Archive for the ‘Health’ Category

Benefits of peer support for mental health

Wednesday, October 9th, 2019
Combating mental health stigma can encourage students to seek help from professionals. NSTP/ASWADI ALIAS.

TOMORROW, Oct 10, is the annual World Mental Health Day, as declared by the World Health Organisation.

The National Health and Morbidity Survey 2015 by the Health Ministry reported that mental health problems among adults aged 16 and above have increased from 10.7 per cent in 1996 to 29.2 per cent in 2015 and this includes university students.

International Islamic University Malaysia Psychology Department senior lecturer and clinical psychologist Dr Jamilah Hanum Abdul Khaiyom said that research has not found a single cause for this occurrence.

Clinical Psychologist and Psychology Department Senior Lecturer International Islamic University Malaysia, Dr, Jamilah Hanum Abdul Khaiyom . NSTP/ASWADI ALIAS

“However, studies have identified several risk factors which include having problems adjusting to the transition from school to university.

“The transition can impact a student’s well-being. They may not be fully prepared to lead an independent life at undergraduate level.”

Sunway University Psychology Department head and clinical psychologist Associate Professor Dr Alvin Ng Lai Oon said that from his experience, students have trouble adapting.

“There is lack of resilience among students in coping with the demands of tertiary education.

“At the undergraduate level, there is a lot more focus on independent study, innovative problem-solving and personal organisation. They may not have the adequate groundwork prior to entering university,” said Ng.

Sunway University Psychology Department head and clinical psychologist Associate Professor Dr Alvin Ng Lai Oon.

Jamilah added: “Dysfunctional families and traumatic life events also contribute to this issue. For example, coming from an abusive family, or being a victim of physical, mental and sexual abuse can have a long-term effect on mental health.

“Disorders can also develop in university due to physical inactivity. Being highly studious and exempting oneself from physical activities can lead to stress and worsen mental health,” she said.

To strengthen the mental well-being of university students, it is important for the campus community to be educated, dispel the stigma and support each other.


Due to the stigmatisation of mentally-ill persons, many often stay in the shadows and are afraid to seek help.

Jamilah said: “We can see patterns of disorders increasing among students. The stigma is one of the reasons why people do not come forward and choose to ignore the symptoms or go to alternative healers first to be treated. They view psychologists and psychiatrists as a last resort.”

Sunway Peer Counselling Volunteers president and Psychology student Jayashan Chinatamy, 21, noted the severity of mental health disorders and suicidal ideation in recent times.

Sunway Peer Counselling Volunteers president and Psychology student Jayashan Chinatamy.

“There is a causal relationship between stigma and suicide in addition to the prevalence of mental health disorders.

“While the youth are more aware about mental health in comparison to the past, many still do not seek help or utilise available resources due to this stigma that has developed into a cultural taboo,” said Jayashan.

IIUM Secretariat of Psychology president Eusoff Fitri Sarnin, 24, said that from a young age, Malaysians are taught that mental illness is unacceptable.

“As the negative perception increases, those with mental disorder symptoms are left feeling ashamed for fear of being judged.”

IIUM Secretariat of Psychology president Eusoff Fitri Sarnin.NSTP/ASWADI ALIAS


A good support system is important in battling mental illness. For most university students, the ones closest to them are their friends.

Ng, who is also a WHO Malaysia Office mental health consultant, said that there are several warning signs that students can look for to help their friends.

He said: “Signs of mental health issues include social isolation, change in eating or sleep patterns, difficulties with concentration, generally low mood and having difficulty enjoying activities that they typically enjoy.

Sunway Peer Counselling Volunteers trying out the virtual reality activity to visualise what it is like to have schizophrenia during the Return To Light campaign.

“Students can help by checking in on their friends and asking if they are all right. It has been found that normalising the distress — by letting them know that it’s okay to be that way — can help.”

Acceptance is key, according to Ng.

“We help first by not downplaying their distress. It’s important to let them know that we accept them the way they are. Just be a friend — you don’t necessarily have to entertain or talk. Just be with them.

“Often they will feel that they are a burden to others so you need to assure them that you’re there to help willingly and that it’s okay to be helped. You can also suggest that they seek the help of a specialist.

“For those who are struggling, remember that when you need help, allow others to help you,” said Ng.

Shutting people out is another warning sign, Jamilah added.

“Those will mental illnesses usually push people away. These include acquaintances, friends and family.

“Students should be observant if their friends utter statements such as ‘there’s no point in life’ or ‘I don’t want to live anymore’.

“Listen when people talk about their problems and suicide. Don’t invalidate their feelings or give unsolicited advice. Just hear them out.

“Do not be judgemental. Being a human being, it’s normal to be vulnerable,” she added.


An IIUM fourth-year student, who wishes to only be known as Kamilah, said she was diagnosed with Bipolar I disorder.

“To cope, I take medicine at night. During the day, I do deep breathing and mindfulness exercises.”

Kamilah said that peer support is important especially for students who live far from home.

“I usually share my thoughts with family and a few friends. However, most of my friends do not really understand mental illness. Some think that depression is just normal sadness.

“I choose my friends carefully because if I share my problems with a person who is judgemental and has low understanding on mental health, it will only worsen my condition.”

Eusoff Fitri said peer support can be effective but it requires proper training and awareness.

Having recently completed his internship with the Universiti Kebangsaan Malaysia’s Medical Centre psychiatric ward, he recounted his experience: “During my stint there, I met a university student with social anxiety and suicidal tendencies. As an intern and psychology student, I participated in giving support and motivation. But I cannot give professional advice.

