Archive for the ‘Health’ Category

Smoking ban in food premises to take effect tomorrow (Jan 1).

Monday, December 31st, 2018

KUALA LUMPUR (Bernama): All food premises have been gazetted as no-smoking zones, effective from midnight Monday (Dec 31), says Health director-general Datuk Dr Noor Hisham Abdullah.

He said the ban was in line with the Control of Tobacco Product Regulations (Amendments) 2018 to protect the public from exposure to cigarette smoke.

He said the Health Ministry was committed to ensuring that the public, especially children, pregnant women and the elderly, were always protected from the dangers of smoke from cigarettes and other tobacco products.

“The public are urged not to smoke in all eateries, whether air-conditioned or not. This includes inside and outside the buildings where the eateries, restaurants and food courts are.

“The ban also covers food stalls and vehicles which provide tables and chairs for people to eat, as well as restaurants on ships and trains,” he said in a statement here on Monday (Dec 31).

Dr Noor Hisham also advised owners and operators of food premises to display smoking ban signage clearly and to take steps to make sure that nobody smokes by not providing facilities like ashtrays.

Anyone found guilty of the offence of smoking in banned areas can be fined up to RM10,000 or jailed up to two years under Regulation 11 of the Control of Tobacco Product Regulations 2004.

Premise or vehicle owners and operators who fail to display the smoking ban signage can be fined up to RM3,000 or jailed up to six months under Regulation 12 of the Control of Tobacco Product Regulations 2004.


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Impact of mental illness stigma

Tuesday, December 11th, 2018
(Stock image for illustration purposes) Stigma devalues a person and affects his self-image.

GOOD mental health is something we all need. It is a feeling of wellbeing, happiness, the ability to cope with life’s many challenges, to accept others and, most of all, to have a positive attitude towards oneself.

Scientific and medical research demonstrates that mental health is a foundation for good health as physical and mental health are inseparable. Despite its increasing significance, the reality is that governments, public health practitioners and citizens alike devote little attention and consequently fewer resources to mental health.

Meanwhile, the suffering caused by mental illness and mental disorders is quite staggering. Patients with mental illness suffer a great deal and are unable to function normally. On top of that, they face discrimination and rejection from the community, and this has a detrimental effect on their recovery.

According to the World Health Organisation, one in four individuals develops a common mental disorder, such as depression or anxiety, every year. Two in every 100 people in our community develop schizophrenia or manic depression (bipolar disorder) in their lifetime. Two to three per cent of all families have a family member who is affected by intellectual disability. Five of the 10 leading causes of disability are mental disorders — depression, substance abuse, schizophrenia, bipolar disorder and obsessive compulsive disorder.

The symptoms of a mental disorder may greatly reduce one’s ability to work, study or participate in community life. The disorder could also lead to other health problems, and in some cases, even suicide. To make matters worse, if one suffers from a mental disorder, he may be shunned by the community.

Why do we do so little? According to WHO, on average, the 37 countries and areas in the Western Pacific region devote less than one per cent of their health budgets to the treatment and prevention of mental disorders. Region-wide, one in five individuals who seeks the help of a healthcare professional suffers from a mental disorder. Of this number, only a fraction are properly diagnosed, and of those who are, few ever get treatment or receive appropriate care.

The number of people at risk of developing mental health problems is increasing daily. People in developing and developed countries of the Western Pacific region are becoming increasingly vulnerable to mental illness.

It is believed that depression will be one of the largest health problems worldwide by 2020. Surveys show that mental disorders occur in one in five individuals, or 20 per cent of the world population, each year.

There is growing evidence to show that the burden of disease in societies is gradually but surely moving towards mental diseases. While heart disease, cancer and HIV-AIDS take their toll yearly in the form of death, mental disorders, such as depression, are rapidly becoming a major source of stress not only to the individual and his family, but also to his community.

In Malaysia, most mental health promotions are focused on the individual. We have overlooked other essential factors, such as the environment in which we live in. Is our environment conducive to the development of healthy bodies and minds?

