaky than ever.

I sat for two hours in semi-darkness tonight, staring blankly at a glaring computer screen, distracted occasionally by the faint sound of an overfed rodent doing his routine workout on his undersized hamster wheel.

I am both apathetic and impatient.

I’m waiting for the day Malaysia gets a new ruling party, one that is different from the corrupted, racist, bigoted federal government we have right now. The Sabah People’s Progressive Party (SAPP) is scheduled to make a groundbreaking announcement by morning. Is this the beginning of a new era for Malaysia or is this another one of those false alarms?

Actually, it doesn’t really matter that much. Regardless of whoever is in power, I know fully well that there will be no radical transformation for the land called Malaysia. The social inequality and religious dominance will remain, if not in one form at least in another. PAS Youth will still make silly unrealistic statements and the DAP will still be opposing fervently. Singapore will still lure the local professionals and Malaysia will remain the greatest supplier of trained and skilful personnel.

Whatever happens, whatever does not, I will not lose sight of the people (and animal friends) that matter to me.

In the end, as Lilo and Stitch put it, family sticks together.

“"This is my family…. It's little, and broken, but still good." Stitch, 2002

Read more!

Sunday, June 15, 2008

Doing A Mahathir, An Abdullah And A Ling Liong Sik Too.

Doing a Mahathir, an Abdullah and a Ling Liong Sik too.

I spent a great deal of the last seven days revisiting this blog like a restless soul wandering aimlessly in a familiar realm it has just departed from.

Maybe I am just too bored running my hamster wheel that’s life but the truth is, I am not. I have far too many events unfolding in my life every day in order to be bored. A patient bleeding from a slash wound in the neck can’t be boring, can it? Neither can that chap from Tuaran with severe facial injuries whose head is more swollen than an overinflated rugby ball. Life is interesting as it is with sleepless busy nights and unpredictable wake-up calls.

Perhaps I am just yet another desperate attention seeker longing for compliments, praises and words of adoration. This isn’t likely either because I seem to receive a lot of unwanted attention – attention as unwanted as the Malaysian citizen that I am and have turned out to be. My head of department spoke to me yesterday. Apparently he too reads this web log after being alerted about it by the other heads of departments. The Ministry of Health is supposedly monitoring the contents of this web log regularly and is more than determined to nab the author in view of the non-subservient nature of the articles. Our brief little chat shall remain confidential but suffice to say, the Ministry of Health is sorely mistaken if it thinks that all heads of departments are blind fools kow-towing humbly to weak leadership.

I do not have too much time on my hands either. I never seem to have enough minutes in a day. I am seemingly always rushing to and fro and back and beyond. Managing a web log is really an activity I can ill-afford at this juncture in life. Essentially though, it’s really a question of will and interest. It took me three days to complete “Doctors Prescribe, Pharmacists Dispense, Patients Suffer” and three weeks to pay my RM 12 water bill. The ageless adage ‘when there’s a will, there’s a way’ holds much wisdom. It can be extrapolated beyond my struggle between the duties of a government doctor and a blogger with an exaggerated sense of self-importance. For example, with adequate political will, the Malaysian Ministry of Health can transform Malaysian healthcare for the better. Instead, they are obsessed with clamping down on a non-submissive blog read by fewer than 300 people per day.

I guess I am just another loud mouth that refuses to be silenced by an authoritarian regime. I was brought up by a mother who advocated courage and resilience in the face of adversities. I guess childhood traits and lessons learnt while growing up do not fade away that easily. Someone has to expose the racist policies in education and healthcare profession. Someone needs to tell the stories of impoverished and forgotten Sabahans and the tangible consequences of Project IC/Project Mahathir. Someone has to be around to deny those corrupted, coward politicians a seamless night sleep. Someone’s gonna do it but it’s not going to be Guiness Stout’s Adam King, Joseph Pairin Kitingan or Liow Tong Lai.

It’s decided then. I am doing a Mahathir, an Abdullah and a Ling Liong Sik too. If Mahathir was allowed to un-resign after tearfully announcing his resignation on national television back in 2002, I too accord myself such a privilege. If Abdullah Ahmad Badawi can get away with blantant lies after lies with black and white press evidence, I too shall cite changing circumstances as the reason for my flip-flop decisions. I am not an MCA fan, but the former head honcho who is currently the Tun Ling Liong Sik feigns resignations and withdrawals the best among all Malaysians.