”Having someone to talk to when you have a problem helps.”

At Sunway University, Peer Counselling Volunteers (PCV) is a student body under the guidance of the Sunway Counselling and Wellness department.

Jayashan said: “We act as a peer support network on campus. Our members are trained by professional Sunway counsellors.

We organise events centred on different aspects of mental health, such as positivity, self-care and suicide prevention.”

The purpose of peer counselling is to establish a support network that is approachable.

“We remain impartial to all our peers and focus on empathising, validating and supporting these students in the place of problem-solving.

“We try our best to help and guide them in overcoming their mental health challenges. Through our efforts, we hope to reduce the stigma associated with mental health.”

In terms of peer counselling, Jayashan said the PCV members act as listeners.

“Any Sunway University students can become PCV members. They undergo Personal Development sessions to better understand themselves and the importance of perspective in peer counselling.”

PCV offers both an online platform and a face-to-face counselling session to students.

“Through the online anonymous platform known as Peer-to-Peer, students can write in to us regarding the challenges that they are facing and how they are affected.

“We will provide a detailed reply within three to five working days after consulting the P2P team, led by counsellors from Student LIFE, the student service centre.”

If the online platform is not helpful enough, students can also schedule an appointment with the peer counsellors.

“Each session is conducted by two peer counsellors. Feedback has been positive, with many saying that they felt better after the sessions.”

However, Jayashan pointed out that peer counselling is not a substitute for professional help.

“Some students may require more professional counselling or may need to be referred to a psychiatrist or clinical psychologist for diagnosis. Sunway Counselling and Wellness has affiliations with external mental health platforms and it is more than willing to give referrals.”

Ng said that it is also significant to note that supporting a friend with mental health can be draining.

“If the helper is distressed, seeing a counsellor can help. It’s important to understand that one can get affected by other people’s distress. It’s a human condition.”


It takes a community to address mental illness. Hence, it is crucial to raise collective consciousness on mental health.

Supported by Subang Jaya assemblywoman Michelle Ng, Sunway University, Taylor’s University and Monash University organised the Return to Light: Mental Health and Suicide Prevention Campaign last month.

PCV was the co-organiser with Sunway Counselling and Wellness and Student LIFE.

Jayashan said: “PCV’s responsibilities include facilitating the Youth Mental Health Forum. At the exhibition, we had a virtual reality activity where students learn what it’s like to suffer from schizophrenia.

“The main goal of the campaign was to increase awareness about mental health within the campus as well as with the public.

“Awareness is the first step for many youths to seek help. The campaign achieved this through workshops on active listening and peer support,” said Jayashan.

Jamilah agreed that that it is important to better educate helpers.

“For example, students need to know the difference between self-harm and suicide attempts. There are people who inflict harm on themselves because they want to feel pain or release pent-up emotions, not to stop living.

“Studies have shown that by talking openly about suicide, people will not desire to end their life. In fact, it has the opposite effect.”

Last April, Jamilah and postgraduate Psychology students also conducted a mental health screening campaign to raise awareness.

“The screening was a one-to-one process. A clinical psychology trainee first conducted a brief interview and administered psychological tests with a student.

“Then, we discussed the results with them and provided recommendations to follow up with the IIUM Counselling and Career Unit or the Psychological Service Unit.”

Another effort in spreading awareness was the #HereForYou campaign by the Secretariat of Psychology in collaboration with Befrienders, a not-for-profit organisation providing emotional support, last year.

For the campaign, they filmed a video of IIUM students who were struggling with mental illness.

Students who were diagnosed with borderline personality disorder and depression shared their personal experiences on camera.

Eusoff Fitri said: “It was difficult to get students to talk about their personal struggles. But this video helped to shed light on how anyone can be affected by mental illness.”

The IIUM Secretariat of Psychology has conducted a lot of trainings and programmes to spread awareness on mental health issues for their students.

This year, in conjunction with World Mental Health Day, the secretariat has planned a series of activities for Mental Health Week on Oct 6 to 11.

The programmes include a talk titled Fighting Against Mental Health Stigma, a mental health screening, mental health awareness training and a sharing session for those with mental illness.

Eusoff Fitri said: “The Secretariat of Psychology’s role is to provide the correct information to the university community. We aim to educate students so that they become more aware about the signs, symptoms and types of mental disorders.”

Sunway University counsellor Cassandra Lee conducting personal development workshop for Peer Counselling Volunteers.


A concerted effort is required to address this issue of mental health among university students.

Jamilah said: “Lecturers can play a role. Before I start my class, I conduct some simple mental health-related activities.

“For example, I carry out mindful breathing and explain to students how ithese activities can help them to be more present and aware about mental health.”

“I personally hope that the university can have more clinical psychologists and counselors.”

Ng also said that more counsellors and psychologists are needed on campus.

He added that the university counselling unit should have referral platforms to external professionals.

“If it is not possible, the alternative is to empower students and staff through the PCV programme to handle the milder cases.

“There are evidence-based methods devised by WHO to train laypersons the skills to manage large-scale distress in communities. The same approach can be used within a university.

“The training can give social support to help people improve their functioning towards stronger resilience.

By Rayyan Rafidi.

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Over 1,000 Hepatitis B cases in Sabah yearly

Friday, October 4th, 2019

KOTA KINABALU: Over 1,000 Hepatitis B cases are reported in Sabah yearly and State Health and People’s Wellbeing Minister Datuk Frankie Poon Ming Fung said it is not easy to contain the disease as most of the newly infected show no symptoms.