Poorly planned urbanisation and uncontrolled deforestation could contribute to poor mental health of the people. Unstable economic status, increased unemployment, poverty and severe stress have proven disruptive to mental health as well.

When dealing with mental disorders, it is essential to address the stigma attached to it. Stigma devalues a person and affects his self-image. Some of the harmful effects of stigma include refusal to accept illness, delaying or refusing treatment, isolation, fear and shame.

Creating greater awareness of mental health, empowering the mentally sick and their family members to stand up against the stigma and discrimination through education and engaging the public to understand the issues related to mental disorders are some strategies that can be undertaken to de-stigmatise mental illness.


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The woes of vape

Sunday, December 9th, 2018
A posed picture of youths vaping. — RAJA FAISAL HISHAN/The Star.

A posed picture of youths vaping. — RAJA FAISAL HISHAN/The Star.

While adults claim that e-cigs are helping them quit smoking, researchers worry that it could draw children to the habit

THE good news is that smoking among children is dropping.

The bad news is that e-cigs and vape could disrupt the positive pattern.

Cambridge Behaviour and Health Research Unit senior research associate Dr Milica Vasiljevic says children are picking up e-cigs more than cigarettes.

While they may not be regular users, the mere fact that they are experimenting with e-cigs, is worrying.

Dr Vasiljevic is the principal investigator of a study on e-cig ads and children’s perceptions of tobacco smoking harms. Published in July, the paper warns that e-cigs could disrupt the trend of smoking decline among children as kids exposed to glamorous e-cig ads, perceive occasional smoking as less harmful. This may lead to more positive attitudes towards smoking and the tobacco industry.

Prof Dame Theresa Marteau, Cambridge Behaviour and Health Research Unit director and the paper’s co-author, believes their experiment is the only one showing how the appeal of tobacco smoking is increased among kids exposed to e-cig ads.

“We see a softening of attitudes towards tobacco smoking harms, and risks. That’s a concern. So if that’s your definition of ‘renormalising smoking’, than yes, that’s happening.”

While e-cigs are less harmful and hold great potential as a cessation tool, the gateway risk is under studied, and warrants further investigation, she feels. She says e-cig companies are consciously targeting children with the flavours they’re putting out.

“E-cig companies are taking their cue from the tobacco, alcohol, and sugary drinks industries. That’s how you sell products. Flavours like bubblegum, chocolate milk, and vanilla ice cream, explicitly target children. If you’re talking about cessation, you shouldn’t have flavours that children would like – what’s the point? Such flavours should be banned to protect children.”

In the old tobacco marketing campaigns, all the cool kids smoke, says Dr Vasiljevic. Now it’s vape. Many researchers and public health practitioners are concerned about the gateway hypothesis where addiction to the nicotine in e-cigs might lead people to tobacco cigarettes.

Dr Vasiljevic, who was involved in other experimental studies looking at the impact of e-cig advertising amongst children, found that e-cigs were being advertised similarly to how cigarettes were advertised in the 1950s and 1960s.

“You can’t do that with tobacco cigarette advertising anymore due to legislative restrictions but children were clearly the main entry points into the consumer market for conventional tobacco cigarettes.

“Our concern is that ads portraying e-cigs as glamorous, and healthier than tobacco, may be a contributing factor for children to start using tobacco.

“Kids may think vaping is good, it’s a gadget for the future, and it’s safe even though there’s nicotine. So these cool and glamorous ads may be resurrecting old smoking norms.

“If e-cigs are intended only for smoking cessation, then it would make sense to advertise them as a medicinal product. Tighter controls on marketing materials may be needed,” says Dr Vasiljevic.

On the reason for her focus on e-cigs and children, Prof Marteau says it’s because smoking rates – particularly in high income countries – are going down. This means that adults are stopping smoking. So, from a public health perspective, there’s a need to prevent children from starting. Fewer children are using tobacco in the UK and elsewhere, and e-cigs are threatening the progress in tobacco control policies, she says.