I am officially retracting my ‘Farewell and Goodbye” and bidding you all Hello and Good Morning.

Let’s kick some asses together. Read more!

Saturday, June 7, 2008

Farewell and God Bless

A Parting Message

This Is My Story (2) will be the last posting on

This web log has outlived its usefulness. It may still have many unfulfilled goals and unexpressed messages but one knows when it is time to leave something behind and move on. It has been a defining period of soul-searching and self-examination.

Amidst the supportive words and uninhibited dissent, this web log has been anything but a futile project.

If you were inspired or repelled, touched or unmoved, encouraged or angered, the credit falls back to you and none to me. I am just another soul walking the earth and watching the sky, expressing my thoughts as truthfully as I can among the oceans of millions.

There will be no more updates regardless of any personal and world events, save for any residual unmoderated comments over the next few days.

I will continue to write if only to myself. Maybe one day, I might compile my articles into a book or two.

I bid you all goodbye and thank you all for your patience and attention. Thank you for bearing with my outrageous eccentricity.

We may cross paths somewhere in SS2 Murni or drive past each other along the PLUS highway. I may be next to you singing a Hillsong in Damansara Utama Methodist Church (DUMC) or roaring for DAP in the next election campaign. When all else fails, we’ll meet in heaven, in the sweet by and by.

Until then, I offer you peace and reconciliation.

The Lord bless thee, and keep thee,
The Lord make his face shine upon thee, and be gracious unto thee,
The Lord lift up his countenance upon thee, and give thee peace,
(Numbers 6:23-26, King James Bible) Read more!

Friday, June 6, 2008

Truly A New Dawn For Malaysia

By his verbal announcement one Wednesday afternoon, lives have been changed forever, some irreversibly. As one colleague said, it’s gonna be painful. With one short press conference, the Prime Minister of Malaysia has effectively crushed the lifelong hopes and dreams of many simple Malaysians.

Truly A New Dawn

Many Malaysians woke up to a different country yesterday.

I am of course referring to the unprecedented 40% increase in fuel price as announced by the Malaysian Prime Minister yesterday. Raising the retail price to RM 2.70 per liter is not itself the greatest shocker of the day. Malaysians were made to understand or at least led to believe that the fuel prices will be raised very gradually by August 2008. To a certain extent, most Malaysians were even prepared mentally to see the day petrol sells at RM 4.00 per liter.

It is very much the element of surprise and the deceitful manner by which the Malaysian Prime Minister Abdullah Badawi that is angering lay people across the country. We knew he was lying when he said there would not be a fuel price increase after the elections. We also know he was not lying when he announced the 40% increase in petrol prices and 60% increase in diesel’s.

By his verbal announcement one Wednesday afternoon, lives have been changed forever, some irreversibly. As one colleague said, it’s gonna be painful. With one short press conference, the Prime Minister of Malaysia has effectively crushed the lifelong hopes and dreams of many simple Malaysians.

The young couple who had been saving for months prior to this for their planned marriage have just withheld their romantic plans. Overnight, the value of their savings has been shelved by almost half. They thought they could finally realize their lifelong dreams by the end of the year but it seems that marriage just might have to wait a little longer. As result, an unborn child initially ‘scheduled’ for 2009 might just not see the light of day till 2014, by the time which Malaysia is already a net importer of oil.

A young man surveying the daily classified ads for an affordable second-hand, single storey home has just thrown his shortlisted options circled in red into the waste bin. He thought he could finally have a place to call his own, his little corner upon this planet where he can be king in his own time and moment, if only for a few hours a day. He has worked overtime for so many years, striving to climb up that career ladder to be qualified for a housing loan. An unoccupied house remains soulless and a diligent chap remains homeless.