He said people need to get themselves tested so that early treatment can be given to prevent the disease from spreading. Parents also need to get their babies vaccinated to avoid infection.

His speech was read by Health Department Director Datuk Dr Christina Rundi at the state-level World Hepatitis Day celebration at the Ministry of Health Training Institute Auditorium in Bukit Padang.

The department recorded 1,168 cases in 2014; 1,004 in 2015; 1,369 in 2016; 1,332 cases in 2017 and 1,281 in 2018, according to Christina.

“Based on the data, those infected are mostly adults because they did not get vaccinated when they were little,” she said.

“The Hepatitis B vaccination programme only started in 1989 and those born before then might not have been vaccinated. Some of them born after 1989 got infected because they did not get vaccinated.

JKNS also organises Hepatitis B vaccination programme for mothers in all districts including rural areas. She urged the public to undergo health screening as there could be more people living with the disease but did not realise it.

Hepatitis B is an infection caused by the hepatitis B virus found in the blood and bodily fluids of an infected person. The virus spreads when an infected person’s blood or bodily fluids enters the bloodstream of another either through an open wound, cut or scratch and, in some cases, used syringes.

“We have to organise health screenings frequently as many people are unaware of the disease and did not get themselves checked. This disease is contagious and you could get infected just by sharing nail clippers, razors, a toothbrush and other personal items.

Treatment can be costly as the projected expenditure is around RM1,200 per patient.

Kota Kinabalu Health Officer Dr. Julaidah Sharip said the department has worked with District Health Offices to organise many health activities to curb the disease and the number of cases decreased by 3.8pc in 2018.

“We conduct Continuos Medical Education (CME) sessions on how to handle patients with Hepatitis. We also carry out health education programmes by handing out patient education brochures. We make sure the kids get vaccinated and health screenings on pregnant women.

She also said chronic hepatitis is inflammation of the liver that lasts at least 6 months and it can result in cirrhosis and liver failure.

Christina also revealed that over 40 people are infected with Hepatitis C annually. The data showed 59 people with Hepatitis C in 2017, 47 in 2018 and 49 people as at epidemiological week 39, this year.

Hepatitis C is also a contagious liver disease caused by the hepatitis C virus (HCV). Hepatitis C is usually only spread through blood-to-blood contact.

By: Saila Saidie.

Gleneagles launches 24-Hour Heart Attack Centre

Sunday, September 29th, 2019

KOTA KINABALU: Gleneagles Kota Kinabalu has recently launched its 24-Hour Heart Attack Centre for the public especially those who are at risk of having heart attack anytime of the day.

Its Chief Executive Officer Noel Cheah said the private hospital has already been providing city folks the service since 2015.

He added that the centre provides 24/7 service for those who feel that they are at risk of having a heart attack or those who recently suffered a heart attack. The centre carries out emergency life-saving procedures such as primary angioplasty, which is a micro-surgical procedure used to open up blocked blood vessel.

Malaysia has 25,000 heart attacks per year and the average age of people in Malaysia having heart attack is 35 to 40. The age range is quite shocking as Malaysia has the youngest average age for heart attack compared to all other South East Asian countries.

“Therefore Gleneagles is committed to provide this service to the public 24/7. If we are able to access and treat the patient fast, this will further enhance their chances of surviving the attack and have better recovery,” he said.

He said this when met by reporters during the event at Gleneagles, which was officiated by Health and Wellbeing Minister Datuk Frankie Poon on Thursday.

Medical evidence has shown that a patient who receives such medical treatment during the first few hours of a heart attack will have a greatly enhanced survival rate and improved long-term recovery.

Meanwhile, he also disclosed that the hospital has also collaborated with Malaysian Association of Tour and Travel Agents in providing free cardiopulmonary resuscitation (CPR) training for their tour guides. So far, Gleneagles has trained 65 tour guides.

“This training is important as we realised that the tourism industry is very big in Sabah. With many tourists coming to Sabah every year, sometimes they may come into health trouble such as cardiac arrest.

“Therefore we collaborated with MATTA to equip their tour guides with necessary skills because you may not know when unwanted incidents happen; for example, a person collapsing in the middle of the sea or while on a boat ride to an island.

“Therefore, if they are equipped with the right skills, they know how to stabilise the patient, while evacuating the patient to the hospital.

“Actually CPR should be learned by everyone who is capable of learning it. The CPR training only takes two or three days,” he added.

Poon applauded Gleneagles for organising the life-saving event.

“I think this is an excellent tool for the industry players and the victims can be saved if they receive proper early treatment.

“We are getting more tourists and we need to take care of them including their health,” he said.

In conjunction with the newly-launched heart attack centre, Gleneagles will also conduct a mass CPR training for the public for two days on Oct 5-6 at Imago Shopping Mall here. The training is free and open to the public.

It is one of the hospital’s ongoing efforts to educate the public with emergency response skills for them to be able to help anyone suffering from cardiac arrest and save lives.


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National Conference for Thalassaemics and Carers on Sept 14-15

Monday, September 16th, 2019

KOTA KINABALU: The first National Conference for Thalassaemics and Carers will be held at the Klagan Regency Hotel from Sept 14 to 15.

President of Federation of Malaysia Thalassaemia Societies Khoo Swee Hong said, unlike most conferences that involve medical practitioners, this event is catered for thalassemia patients and their families.