But the fact that tobacco prevalence among children has gone down dramatically at a time where e-cig experimentation has risen, says Paul Aveyard, Professor of Behavioural Medicine at the University of Oxford, implies that whatever gateway there is, is very small.

You can’t have both trains going in opposite directions and saying: ‘Oh it’s luring lots of people into smoking’, Prof Aveyard who is also the senior editor of the journal Addiction, and coordinating editor of the Cochrane Tobacco Addiction Group, argues.

An alternative way of looking at it, he says, is to ask why young people smoke.

“It’s the rebels – the kids who are unengaged with school, and those whose social identities are other than hardworking. Maybe e-cigs are just taking the place of cigarettes. We don’t know that anymore than we know whether e-cigs are a gateway to smoking or whether e-cigs have driven down the prevalence of smoking in young people. It’s all speculative at this point.

“I don’t want kids exposed to e-cig ads to perceive smoking as less harmful than it is, but this has to do with better ad regulations.”

In Malaysia, the Health Ministry defines devices that contain nicotine as e-cig, and those without as vape, or vaping.

The ministry’s deputy director-general (public health) Datuk Dr Chong Chee Kheong says e-cigs with nicotine are regulated under the Poison Act 1952. Nicotine is grouped under Group C Poisons and cannot be sold or supplied by retailer to any person except as dispensed medicine or an ingredient of a dispensed medicine.

“E-cigs without nicotine is not controlled under any law – for now.”

It’s worrying, he says, that ads for non-nicotine liquids or vape, are not banned on social media and the Internet.

“While e-cigs containing nicotine are banned, when it’s advertised online, we don’t know whether it’s really nicotine-free because you cannot tell from the physical look of the liquids.”

Consumers Association of Penang’s (CAP) education officer N.V. Subbarow shares the concern – especially with newer, sleeker devices, like Juul, hitting the market.

Juul which mimics the nicotine hit of a real cigarette, has popped up in schools across the US, sparking concern among parents, educators and regulators.

‘Juuling’ refers to the recreational use of the device which resembles USB drives.

The sale of fruit and candy flavours in convenience stores and gas stations, has been banned by the US Food and Drug Administration (FDA) to counter a surge in teenage use of e-cigs by more than 75% since last year. The FDA will also introduce stricter age-verification requirements for online sales of e-cigs, Reuters recently reported.

Subbarow fears that children and adolescents who see ‘Juuling’ clips on YouTube, will be tempted to try the fad.

“Curiosity gets the better of them and they pick up an e-cig even though they have never smoked before. That’s dangerous.”

International Islamic University Malaysia Assoc Prof Dr Mohamad Haniki Nik Mohamed calls on parents and teachers to be alert.

E-cigs used to be huge but now the latest in the market is a flat, and sleek version that fits into the pocket, Dr Mohamad Haniki, who is the National E-cigarette Survey (NECS) 2016 principal investigator, says.

By Christina Chin
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Health Ministry: 80 percent of eye diseases are preventable, treatable.

Thursday, October 11th, 2018

JOHOR BARU: At least 80 percent of all blindness or limited vision cases can be prevented or treated.

Health Minister Dr Dzulkefly Ahmad said that based on a National Eye Survey in 2014, there are at least 1.2 percent or 63,000 Malaysians who had been diagnosed as blind in the country.

“There are also some 350,000 people or 5.4 percent with limited vision,” he said.

According to Dr Dzulkefly, 58 percent of those going blind was due to cataract while 10 percent due to diabetes and 7 percent because of glaucoma.

Dr Dzulkefly said that with an ageing population and increase in diabetic cases, the ministry expects increase in eye diseases such as cataract and glaucoma.

He said this at the launch of the national level World Sight Day here on Thursday (Oct 11).

By Nelson Benjamin
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I am 33 – and I just had a stroke.

Monday, October 8th, 2018

I’m going to begin the fourth anniversary article of In Your Face with a cliche – that speed kills. In most cases, that is true. However, the opposite is true in the case of a stroke – a lesson driven home when I overcame a stroke at the end of August.