Over in the local Society of Prevention of Cruely to Animals (SPCA), a charming tabby was awaiting a young girl to meet and fall in love with his beautiful fur and soothing purr. He has been fighting against time for weeks now and through the steel bars that held him in, was sure that he saw love and acceptance when his crystal green eyes met with her hazel-hued ones. His time is running out now though. Raising a feline friend is not cheap or easy but it is worth every neurotic moment and spent emotion. Tried as she could, the little girl has failed to persuade her daddy struggling with home expenditure to invest in a lonely meowing soul. The pensive tabby would most likely be put to sleep soon, along with other canine buddies and feline comrades awaiting adoption by a Malaysian population more concerned with making ends meet more than ever before. The tabby will make a quiet exit from this world, breathing his last without experiencing the warm and firm embrace of a wide-eyed child still teeming with curiosity and admiration. It was a wonderful relationship that could have been but never did materialize.

My hamsters will be affected too. They have outgrown their cage and running wheel in a short period of two months. They were to get their individual cages and in bigger sizes too. That might have to wait a while longer for now. I have my own hamster wheel to run in obligation, waking up each day to work and back and back to work again. I was never a fan of rodents but they have won me over with their innocent gaze and why-don’t-you-pick-me-up stare. They would have to make do with a overcrowded cage for now, until I earn enough locum cash before acquiring that coveted property fit for a full-grown long-haired Syrian hamster.

Elsewhere, Mukiah Upas of Kampung Tanjong Kapor, Kudat are having second thoughts about sending his seven-year-old daughter to school next year. He had always believed that ladies do not need education, until the day he met the paediatric medical officer who convinced him that his daughter would have a brighter future only with adequate education in life. With the latest round of fuel price increase, Mukiah will now revert to his previous decision not to educate his children, but for a different reason. His daily earnings as a low-time fisherman simply does not allow the privilege of educating the young minds in his home.

A lot of rural folks will be affected in other ways as well. As it already is, patients from district with life-threatening conditions are already presenting late to healthcare centers because of the lack of transportation or because of insufficient funds to hire one. The inevitable increase in transportation costs is bound to discourage more ill patients from the district to seek medical care, until it is already too late and too irreparable of course. The old man from Kota Marudu with a perforated peptic ulcer will only present after ten days of insult while the bent elderly lady from Ranau with intestinal obstruction will arrive at the hospital only after full blown infection has set in.

Businesses will suffer too. The first to feel the effect are those of non-essential nature. The overpriced gift shops and religious bookstores, the florists and trendy hair saloons and the video outlets selling original DVDs – these are the ideal candidates to feel the early effects of an economic slowdown.

I am not an economist and am not qualified to comment of the wisdom of increasing fuel price and removing oil subsidies. I am however not so dumb and stupid that I can’t smell a liar when I am faced with one. The crux of the issue is really not so much about how much the government is spending on fuel subsidies. More than anything, it is about how much taxpayers’ money has been wasted in all the years the BN government has been in power. Their grandiose expenditure on overseas trips and the sumptuous servings at every bureaucratic event, the endless white elephant projects and leakage of funds to cronies – these are the issues that should be tackled together with a ballooning oil subsidy.

As is typical for Malaysia, everyone is equal but some are more equal than the others. Even in suffering and struggles, some of us will struggle much more than the others.

The UMNO/BN cronies, the Ananda Krishnans and Tony Fernandez-es will feel nothing over paying RM 2.70 per liter of petrol. They will resume life as though life never changed. The snatch thieves will continue to snatch and the rapists continue to rape. Some of us though, will have to grapple not only with a steep increase in fuel prices and later on essential items, but also the task of raising a child till the age of 25 without very little possibility of any aid in the form of boarding schools, matriculation or government scholarships in the process.

This I’m afraid, is the reality of Malaysia.

Read more!

Monday, June 2, 2008

Times I Screwed Up (3)

It was already two days after the traumatic episode on the day I first saw him. From a young bull working with concrete cement and heavy tools, Kumar was reduced to a pathetic soul fighting for a brief breath of fresh air. Kumar was heavily sedated and connected to a portable bedside ventilator providing much needed breathing assistance.

Times I Screwed Up (3)

He was already in a very ill condition on the first day I saw him. Kumar hailed from India, a migrant worker who traveled across the ocean to do hard labor in a construction site in Sabah Borneo. Twenty-three years old with abundant energy and presumably lots of hopes and dreams, he was on the building’s second floor when it collapsed under him one humid Sabah afternoon.