Themed ‘Empowerment through Knowledge’, she said the organising committee hopes to impart knowledge and bring awareness among thalassaemics themselves over their condition and how to manage them.

“Now that the government is giving free treatment, there is no reason that a thalassaemic should die because of iron overload, there is no longer an excuse.

“However, we still lose a lot of thalassaemics because the regime in getting rid of iron is difficult…living with a chronic disorder for their whole life, a lot of thalassemics tend to deny that they are thalassaemics and want to be normal and therefore forgo their management and that’s where the danger is.

“With this conference, we hope to empower them, to make them realise their condition is one of the best to have if you ever need to have a condition,” she said in a press conference.

The conference, which was initially targeted for patients throughout Malaysia, she noted, had received 337 participations including from neighbouring countries Singapore, Brunei, Philippines, and Indonesia.

She explained that among others, another main objective of the conference is to educate the people and change public perception on thalassaemia and those afflicted with it.

Describing the disorder as the only health condition that can be made better, she asserted that thalassaemics are perfectly fine with proper management, adding that they are mentally strong individuals for having to deal with thalassaemia throughout their lives.

“There weren’t free drugs then, so nobody could afford the treatment. But now, thalassaemics have gone to universities – they are really productive adults who can contribute to the society.

“Unfortunately, there is still stigma that whenever somebody goes to job interviews and they (employers) find out they are thalassaemics, they tend to be rejected.

“Therefore in this conference, we would also like to show to people that they are capable.

“In fact, every single thing in this event is run by thalassaemics without help from any event company; the whole conference is unique because it is done by thalassaemics, managed by thalassaemics, for thalassaemics,” she said.

President of Sabah Thalassaemia Society Francis Mujim said they hope the conference would bring changes within thalassaemia patients and increase their self-esteem and motivation by showing their capability of a life equal to those without the disorder.

He noted that several thalassaemics in Sabah are currently studying in universities with some pursuing masters and PhD, which proved their abilities despite the affliction.

He said among the speakers at the conference is George Constantinou, a 61-year-old thalassaemic from the United Kingdom who is a member of Thalassaemia International Federation Board and an advocate of the disorder.

“I purposely pulled him in to Sabah for the conference because Sabah, at the time, is still the State with the highest number of thalassaemia major patients in Malaysia and we want to expose these patients to others outside who have reached good health level because of good management.

“There is no difference between medication and management for thalassaemics in the UK and anywhere in the world; they also go through blood transfusion every month so if they can be successful, why can’t we?


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How can we tell if our health system is healthy?

Monday, July 8th, 2019

Malaysia’s health system is so large, complex and inter-connected that there is no one solution for all its problems; but we can improve it together by first deconstructing the system and understanding it.

“WHAT are the patient’s vital signs?” asks the emergency physician as the unconscious patient is hurriedly wheeled into the Accident and Emergency Department.

A team of nurses and paramedics spring into action, coordinating their efforts towards one single objective: the stabilisation of the patient’s blood pressure, pulse rate, breathing rate and temperature – his vital signs.

Every doctor seeing every patient in almost every setting will check the patient’s vital signs.

Vital signs are, well, vital because the human body should always be in homeostasis (i.e. a state of physiological equilibrium, or more simply, balance).

Any readings outside the normal ranges, either too high or too low, will cause concern; the larger or the more sudden the deviation, the bigger the concern.

Doctors will search for the causes, and treat if necessary. This is the basis of medicine.

So, if there are vital signs for the human body, are there vital signs for a country’s health system too?

How would we know if Malaysia’s health system also requires urgent life-saving measures?

Are there vital signs for health systems? Or are they so big that a few numbers or data points will not be able to properly represent their “health”?

These are good questions for citizens, as health is too important to be left to governments, the private sector and non-governmental agencies (NGOs) alone.

In the World Health Organisation’s (WHO) “whole-of-society” approach to health, all citizens can and must be equal and thoughtful participants in health systems, and not just passive recipients of health services.

Fortunately and understandably, all Malaysians already want urgent reforms for cheaper, better and more accessible healthcare.

However, we cannot successfully implement any reforms before we understand our health system slightly better.

There is one colossal challenge though: Malaysia’s health system is a “hyperobject”, which is so large that we can only understand it through patient and systematic deconstruction, and so complex that there are no simple explanations or solutions.

The term “hyperobject” was introduced by Prof Timothy Morton in 2010 in his book The Ecological Thought.

He suggested plastics, Styrofoam or climate change as examples of things so massive that they transcend time and space.

I will share two more examples: although we use WiFi and ATMs daily, it is difficult to grasp the full extent of the Internet or the US$80 trillion (RM333.2 trillion) global economy – objects so massive that they stretch our understanding, and perhaps even our control.

Too huge to comprehend

WHO divides health systems into six building blocks – workforce, financing, delivery, essential medicines, information systems and governance – each of which are infinitely complex.

To demonstrate the gargantuan size and complexity of Malaysia’s health system, here are some fun facts for each block.

In 2017, Malaysia spent a total of RM56 billion on health, with 3.5 million inpatient admissions and 70.1 million outpatient attendances in 417 hospitals and 9,849 clinics.

The Health Ministry’s 2017 annual report runs to 490 pages, and the ministry has approximately 268,000 employees, with 65,000 nurses, 35,000 doctors, and 27 different sub-categories of allied healthcare professionals (from dieticians to entomologists).