And how did I learn this lesson that got me the swift medical care that saved my life? This was a lesson I learned when I interviewed National Stroke Association of Malaysia (Nasam) founder Janet Yeo for an article I wrote to help Nasam raise awareness for Stroke Awareness Day, which falls on Oct 29.

“First look at the face, the face will be a little distorted. Then ask the person to raise their arms. Strokes always affect one side, so an arm will keep falling down. Then listen to their speech and ask them to smile, if the speech is slurred and they have difficulty smiling it is time to call the hospital. And this is what I always urge people – go straight to the hospital, don’t go to a clinic. Go to the emergency ward,” said Yeo.

In this instance, a pearl of wisdom from an interview for a previous In Your Face preserved my quality of life and prevented me from serious brain damage as my quick action led to me receiving expert medical attention within half an hour of symptoms – before any lasting damage could occur

On this, Yeo said that strokes are not something that adults – especially senior citizens – have to worry about as even children can also get strokes.

“Our youngest stroke survivor had a stroke in her mother’s womb, but it was only found out when she was unable to turn as a baby. By the time they diagnosed her, she was nearly a year old. Today, she’s going to school and learning ballet. We have a lot of survivors at our centres in their 20s and 30s,” she said

Yeo added that 52,000 people in Malaysia will get a stroke every year, and according to global statistics one in every six people gets a stroke daily.

“If you look at the statistics, one in six people will get a stroke. These statistics are accurate, and this means that someone you know could very well have a stroke. It could be someone in your family or a friend. It could be you. We have to think carefully before saying that a stroke will never happen to us,” said Yeo.

It would be fair to say that if I hadn’t learned this from her – I might have dismissed the possibility that I was having a stroke offhand – and not sought the right treatment rapidly enough, and on that note I am also sharing links to four life lessons I’ve learned over the years writing In Your Face after the end of this article.

She added that strokes – which are caused when brain cells die due to an interruption in the blood nourishing our body’s nerve centre – are the third largest cause of deaths in Malaysia after heart diseases and cancer and that strokes are the single most common cause of severe disabilities in Malaysia.

It was at this point that Yeo shared with me the importance of the post-stroke rehabilitation provided by Nasam through its physiotherapists, occupational therapists, speech therapists and counselors. at its nine centres nationwide

“There is life after a stroke despite the damage, because you can still live your life and enjoy your life even though you are a wheelchair user. We have a philosophy that there is a life after a stroke,” said Yeo.

In fact, she encourages stroke survivors to live their lives fully instead of giving up because they face challenges after having a stroke.

“I want to discourage stroke survivors from thinking that they have to wait until they get better before they go out and live their lives. I tell them that it takes a long time to recover from a stroke, I had a stroke 28 years ago and I am still recovering. The moment I came home from the hospital, my husband said that I’m going out for dinner, to the market and I am going back to the office. I lived my life. I went through it and now I am preaching what I practiced,” said Yeo.

“I could have been bedridden or a wheelchair user as my stroke was that severe, but my husband believed that I would rise to the challenge if he challenged me. I want stroke survivors to challenge themselves and believe in themselves,” added Yeo.

Yeo added that a stroke can be seen as a challenge for a person to overcome by reinventing themselves.

“I tell stroke survivors to approach every day with a new outlook, that they’re going to work and not laze around in bed. Get ready, shower, dress well and treat coming to Nasam as if they’re coming to work for two hours. And what is the purpose of the work? To rebuild yourself. It is a yes I can mindset that is aimed at lifting the spirit,” said Yeo.

She added that Nasam helps people develop new talents they never knew they had and believe that there’s a life after a stroke.

“We have been blessed with a lot of talents, so let’s move on to the next talent. We get people to see that a stroke is a turning point and to see the positive points about it – that they’re making new friends and discovering talents they never knew they had,” said Yeo, who added that Nasam helps about 500 people every day.

