Monday, February 23, 2009

An Open Apology To The Health Minister

Dear Yang Amat Berhormat (YAB) Datuk Liow Tiong Lai,

I am sincerely sorry for my unwarranted outburst in my previous letter.

Your kind intentions have been severely misinterpreted.

I am utterly sorry if I appeared to belittle your credentials and leadership capabilities.

I can see now what an ignorant nincompoop I have been by accusing so very unjustly.

Dear YAB,

I realise now that you had far-sighted goals when you closed down our operation theatres and wards. In line with global medical education and training, you wanted the doctors in Sabah to be well-versed in acute care and emergency healthcare services.

Therefore, you abruptly but wisely witheld all non-emergency surgeries like colon cancers and enlarged prostates. You knew that one day these tumors would grow and spread and cause potentially irrversible severe systemic upset. That is the perfect time when we doctors will finally get the opportunity to provide acute care.

I am also apologetic for accusing the Minisry of deliberate feet-dragging in building a new general hospital for Sabah. In fact, I am losing sleep over my unfounded allegations that cronies of the state and federal government are reaping indecent profits from the current health crisis.

I should have known better. Malaysia is after all, not spared from the global economic turmoil. We should be more thrifty and save our funds and billions of ringgit for projects of greater public interest, like the national space program and the many buy-elections ahead.

Oh, how were you misunderstood! A thousand apologies from me!

Dear Datuk,

I was also uninformed and ignorant of your noble mission to improve palliative services in Sabah and the country as a whole. Why should we doctors perform complicated and heroic surgeries trying to cure cancer and degenerative diseases? After all, there is a oft-repeated medical slogan that clinicians should ‘cure sometimes, relieve often and comfort always’. If only I had known that you were a staunch believer in palliative care, I would not have bombarded the Ministry with such contempt.

From now on, I will stop pleading the Ministry of Health for more operating theatres, recovery wards and medical staff trained in life-saving clinical work. I will instead persuade cancer patients against surgery and opt for palliative care instead. I will encourage my colleagues to do the same although I can’t guarantee that they will do the same. They are very stubborn and determined doctors, you see – not unlike me when I wrote my first letter to you.

Dear most honorable and esteemed Minister,

After today, I will based all my clinical judgement on bedside assessment instead of relying on x-rays, CT scans and various blood results. I realise now that you were only trying to make us into more astute clinicians when you seemingly neglected Sabah by not providing us a CT scan and various diagnostic lab tests.

Lastly, my most respected and magnanimous Health Minister, I apologise from the bottom of my heart and beg for pardon for my excessive sarcasm in this second letter.

I am after all, a product of the system.

Read more!

Saturday, February 21, 2009

An Open Letter To The Minister of Health

Unlike MCA members, not everyone enjoys being labeled a ‘squatter’....Mr Minister, how would you like to have a tumor growing in your rectum with no avenue of getting it removed?...

Dear Health Minister,

Ali, a 32-year-old road traffic accident victim, travelled three hours from the district of Sabah and arrived in Kota Kinabalu six hours after the initial trauma. After the initial assessment in the emergency department, a CT scan of the head and abdomen was ordered to exclude intracranial bleeding and intraabdominal injury.

He was whisked back onto an ambulance to the privately-owned Sabah Medical Center (SMC) for the required scans. After the ten-minute procedure, he was repacked into the ambulance back to Queen Elizabeth Hospital (QEH) to undergo further assessment while awaiting the results of his blood tests and x-rays. His scans and X-rays were reviewed.

Ali was found to have a lacerated liver and a fractured long bone with multiple superficial wounds. He was then prepared for emergency surgery.

For that, the young man was then re-wheeled into the ambulance headed once again to the SMC where the operating theatre and intensive care unit of QEH are currently housed.
By the time surgery starts, it was already nine hours from the time of his motor vehicle accident.
My story hasn’t finished, Mr Minister.

One hour into the operation, our young chap bled tremendously that he required more blood products to sustain life. It would not be another hour or so before the blood products arrive from the blood bank of QEH to the SMC. You see YB, blood has to be taken from the patient and passed to a house officer. The house officer will fill in the necessary forms and hand them over to an attendant. The attendant will wait for a chartered bus or ambulance to head back to the Queen Elizabeth Hospital or rather, what remains of it.

Back in QEH, the attendant will wait 45 minutes for the blood to be cross-matched and then wait a while more for the arrival of a chartered bus or ambulance to ferry him (or her) back to SMC.
Anyway, being a fit and healthy young man previously, Ali survived the operation. He was admitted to the ICU and needed a repeated chest x-ray.