Three of his co-workers were killed instantly in the concrete rubble. According to eyewitnesses, they were on the ground floor when ferrying bricks with a wheelbarrow the roof came tumbling upon them. Kumar was one of the seven survivors. He also had the worst injuries. Upon arrival at the casualty unit, he gsping for breath and was already drifting in and out of consciousness. He was instantly intubated to protect his airways from blood, secretions and any recently ingested food. His injuries included a broken jaw and a fractured tibia. There were no notable brain injuries on the CT scans.

It was already two days after the traumatic episode on the day I first saw him. From a young bull working with concrete cement and heavy tools, Kumar was reduced to a pathetic soul fighting for a brief breath of fresh air. Kumar was heavily sedated and connected to a portable bedside ventilator providing much needed breathing assistance.

Tousled lines and meandering tubes protruded out of his bodily orifices. Figures in red were blinking in a frenzy on the monitor screen next to him, pleading for attention from any passer by. He emitted a terrible stench comprising a blend of dried, stale blood with fresh, loose stools, spilled concentrated urine with thick, greenish retained phlegm. His left leg was wrapped in a cast, with scattered areas stained by blood and pus seeping through the bandage. His other limbs were restrained to the bed, indicating a recent attempt by the patient to remove the many irritating apparatuses invading his now frail body.

It was a daunting task to review an ill patient for the first time. A ventilated patient can’t talk. One has to read through the thick medical notes from page one to get a faint idea of who the patient is. It didn’t help that most doctors’ writing is as decipherable as the Dead Sea Scrolls.

Kumar’s observation charts were not very reassuring either. He was running a high grade fever despite being on multiple antibiotics. He was not passing much urine despite the voluminous fluids. His heart rate ran between 120-140 beats per minute, with an increasingly low blood pressure. Blood investigations revealed a deteriorating kidney.

We changed antibiotics and searched for any hidden foci of infection. Blood cultures, urine sampling, tracheal aspiration and wound swabs yielded nothing, yet his fever and symptoms of worsening sepsis did not relent. Despite aggressive hydration and eventual inotropic support, Kumar remained critically ill on the brink of death. He was taken off sedation and morphine two days later.

He did not wake up, however.

In fact, Kumar never woke up ever again.

He merely deteriorated into a deep comatose state and passed on uneventfully.

His employers came to collect his remains. The agent who brought him to Borneo made a brief mention of a wife and two young kids and duly moved on.

I moved on too. It was hard trying to feel sad and sympathetic over a patient whom I’ve not spoken to directly or gotten acquainted to personally. A mortality meeting was held to discuss his death but these audits are usually done as a routine practice rather than a genuine inquiry. We came out of the meeting with no conclusion on Kumar’s death.

Cause of death: Indeterminate.

I may sound callous but to be honest, Kumar was quickly erased from my mind.

He was gone and very much forgotten, until one day – one typical, lackluster working day.

An elderly man was not passing urine after his hip operation. He was fasted the whole night before and was still kept fasted after the surgery. I checked on him and discovered that his left arm was entirely swollen and effusive. It felt doughy. It happened overnight according to him.

It was at that moment that I experienced both a dumbstruck and a eureka moment. Suddenly, everything about Kumar came rushing back to haunt me demanding accountability and a verdict.

Kumar did not die of a overwhelming infection. Kumar did not pass away from a severe brain injury. Kumar did not succumb to a fractured tibia or a broken jaw.

Kumar died from dehydration.

His intravenous (i.v) drip was not running. The i.v line was out of place. His right arm was swollen, just like the old man I was attending to.

All the fluids we were giving. All the costly antibiotics and supportive medications. They never reached the man. He was basically drying up inside out while remaining sedated and restrained. No wonder he never responded to any treatment. That was why his kidneys were failing and he passed little urine. We did everything but did not check his iv line. As a result of our carelessness and oversight, a wife will walk life without her husband and two kids will grow up not knowing their father.

A team of skilful surgeons, a band of enthusiastic interns, an armamentarium of sophisticated medical contraptions, a cocktail of potent medications – they were all defeated and put to shame by a non-functioning intravenous line.

What a needless death.

Such an unredeemable mistake.

Guilt and remorse show no mercy when they punish the convicted. In Kumar’s case, I plead guilty as charged.

Will he be one of the five people I meet in heaven?

If I ever reach heaven, that is.
Read more!