At this point I asked her how people can seek Nasam’s help if they or someone they know has been affected by a stroke.

“They just call up for an appointment at any one of the centres. An appointment has to be made because we need to arrange for our chief physiotherapist to do an assessment. What will happen when they come in is that the stroke survivor will be given an introduction to Nasam and what we do, and the centre’s chief physiotherapist will assess them and prescribe the program best suited to them depending on their age and the severity of the stroke so that we are more effective,” said Yeo.

She also said that Nasam – contactable via email at – welcomes the support of the public.

“Participate in our activities. If we’re having a Stroke Games, come and cheer us on. Come and volunteer your time. When we have a public forum, come and listen. Additionally, we are starting to recruit new volunteers as we have arts, craft and music in our holistic programme. These are all the programmes we have. So be a volunteer. Teach them how to do handcraft, teach them how to do gardening. Be a volunteer,” she said.

Yeo added that more therapists were also needed.

“Just a few years ago I had to employ therapists from Mumbai. We were using locums for quite some time, and quite a few therapists in Malaysia at the time were being hired by the hospitals. When I say therapists I mean physiotherapists, occupational therapists and speech therapists. Speech therapists and occupational therapists are very hard to come by,” she added

By Tan Yi Liang
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Be alert to signs of suicide

Thursday, October 4th, 2018
Mental health and the associated problem of suicide must be taken seriously.

ACCORDING to the World Health Organisation, an estimated 800,000 people die due to suicide every year—a staggering 40 people per second.

These numbers make suicide the second leading cause of death among 15-29-year-olds globally.

Malaysia is not exempt from such woes.

The Malaysian Mental Healthcare Performance technical report for 2016 by the Ministry of Health stated that mental health disorders in the country are estimated to be responsible for 8.6 per cent of total DALYs. A DALY is a system for quantifying the burden of disease from mortality and morbidity, with one DALY being one lost year of “healthy” life.

The National Health Morbidity Survey in 2015 reported that 29.2 per cent of adults and 12.1 per cent of children suffered from mental health, with the prevalence of suicide attempts “apparently” increasing. In a study published by Bertolote & Fleischmann titled A Global Perspective in the Epidemiology of Suicide, 90 per cent of those who take their own lives had a psychiatric disorder at the time of death.

The study added that “data on the prevalence of mental health illness in Malaysia are limited” so the situation may be worse than we think.

Another issue is the source of data for suicide rates is not well-established due to challenges in establishing actual cause of death. Suicide also comes with stigma to the family, further complicated by the legal implications of a successful suicide attempt.

In an article written by Suzanna Pillay in the New Straits Times last year, it was noted in a 2014 study by Associate Professor Dr Fairuz Nazri Abd Rahman that for developing countries such as Malaysia, the highest suicide rate was found among the young or those below 30, with married women at higher risk.

It is easy to tell someone that they are young and have their lives ahead of them. And that is just the thing, youths do have their lives ahead of them, and this is why mental health and the associated problem of suicide must be taken seriously.

The higher education environment is stressful for young people and it is important to know the warning signs of suicide before we can offer support.

These include but are not limited to threatening to harm or end one’s life, seeking access to means of suicide, expression of suicidal plans, expression of ideation about suicide, hopelessness, withdrawal from family, friends and society, dramatic changes in mood and an expression that there is no reason for living or a purpose in life.

Once the signs are identified, take action. We should always ask questions. Ask the person at risk if he needs to talk and if he is thinking of committing suicide. What comes next is the most important. If the person decides to open up to you, there is one thing you should never do — dismiss him.

Listen empathetically and allow him to talk freely. Take time to consider his story so that he does not feel dismissed and do not judge. Avoid issues pertaining to morality and religion — you are entrusted with his pain, judgment is only fuel for a fire. Do not offer solutions or make promises that cannot be kept. Leave it to a psychiatrist to make a diagnosis.