There are at least 26 different laws (PDF) governing Malaysia’s healthcare, at least 86 clinical practice guidelines by the Academy of Medicine Malaysia that list best medical and treatment practices for a variety of different medical conditions, and hundreds of ways that Malaysia can fund our healthcare.

These massive numbers prove that Malaysia’s health system is so gargantuan and complex that it could become incomprehensible or ungovernable, despite our best efforts and intentions.

Some may then argue that we must return to our previous “small /simple” health system, but that’s impossible.

Indeed, the success of yesterday’s system created today’s “large/ complex” system. We can see this in our larger and healthier population, all of whom live longer, have with more complicated diseases, are more educated and demand better quality care.

To understand and improve our health system, we must accept that it has complex and inter-connected problems with multiple root causes, and that there are no easy, magic or overnight cures.

While we can and must simplify processes and bureaucracy, there will still be no single/ simple solutions to the rising cost of healthcare, the over-supply of junior doctors or long queues in public hospitals, to name just three problems.

With many causes, there must be many solutions. Therefore, what Malaysia needs is a basket-of-solutions.

As our health system issues do not have only one single best answer, we must adopt a multipronged approach because there are many right answers.

Then, we will need everyone in society, from the Prime Minister to the man (and woman) on the street, to help implement these solutions, with all citizens actively participating in the health system that we jointly own.

Part of the solution

This column aims to be a part of that basket-of-solutions.

In it, we will deconstruct our large and complex health system into its smaller component parts, provide more light (rather than heat) into the public discourse, and deliver solutions for a large and complex system with more civil participation.

We will examine our system in digestible weekly doses using a structured, neutral and pragmatic approach.

Every column will look at a single element, peel back the layers, connect it to other relevant (and sometimes surprising!) elements, and discover some practical improvements.

This methodical approach and holistic view will also never neglect the urgent issues of the day.

Malaysia’s health system isn’t dramatically dying in our arms. A better description is of a complacent middle-aged person with some mild-to-moderate disease, who needs better lifestyle choices and a few bitter remedies to avoid deteriorating.

We still have time (but not a lot) to “save” our health system. If we work together on that basket-of-solutions, we can surely achieve the health and well-being that we Malaysians all want and deserve.

By Dr Khor Swee Kheng
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70 child cancer cases in Sabah every year

Sunday, July 7th, 2019

KOTA KINABALU: Some 70 children are diagnosed with cancer every year in Sabah, said State Health and People’s Wellbeing Minister Datuk Frankie Poon.

He said based on recent statistics, the numbers are under-reported as there is still a lack of childhood cancer awareness.

Based on the statistics, Poon said 43 children are diagnosed with cancer every single day around the world and 400 children in Malaysia are diagnosed with blood-related cancer every year.

“The three most common childhood cancers are leukaemia, brain cancer and lymphoma.

“3.34 per cent of these children will die within 30 years. Nineteen per cent will survive at least 30 years but suffer life-threatening or disabling chronic health conditions.

“Twenty-five per cent will survive at least 30 years but suffer mild or moderate chronic health conditions, while 22 per cent will live at least 30 years without any chronic health condition.

“These rates can be reduced and cure rates could be much greater through early detection and awareness,” said Poon when launching Junior Chamber International (JCI) Kota Kinabalu’s second year flagship project “Go Botak 2019”, here, Saturday.

Poon hoped JCI KK will continue to hold the project and pledged support for it in any way he could to ensure its success.

He said the project is to create awareness on childhood cancer as well as to help cancer-stricken children.

“As a community, we play a huge role too to fight childhood cancer.” Meanwhile, project organising chairperson Kimberly Lim said the objectives of the project are to create awareness of childhood cancer and also to produce children wigs by raising funds and inspire the community to donate their ponytails or shave their heads.

“This is to encourage the young cancer patients to regain their confidence to battle childhood cancer with a positive and fighting spirit, and to know that they are not alone in the fight.

“We want to raise awareness of childhood cancer by educating parents or anyone that childhood cancer patients need to pay more attention and need early detection.

“This project will end in September in conjunction with the childhood cancer awareness month.

“I am very positive that this project will create a sustainable impact in our community, as awareness and support for childhood cancer is still minimal,” said Lim during a press conference on the project, here, Saturday.

According to Lim, the minimum length to donate ponytail is 15cm and must be natural and untreated and it takes 35 to 40 donated ponytails to produce one children wig.

Lim said the ponytail donations may be made at collaborating saloons, namely Ar Saloon, Young Style Unisex Saloon, Turning Points, Hair Impressions, Mission Cut and G Cut.

For this year project, the E-Post is the main sponsor.

By: Cynthia D Baga.

Early diagnosis and treatment of mental illness increases chances of recovery

Tuesday, July 2nd, 2019
In Malaysia, there has been a three-fold increase in mental health problems among the population over the past 20 years.

THE workplace is not immune to mental health problems and their impact in psychological, social and economic terms is high.

Globally, it was reported that an estimated 264 million people suffer from depression, one of the leading causes of disability; the cost of mental illness has been estimated at US$2.5 trillion (RM10.35 trillion) in 2010 and is projected to reach US$6 trillion in 2030.

In Malaysia, there has been a three-fold increase in mental health problems among the population over the past 20 years. If we apply the same projection, than the estimated loss for Malaysia was US$10.6 billion for 2010; by 2030 it is expected to soar to US$24.3 billion.

A study conducted by the Education Ministry in 2017 also shows that 4.4 per cent or 2,123 teachers were identified as experiencing moderate stress level while civil servants also achieved an average score in the Malaysia Psychological Wellbeing Index which was conducted in August 2018.