For that, the radiography team in QEH is informed. The duo will then take a the chartered bus or ambulance SMC to perform the X-ray. Shooting an X-ray takes all but two minutes. Processing the cassette will take another five. However, the processing is done back in the hospital and delivered by the next available ambulance back to SMC. By the time the X-ray films reach the patient, it could be anything from three to twelve hours later.

Dear Yang Berkhidmat (YB) Liow,

I hope you notice the unacceptable predicament our Sabahan patients (and medical staff) are facing currently.

It is already six months since the initial and abrupt closure of Kota Kinabalu’s Queen Elizabeth Hospital. Since then, we have been without a proper operating theatre and intensive care unit. We are also without distinctive wards for many of our surgical patients of most disciplines.

Frankly speaking, the health crisis of the state of Sabah has run so deep and far along that I do not where to begin.

I will instead serve an eye opening fact to you, Mr. Liow.

At the height of the Severe Acute Respiratory Syndrome (SARS) epidemic, the the communist government of the People’s Republic of China erected a 1,000-bedded hospital within seven days. Work on the Xiaotangshan Hospital started on April 24, 2003 and completed on April 30th, with 7,000 workers and 500 machines tirelessly on duty around the clock. Far from being a melamine-laced structure, the Xiaotangshan Hospital is equipped with the then state-of-the-art anti-infective measures and facilities. The structure built within a week is still standing firm six years later today, ready to house any ill and potentially infective patient in the event of any unforeseen health crisis.

Mr Health Minister,

That is exactly what Sabahans are in right now – a health crisis!

The Barisan Nasional government chants ‘Malaysia Boleh’ like some proverbial battlecry but the Sabah state health crisis has proven that empty vessels make the most noise.

Unlike MCA members, not everyone enjoys being labeled a ‘squatter’.

For six months, the medical staff and patients of Sabah have been housed in sections of the Sabah Medical Center paying a whooping rental of RM 90,000 per day.

For five months since our forced relocation into your prized SMC, we only had one operating room for life-threatening emergency cases. Elective surgeries were postponed indefinitely even those involving cancers and prostates and suspicious breast lumps.

We only restarted elective surgeries a month ago but even so, the backlog of cases is tremendous and catastrophic.

I wonder Mr Minister, how would you like to have a tumor growing in your rectum with no avenue of getting it removed?

That is exactly what our poor Sabah folks were facing. They were without money and without a hospital to get operated in. In fact, they still don’t because they do not have a formal general hospital for Kota Kinabalu anymore.

Heck, we don’t even have our own CT scan.

What we do have however is lots of bills to pay and debts to settle.

Is it true that the state department of health owes SMC a total of RM 6.1 million for CT scan services? Is it true that Hantaran Wira, the company contracted to provide transport to and fro SMC-QEH is paid RM 0.5 million per month?

Mr. Minister,

You owe the 3.4 million population of Sabah a lot of answers, wasted lives and needless deaths.

Money cannot solve all problems in life.

Thank you for listening.

Yang menurut perintah,
Product of the System.

Read more!

Friday, February 6, 2009

Judas, Jesus and the Repercussions of Betrayal

Dedicated to the four Judas-es of the Perak State Assembly.

Matthew chapter 26-27
(New International Version, edited)

Judas Agrees to Betray Jesus
Then one of the Twelve—the one called Judas Iscariot—went to the chief priests and asked, "What are you willing to give me if I hand him over to you?" So they counted out for him thirty silver coins. From then on Judas watched for an opportunity to hand him over.

The Lord's Supper
When evening came, Jesus was reclining at the table with the Twelve. And while they were eating, he said, "I tell you the truth, one of you will betray me."
Then Judas, the one who would betray him, said, "Surely not I, Rabbi?"
Jesus answered, "Yes, it is you."

Then Jesus went with his disciples to a place called Gethsemane, and he said to them, "Sit here while I go over there and pray."
Then he returned to the disciples and said to them, "Are you still sleeping and resting? Look, the hour is near, and the Son of Man is betrayed into the hands of sinners. Rise, let us go! Here comes my betrayer!"

Jesus Arrested
While he was still speaking, Judas, one of the Twelve, arrived. With him was a large crowd armed with swords and clubs, sent from the chief priests and the elders of the people. Now the betrayer had arranged a signal with them: "The one I kiss is the man; arrest him." Going at once to Jesus, Judas said, "Greetings, Rabbi!" and kissed him.

Judas Hangs Himself
Early in the morning, all the chief priests and the elders of the people came to the decision to put Jesus to death. They bound him, led him away and handed him over to Pilate, the governor.

When Judas, who had betrayed him, saw that Jesus was condemned, he was seized with remorse and returned the thirty silver coins to the chief priests and the elders. "I have sinned," he said, "for I have betrayed innocent blood." "What is that to us?" they replied. "That's your responsibility."

So Judas threw the money into the temple and left. Then he went away and hanged himself. Read more!