Malaysia does not have a high density of psychiatrists despite the integration of mental healthcare into hospitals. But we do have options to get help. On campus, there are university counsellors. Befrienders has a helpline (03-7956 8145) and email address (

Call the Life Line Association Malaysia, an organisation which has a large number of Mandarin speakers (03-4265 7995). Relate Malaysia ( is an online-based resource which offers group therapy. The Malaysian Mental Health Association ( has a directory of resources for mental health in the country.


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Negative stigma contributes to rise in breast cancer cases

Wednesday, October 3rd, 2018


GREATER AWARENESS … Nancy (3rd right) and Annie (far left) with recipients of the Prosthesis and Mastectomy Bras.

KOTA KINABALU: Breast cancer remains the number one killer cancer in Sabah with negative stigma contributing to the continuously increasing number.

In 2017, Queen Elizabeth Hospital II (QEH II) recorded a total of 168 breast cancer patients with more than half being in the late stages – 40 per cent in Stage 4 and 22 per cent in Stage 3.

According to QEH II Pink Ribbon Centre medical officer in charge Dr. Farhana Harzila, the late detection was mostly caused by fear and painless lumps among patients apart from myths revolving around cancers.

“They’re afraid of the stigma that once you have cancer, you will die as well as all the painful treatments; we have a lot of myth that once you get chemotherapy, you will pass away and once you are operated, the cancer will spread more – these are all wrong,” she said.

As the number of cases continued to rise by less than 20 people in the hospital, she noted that around 1 in 1,000 people are diagnosed with the disease which is also the number one killer in Malaysia.

With a majority being detected in the final stages, she urged for a greater awareness and education in the community particularly in rural areas.

What is more alarming was that more people from as young as 20 years old have been detected with the disease with the exact cause of the cancer yet to be identified.

“Previously, statistics showed age group of 41-50 as the highest (number of patients). Although it is similar now, but 31-40 and also 20-30 years are picking up so people need to be careful because even though they are under 40, it is not impossible to get breast cancer.

“There is no specific reason why breast cancer develops, it’s all about the risk factors among which are family history, way of life, and a history of cancer – there is a chance for you to get recurrence,” she said.

While breast cancer is common among women, it could also affect men, although it is rare – two male patients were detected with the disease in 2016.

“It is actually much easier to detect among men because it’s easier to feel the lump.

“For women, if the lump is deep seated inside, we cannot feel it so that is why we need mammogram especially for those aged above 40 years old – we can see the imaging even though you don’t feel anything.

“We encourage our women to do mammogram after 40 years old – that’s our way to detect early,” she said to reporters after a Kinabalu Pink Ribbon (KPR) press conference here yesterday.

The Pink Ribbon centre at QEH II, she said, was established in Feb this year to focus more on breast cancer patients.

It receives referrals from health clinics via the Ministry of Health from both rural and urban areas – all patients aged 30 and above who are found to have lumps bigger than 5cm will be referred to the centre.

“Breast cancer is a journey treatment, not a one year treatment – we need to see in within 5 to 10 years of progress.

“With the Pink Ribbon centre just established this year, we are working very hard and we hope to get more correct data with patients’ survival rate,” she said.

The centre currently has two medical officers, two dedicated staff nurse and a specialist on breast cancer while the QEH II Breast Clinic which has now seen a decrease in number of patients has 10 medical officers, two specialists and more than 10 nurses.


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Consumer group wants stricter regulations on sale of health juices

Wednesday, September 26th, 2018
The government should make it mandatory for supplements to be inspected and approved by the Health Ministry before the products are allowed to enter the market, Consumers’ Association of Penang (CAP) said today.

GEORGE TOWN: The government should make it mandatory for supplements to be inspected and approved by the Health Ministry before the products are allowed to enter the market, Consumers’ Association of Penang (CAP) said today.

This comes following the ministry’s ban on three health juices – Jus Al Sunnah, Jus Al Sunnah Gold and Jus Al-Sunnah Penawar – produced by Sri Saga Marketing Sdn Bhd, a company which does not exist.