According to the Malaysian Health System Research report (March 2016), mental illness is a leading cause of economic loss at the individual, family, employer, health system, and national levels, due to direct and indirect health costs, absenteeism, lost productivity while at work, and decreased income which can result in reduced national economic output.

When addressing participants at Malaysia’s 1st Mental Health Experiential Conference (# MyMHEC2019) in Petaling Jaya recently (June 19), I stressed that mental health at workplace should no longer be ignored as it could cost employers and the country billions of ringgit if not properly addressed.

Neglect of mental health and psychosocial factors at the workplace is not only detrimental to the individual worker but also directly affects productivity, efficiency and output of any organisation.

Accidents at workplaces are not only caused by poor work safety practices but also due to mental health issues. I have consistently raised about mental and psychosocial issues as they are also affecting workplaces.

Meal health issues at the workplace are caused by a combination of factors such as personal work, work environment and organisational factor.

Workplace stress is defined by the World Health Organisation (WHO) as “the response people may have when presented with work demands and pressures that are not matched to their knowledge and abilities and which challenge their ability to cope”.

There are many types of work-related stress such as job insecurity, low control in work, low social support from co-workers, dissatisfaction with work and problems associated with depression and anxiety.

Unemployment is a well-recognised risk factor for mental health problems and negative working environment may lead to physical and mental health problems, harmful use of substances or alcohol, absenteeism and lost productivity.

Studies show that workplaces that promote mental health and support for people with mental disorders are more likely to reduce absenteeism, increase productivity and benefit from associated economic gains.

More young workers nowadays are also stressed out or experiencing symptoms of stress-related illnesses such as anxiety or depression due to life experiences or environmental factors.

Struggling to cope with work, new financial commitments, family expectations and relationships are among the topics of concern for young adults.

It is not only happening here but all around the globe since the demands of living in current times are causing depression, anxiety and other mental health problems in young people.

As fresh graduates for example, it is normal for them to wish for a permanent job with a handsome salary, dream car and house but life is not always smooth sailing.

While some young working adults might soldier on amidst the trials and tribulations, others struggle with emotional and physical issues as soon as they leave university, or even before and enter the working world.

Though each generation has faced its own set of problems, dilemmas faced by young adults during present time appear to have wide-ranging social and economic implications, with a rising number being diagnosed with depression, anxiety or other mental health problems.

A healthy workplace can be described as one where workers and managers actively contribute to the working environment by promoting and protecting the health, safety and well-being of all employees.

Mental health interventions should be delivered as part of an integrated health and wellbeing strategy that covers prevention, early identification, support and rehabilitation.

Key to success is involving stakeholders and staff at all levels when providing protection, promotion and support interventions and when monitoring their effectiveness.

All parties should also strive to stop the stigmatisation of mentally ill persons who are often regarded as “orang gila” or crazy people.

Instead of insulting them, the community members should help those with mental disorders to get counselling or psychiatric treatment.

Prevention in the early stage can certainly reduce the likelihood of people with mental problems turning violent or doing extreme things including murder and committing suicide.

Family members, office colleagues and the local community should know how to identify the symptoms and ways to help those who are suffering from mental illness.

Most families, employers and co-workers are not prepared to cope with learning that their loved ones or office mates have mental illness.

As for the victims, It can be physically and emotionally trying, and can make them feel vulnerable to the opinions and judgments of others.

The World Health Organisation (WHO) has stressed that organisations have a responsibility to support individuals with mental disorders in either continuing or returning to work.

Soe of the initiatives that may help individuals with mental disorders include flexible hours, job-redesign, addressing negative workplace dynamics and supportive and confidential communication with the management.

Researches also show that unemployment, particularly long term unemployment, can have a detrimental impact on mental health.

Asthe country’s leading institute for occupational safety and health (OSH), NIOSH has already introduced several programmes to help employers and their staff manage mental health at the workplace apart from organising various health promotional programmes.

One of them is the mental health module, which was introduced under a collaboration with the Ministry of Health. It is part of NIOSH’s Total Wellness and Health Promotion Program (TWHP), where the employers and their employees will learn about mental health issues and adopt the best strategies to manage the problem.

It is important to know that early diagnosis and treatment greatly increases the chances of individuals affected by mental illness to regain a reasonable state of health and wellbeing and satisfying quality of life.

There is a need to implement the Employee Assistance Programme (EAP) which can provide both prevention and early intervention for employees affected by stress, emotional and mental health issues which jeopardise job performance.

Funds spent on EAPs have documented investment returns in such areas as productivity and work performance. Companies are finding that investing in employee’ emotional wellbeing can mean a healthier bottom line.

It was predicted that mental health problems will become the second biggest health problem affecting Malaysians after heart disease by 2020, unless proper measures are taken to address the issue.

Because of the stigma associated with mental disorders, employers need to ensure that individuals feel supported and able to ask for support in continuing with or returning to work and are provided with the necessary resources to do their job.

Article 27 of The UN Convention on the Rights of Persons with Disabilities (CRPD) provides a legally-binding global framework for promoting the rights of people with disabilities (including psychosocial disabilities). It recognizes that every person with a disability has the right to work, should be treated equally and not be discriminated against, and should be provided with support in the workplace.


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A price control headache

Sunday, May 12th, 2019
Addressing the very complex issue of setting up a drug price control mechanism to ensure people have better access to affordable drugs.