If I were...the Sultan of Perak Darul Ridzuan

If I were the Sultan of Perak, I will recognize that the quagmire that my state is in is possibily destiny's beckoning. I would first take a deep breath and sit down to think before making any decision on the political impasse in my state.

As a legally-trained professional, I will remind myself again and again what I have always preached on the topic of good governance and the importance of integrity in leading a nation. It was not too long ago when I myself lectured that ‘only those who are capable, responsible and scrupulously honest should be allowed to serve in positions of leadership.’

I will bear in mind my esteemed reputation as the most wise and respected ruler in the Council of Malay Rulers, regardless whether the larger-than-life standing was truly justified. Knowing fully well that Malaysians are currently in state of political awakening, I must do the right thing so that my subjects in the Silver State will remember me as the ruler who defied feudal warlords. We are after all, mere mortals and will one day leave this earth without any of our worldly possessions.

Apart from that, I will look back at the times when Ipoh and Perak as a whole was a shining example of sound leadership as opposed to the current state of affairs. I have ruled and reigned long enough to see the marked deterioration of Ipoh city. The city built on tin is more of a retirement home now. The young have let to seek job opportunities in Penang, Kuala Lumpur and Singapore. Abandoned homes and vacant shops are a dime a dozen. The elderly in land who have contributed to its development are growing old without the company of their children or the pleasure of noisy, rowdy grandchildren.

The airport named after me receives only one flight each day and even so, an airplane that is barely occupied. This airport that bares my names pales in comparison to the bustling Kota Baru airport in PAS-led Kelantan. If there was one thing my state can boast to superior in, it’s the ubiquity of old folks’ home and other nursing institutions.

At this juncture, I will realise that Perak has truly degenerated and regressed from its namesake. It is no longer silver, it’s not even scrap metal. It’s just a vast piece of land with abundant resources that has been plundered repeatedly and shamelessly over the last 50 years. While the daylight looters robbed and enriched themselves in the name of democracy, the people remained poor and perhaps became even poorer over the years. This is something I do not have to search far and wide to see for myself. Not far from the heart of Ipoh city - in Buntong, Meru and Pasir Pinji my rakyat are still staying in makeshift homes made out of zinc and leftover plywood.

I will now question myself whether I have lived up to my reputation and much lauded preaching. Can I look back and honestly claim that I have safeguarded the interests of the simple folks of Perak Darul Ridzuan? Can I even claim to have upheld the integrity and sovereignity of the Malay Royalty? Have I in a state of unintended complacency allowed a party of money-minded politicians to insult the intelligence of my citizens and usurp the rights and powers of the Malay royalty?

I will consider the implications of ordering a power transfer to the Barisan Nasional. At first glance, I will notice that it is not even BN as I know it to be. Essentially, it will be an UMNO government, with UMNO holding 28 seats and MCA a solitary seat. Not only that, I am also empowering the likes of Hamidah Osman, state assemblywoman for Sungai Rapat who regarded Indian Malaysians as worse than snakes. Is this the legacy that I desire to leave behind?

My thoughts are increasingly disturbing by now. I must however look back at the last ten months of governance under the informal coalition christened as Pakatan Rakyat by Malaysians of all races and religion. It was a short time to gauge any state government. Nevertheless, news from the ground and even from the BN-dominated mainstream media have given positive reviews to the bedfellows made up of supposed DAP Chinese chauvinists and PAS ultra-Islamists.

In the last ten months, my subjects living in new villages for the last 50 years were finally given the opportunity to apply for freehold land titles. Malay villagers crying foul that their land for cattle-grazing has been snatched are finally getting their voices heard by none other that the Menteri Besar Nizar Jamalludin himself. For the first time in the history of Malaysia, an Indian Malaysian was given the post of Speaker of the State Assembly. I should have felt proud that this took place in my beloved Perak Darul Ridzuan. Perhaps I should have gone to the ground and asked the people if they were satisfied with the leadership and administration of the Pakatan Rakyat state government?

Indeed, if I were the Sultan of Perak, I will dissolve the state assembly and allow my rakyat to speak up once again.

As it is however, I am not the Sultan of Perak, which is why UMNO has now hijacked the silver state of Malaysia. Read more!

Thursday, February 5, 2009

A Time To Speak Up

After a hiatus of almost three months, I think the time is ripe to put reflections into words once again.

Keeping silent and refraining from expressing one's thoughts isn't easy, but thousands of Malaysians are effortlessly doing it so every day.

Of the many issues close to my heart, the on-going Sabah state health crisis is particularly outstanding.

It isn't easy watching simple folks receive substandard healthcare while UMNO/BN politicians reap shameless unspeakable wealth from the sufferings of the ones who placed them in power in the first place. Read more!