Its president S.M. Mohamed Idris said the only way to stop these products from being sold in the market was for the ministry to impose stricter regulations.

“As such, we ask that it be made mandatory for supplements to be inspected and approved by the ministry before they are allowed to enter the market.

“In the case of the Jus Al Sunnah products, the ministry also has to send out its enforcement officers to confiscate the products instead of waiting for retailers to hand over their stocks, and also to promptly withdraw all similar products from the market.

“We are extremely disappointed that the ministry is only doing this now which shows its lackadaisical attitude towards the people’s health and safety… There are so many things wrong with this Jus Al Sunnah situation,” he said.

Elaborating, Idris said the products had already been banned in several countries after they were found to contain steroids.

“Singapore had already banned the products in 2017. Brunei had stated clearly on June 9, this year on their website why the three Jus Al Sunnah juices as well as three other products manufactured in Malaysia were banned.

“CAP has also highlighted this issue to the ministry’s Food Safety and Quality Division and Pharmaceutical Services Division in our letter dated June 27, this year. Why did the Health Ministry wait so long to ban these dangerous products?

“One might also ask how such dangerous products even made it into the market. The answer is that supplements are not classified as medicines and thus do not need to be inspected by the Pharmaceutical Services Division.

“Instead supplements are labelled as food products… Therefore any action is always taken after the products are found to have violated provisions of the Food Act 1983,” he added.

Idris said, even though the Health Ministry was the proper authority in this matter, at least in this case, other ministries should also be held responsible.

He added that the Jus Al Sunnah products were made to be marketed to Muslims.

“The name of the product itself, ‘Al Sunnah’, is a clear indication that the masterminds behind this venture had commercialised Islam to target Muslim consumers.

“More importantly Muslims look for the official Halal label on products to determine if they are permissible, and the Jus Al Sunnah products had the official label,” he said, noting that the official label could also be easily be printed on products to fool Muslim consumers.

By Audrey Dermawan.

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Smoking may kill 500,000 in Asean

Monday, September 17th, 2018
(Stock image for illustration purposes) Among Asean countries, the male adult smoking prevalence is highest in Indonesia (66 per cent) and lowest in Singapore (21.1 per cent).
By Wendell C. Balderas - September 16, 2018 @ 11:31am

The tobacco industry undermines public health and sustainable development. Asean member nations must invest in and strengthen implementation of the WHO Framework Convention on Tobacco Control (FCTC) to reduce the devastating health, social, economic and environmental harms of tobacco, save more lives, and thereby, achieve Sustainable Development Goals (SDGs).

Southeast Asia Tobacco Control Alliance (Seatca) executive director Dr Ulysses Dorotheo said: “This 12th Asia-Pacific Conference on Tobacco or Health is an opportunity to remind governments of their obligations to protect people and planet by implementing FCTC.”

The theme of this week’s Bali conference, with more than 900 participants, is “Tobacco Control for Sustainable Development: Ensuring a Healthy Generation”.

Among Asean countries, the male adult smoking prevalence is highest in Indonesia (66 per cent) and lowest in Singapore (21.1 per cent).

This year, the region is projected to consume 548 billion cigarettes, primarily in Indonesia, the Philippines, Thailand and Vietnam as transnational tobacco companies shift from developed countries, targeting markets in poorer, less-developed countries where tobacco control policy is not as stringent.

Dorotheo said: “Tobacco negatively affects many of the 17 SDGs, so tobacco control is essential for sustainable development. The inclusion of FCTC implementation as a key target for the health goal recognises the magnitude of the smoking epidemic. SDGs cannot be achieved without a strong commitment to tobacco control.”

Seatca’s first Asian Tobacco Industry (TI) Interference Index indicates that most countries are moving at a glacial pace in protecting public policy from tobacco industry influence and interference, as recommended by the World Health Organisation’s FCTC Article 5.3 guidelines.

Corporate social responsibility (CSR) activities are one of the key strategies the tobacco industry uses to undermine bans on tobacco advertising, promotions and sponsorship.