ELEEN Ooi, 38, could not believe her eyes when she got the bill for the removal of a peanut stuck in her four-year-old daughter’s nose.

The private hospital’s itemised bill for the 15-minute procedure ran into two full pages and came up to RM4,000.

And she noticed that she was charged RM43.60 for a baby nasal spray which she could get for RM27 from a pharmacy.

She, like many patients, alleges that hospitals are charging high prices for drugs and services resulting in high insurance premiums in the country.

Drug prices are a major contributor to high healthcare costs and the government should regulate them across the board and at every dispensary, she says.

“The price of drugs needs to be more affordable for the public, especially drugs where patents have expired,” says Ooi, a lecturer.

She says when people cannot afford to sustain paying for the high costs of medicine, especially those taken for the long-term, they are forced to use the public health system.

For this reason, she welcomes the Cabinet’s decision to impose drug price controls.

A solution to fit all

Health Minister Datuk Seri Dr Dzulkefly Ahmad says the Cabinet approved the measure on April 12 and that the ministry will get pharmaceutical companies’ responses on the price control mechanism this month.

The ministry will use external reference pricing to benchmark drug prices in Malaysia, choosing the three lowest prices and averaging them to determine the ceiling price.

The ministry has not decided which country’s system it will model the control mechanism on, he said at a press conference held recently in conjunction with Pakatan Harapan’s first year in office.

Dzulkefly says the ceiling price will be imposed at the wholesale level as well as the retail/consumer level at clinics, hospitals and pharmacies.

Controlling the prices of drugs is provided for in the Price Control and Anti-Profiteering Act 2011, which is monitored by the Domestic Trade and Consumer Affairs Ministry. The Cabinet has agreed that this ministry will appoint Health Ministry officers as price assistant officers to carry out drug price control enforcement activities, he says.

Dzulkefly says the move will ensure that people have access to affordable drugs, especially expensive new drugs; it will also encourage innovation and healthy competition for industry growth.

The private sector may not be happy with a price control but the country needs a solution that fits all, he says.

It was recently reported that Penang Institute political studies senior analyst Lim Chee Han had quoted the 2017 Medicine Prices Monitoring report showing that the median mark-up for originators’ and lowest-priced generics’ retail prices in private hospitals was 51% and 167% respectively.

In pharmacies these figures were lower, at 22.4% and 94.7%.

“This shows that the mark-up range can be exceedingly large; in some extreme cases in private hospitals, it could even spike up to 117.4% and 900%!” Lim says.

NGOs welcome move, industry wants competition

Non-governmental organisations (NGOs) welcome a drug price control but local drug producers prefer market competition.

Third World Network (TWN) adviser Dr Lim Mah Hui says he supports the effort but it should not be rushed as it is a complex issue and the government needs to look at different models and choose the best to emulate.

Dr Lim says there is a lack of transparency in drug pricing at different levels – manufacturers, middlemen, pharmacies, hospitals and clinics – and there should be some regulation of the price range they can mark up.

“We hear about discriminatory preferential pricing. Manufacturers selling (the same) drugs at different rates to different buyers and some medicines not being made available to certain pharmacies.

“I am not saying that the industry should not make a profit, but the profits should be reasonable,” he says.

Africa introduced a single exit price in 2004 which requires the manufacturer to declare the price when the drug comes out of the factory. It also put a stop to discounts and preferential pricing, he says.

In June last year, The Star quoted Dr Lim saying the government should initiate centralised purchasing and regulate drug prices as is done in advanced countries, and carry out a study on the drug procurement system to ensure drug prices are affordable.

Last August, TWN programmes director Chee Yoke Ling also highlighted the need to tighten up unnecessary patent monopoly and additional patents that extend monopolies beyond 20 years, pushing up the cost of some crucial medications.

Malaysian Pharmaceutical Society president Amrahi Buang says the government’s decision shows it has the political will to address this chronic problem, calling it a “major breakthrough”.

He adds, “The price control should not be applicable to all types of medicines but should focus on medicines requiring prescription and also address proper labelling and itemised billing,” he says.

Meanwhile, Medical Practitioners Coalition Association of Malaysia representative Dr M. Raj Kumar recently said that prices of drugs should be controlled but this should be done in tandem with the harmonisation of the fee schedule for general practitioners with private hospital-based doctors.

Malaysian Organisation of Pharmaceutical Industries (Mopi) president Billy Urudra says Mopi, which is made up of 45 members who are mostly local generic drug manufacturers, prefers that open market competition determines fair price instead of a price control. This was expressed to the Health Minister in a townhall meeting on April 2.

He says it is more important for the government to expedite approval of generic drugs to get them into the market faster and allow competition, and to update intellectual property laws to prevent the lengthening of protection for innovators that leads to continuous high prices.

A mechanism to establish a price based on prices from various countries seems acceptable, Urudra says, but it is best to choose a country that has a similar economic growth as Malaysia because benchmarking against developed countries may result in higher prices, he says.

Although Thailand and the Philippines do not have such a control mechanism, the prices in these countries could serve as a comparison, he adds.

Consider cost variance

While the Pharmaceutical Association of Malaysia declined comment for this article, the Association of Private Hospitals of Malaysia president Datuk Dr Kuljit Singh says the association does not support a move that seeks to control the prices of medicines in private hospitals.

Unlike dispensing in a retail pharmacy, medication administration in a hospital involves other costs, such as medication review, drug counselling, compliance monitoring, and titration of dosages as patient conditions change, he says.