Since governments have committed to implementing SDGs through long-term plans based on partnerships, the tobacco industry has re-aligned its CSR programmes along the lines of SDGs. Tobacco industry programmes and documents are peppered with SDGs and the word “sustainability” to win political approval.

“We call on governments to reject the tobacco industry and set up safeguards to prevent interactions with the industry, limit interactions necessary for tobacco regulation and implement transparency measures to protect public health policies from tobacco industry interference,” said Dorotheo.

FCTC provides a roadmap to tackle the tobacco epidemic and reduce the tobacco burden to help countries speed up achievement of SDGs.

Effective and inexpensive public health measures include substantial tobacco tax increases, adopting a code of conduct in dealing with the industry, comprehensive bans on tobacco advertising and promotions, such as pack displays, 100 per cent smoke-free policies and plain packaging of tobacco.

This is a crucial time for governments to consider feasible and sustainable financing mechanisms, such as dedicated tobacco and alcohol tax revenues, as part of public financing towards achieving SDGs, especially health goals.

Tobacco use remains one of the world’s leading preventable causes of premature death.

By Wendell C. Balderas.

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What public wants from doctors

Wednesday, September 5th, 2018

Doctors must be held accountable for every action they do or not do, and for every advice given or not given. REUTERS PIC
By DR JOHN TEO - September 5, 2018 @ 9:20am

THE public wants doctors to be well trained so that they can make quick diagnosis, give the right advice and start treatment to cure them instantly.

They want doctors to train in prestigious institutions for five to six years, at a cost of at least RM1 million, if not more.

They want the universities training doctors to be staffed with the best, most experienced and knowledgeable professors and lecturers, and equipped with the best teaching hospitals and facilities.

After all, they are going to be the future of our medical profession and backbone of the healthcare system.

For good measure, they also want the brightest students to enter the medical faculty — those with all 9A+s and above, and they want them to be passionate about healing and helping others. No half-baked students doing medicine — we definitely cannot have that!

Once the students graduate, the public wants them to have all the experience that they can get, be taught by the most senior doctors and be exposed to the most complex of patients’ problems and how to manage them.

They want them to work long hours, see patients all the time, meet all types of patients and gain as much experience as possible during at least two years of housemanship, if not more.

At the end of every posting, they must have assessment to ensure they are well trained and taught, if not they will be retained.

After that, they must do medical officer postings, some in major hospitals and others in districts for at least another three to four years — all this so they can be competent and safe doctors, or go through the Family Medicine programme and rotate with other doctors on major postings for another five years. Additionally, it would be five years, with medical examinations, to be a good and qualified doctor.

Once in private practice and on their own after more than 10 years of training, at least, and deemed safe and competent, the public wants these doctors to help the community.

They want them to be ethical, provide the best of services and facilities, and be available at all times. For that, they demand 24- hour clinics, and doctors be available in the clinic at all hours and contacted by phone, WhatsApp or Telegram to answer patients’ queries. And the hours can be during lunch or dinner, or even bedtime — any time the patient feels worried or when something is troubling them.

To top it off, they want these consultations to be free. Sometimes, they even ask on behalf of their friends or relatives.

For good measure, they slap 33 laws and any other imaginable regulations on doctors and their clinics and make sure they are perfect, and send enforcement personnel to check on them so that doctors do not stray even 1mm off their mark.

They also want to make sure every clinic is up to mark with impeccable services and standard operating procedures are strictly adhered to.

And if these are not dutifully adhered to, we slap them with a heavy fine or even send them to jail. This is indeed a serious profession and we hold them to the highest standards.

Sometimes, we even sue them for millions of ringgit if we feel that we have suffered much.

After all, we are talking about healthcare here — someone’s life, someone’s livelihood and someone’s future. Doctors must be held accountable for every action they do or not do, and for every advice given or not given.

Finally, of course, for all these, their fees must be affordable as healthcare is a right. So, RM10 to RM15 per consultation is reasonable and, of course, only if there is medicine prescribed.


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