He says there is a host of direct and indirect costs associated with dispensing medications in a hospital, which varies across private hospitals depending on geographical locations, levels of service, and specialities.

“We have cautioned against a blunt policy that disregards this cost variance and brought this up with the Pharmaceutical Services Division at a townhall meeting on Feb 28 this year.

“We were given an undertaking it would be considered,” he says.

Dr Kuljit also says that such policy and regulatory measures should be made in tandem with adjustments to private hospitals’ overall payment system where direct and indirect costs are lumped together into a few chargeable items – medication services is one of these.

“This was the result of a distorted payment structure for private healthcare where proposals to realign increases in these costs to their proper categories – such as room and board rates – were met with resistance.

“The increases were inevitable due to a number of factors such as inflation, exchange rates and higher manpower requirements,” he says.

Asked what other charges are lumped together with medicines and other “charge-able items”, Dr Kuljit says there is expensive equipment that hospitals can only charge for when used such as medical pumps, used after cardiac surgery in an emergency.

On why drug prices in private hospitals are much higher than that of drugs sold in pharmacy outlets, he says the overhead costs of running the pharmacies are lower and they can buy in bigger bulk.

Dr Kuljit argues that private hospitals make an average of 5% to 7% profit, up to a maximum of 10%, and this is considered low.

Ooi, who is also a business consultant, questions the need for the high mark ups on drugs when the hospitals are already charging for almost every other possible thing, including cotton wool.

“The only way to show proof is to see their bottom line,” she says.

Private hospitals have captive customers which retail pharmacies do not have, which indicates a higher economies of scale, she argues.

Moreover, most retail pharmacies are placed in prime locations with rental per month ranging from RM7,000 to as high as RM50,000, she says.

Meanwhile, TWN’s Dr Lim asks if private hospitals are not making money hand over fist, adding that the CEO of one healthcare company is one of the highest paid CEOs in the country, earning more than RM33mil last year, according to reports.

“And are the big private hospitals not making huge profits, or else why are they expanding?” he asks.

For decades, Malaysians have complained of high medical charges, with some facing a financial catastrophe or maxing out their insurance coverage in a health crisis. High drug costs are a major concern here.

The drug price control measure and a central pool procurement system for medicines (to begin at the end of the year) are the bold measures the government has announced it will implement to address the issue.

However, in tandem with these measures, the government also needs to remove the unnecessary extensions of patents and examine the role of the middleman in the drug supply chain to the government.

By Loh Foon Fong
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Rise in Sabah Malaria cases

Thursday, May 2nd, 2019

KOTA BELUD: A total of 2,316 Malaria cases were reported in Sabah in 2018 with two deaths compared to 2,004 cases in 2017. This showed an increase of 15.56 per cent in the number of cases.

“This year alone, 768 Malaria cases have been reported,” said Tempasuk Assemblyman Datuk Musbah Jamli.

For Kota Belud, in 2018, there were 57 cases reported where Kg Taburon contributed nine cases. This year there were 11 cases reported compared to 25 cases in 2018.

“Most of Malaria cases were attributed to the various activities of villagers comprising plantation, agriculture, hunting and forestry.

“The prevention of malaria should not only be the responsibility of the Health Department or government alone, but society should be equally responsible for maintaining the health of families,” he said when officiating at the World Malaria Day Programme at Kg Taburon, here.

Musbah said the department carried out various preventative measures including fogging and raising awareness on the matter.

It is important for the community to take precautionary measures to prevent malaria infection, in line with the theme of World Malaria Day this year, “Zero Malaria Starts From Us”.

“Among the steps we can take is to reduce outdoor activities at night and wear appropriate clothing when performing activities such as rubber tapping. The use of insect repellent is also strongly encouraged.

By: Gindanau Sakat.

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Eat more rice, lose weight … yes, according to this study.

Wednesday, May 1st, 2019

GLASGOW (Bloomberg): Eating rice may help prevent obesity, research suggests.

Experts found that people following a Japanese or Asian-style diet based on rice were less likely to be obese than those living in countries where rice consumption was low.

Researchers said low-carbohydrate diets “which limit rice” are a popular weight-loss strategy in developed countries but the effect of rice on obesity has been unclear.

They looked at rice consumption in terms of grams per day per person and calorie intake in 136 countries.

The researchers calculated that even a modest increase in rice consumption of 50g per day per person could reduce the worldwide prevalence of obesity by 1% (from 650 million adults to 643.5 million).

Prof Tomoko Imai, from Doshisha Women’s College of Liberal Arts, Kyoto, Japan, who led the research, said: “The observed associations suggest that the obesity rate is low in countries that eat rice as a staple food.

“Therefore, a Japanese food or an Asian-food-style diet based on rice may help prevent obesity.

“Given the rising levels of obesity worldwide, eating more rice should be recommended to protect against obesity even in Western countries.”

Giving possible reasons why rice can help, Prof Imai said rice was low fat, adding: “It’s possible that the fibre, nutrients and plant compounds found in whole grains may increase feelings of fullness and prevent overeating.”

The authors concluded: “The prevalence of obesity was significantly lower in the countries with higher rice supply even after controlling for lifestyle and socioeconomic indicators.”

Tam Fry, chairman of the National Obesity Forum, said: “We have known for centuries that Far Eastern populations tend to be slimmer than in the West because rice is a staple food, but few obesity specialists may have appreciated why.

“This novel research is the first to hypothesise that we could nail obesity by eating a modest amount more.”

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