On Health Matters For Common Folk And Health Care Facilities For The Haves And Have-Nots — Dr Ghazali Ahmad

When British Prime Minister Boris Johnson was down with Covid-19 in April final yr, he was suggested by his private doctor to be admitted to hospital, which he promptly complied with.

At one stage, when his well being was threatened, he was reportedly admitted to the ICU for intensive care and nearer remark. Not that there have been no different extra respected non-public hospitals, however the Nationwide Well being Service’s St Thomas Hospital, the place Johnson was admitted is likely one of the finest hospitals for a commoner, what extra a sitting British prime minister. 

In Asian nations akin to Japan, South Korea, Indonesia, Thailand, and Singapore, the highest hospitals are the college hospitals and public hospitals, and never essentially privately run.

These examples needs to be ample and convincing sufficient to argue for the case of getting one of the best well being care amenities in public establishments in our nation.

Public well being care amenities for the individuals needs to be the the equal of amenities obtainable and accessible for these larger up on the social ladder. 

As we’re rising from the Covid-19 pandemic, Malaysia is waking as much as many new promising developments. The well being minister has been elected the Vice President of the World Well being Meeting, and the Malaysian Well being Journey Council is able to entice worldwide well being vacationers once more, hoping to seize a wholesome chunk of the profitable well being tourism market.

And it has additionally been introduced that the Institute for Medical Analysis (IMR) will lead a nationwide process drive to champion vaccine manufacturing for native wants and past.  

Whereas we greet these bulletins with hope, we needs to be ready for the likelihood that they might not transfer past the preliminary self-gratification, if we hyperlink the state of the highest public well being amenities in different nations and examine them with what we have now right here. 

We must always ask the next questions in relation to those current developments.

1. The place do our VIPs, political and administrative leaders go to for his or her medical or surgical remedies? Whether it is in Malaysia, had been they largely handled in costly non-public hospitals, or had been they handled by senior docs in college hospitals or Ministry of Well being (MOH) hospitals? 

2. The place are one of the best and most skilled oncologists, cardiologists, nephrologists, neurologists, hepatologists, hematologists, and gastroenterologists, and are they in public hospitals? The place can we discover one of the best gynaecologists, neurosurgeons, cardiothoracic surgeons, spinal surgeons, hand and micro-surgeons, and plastic surgeons? What about paediatric oncologists, paediatric urologists, paediatric cardiologists, and paediatric plastic surgeons? Since they’re one of the best clinicians, are additionally they one of the best scientific academics to show and prepare future docs and specialists to satisfy the ever rising wants of the well being care wants of the nation?

3. For extra complicated scientific providers, together with organ transplants, the place can sufferers in want go to get their liver, kidney, bone marrow, coronary heart and lung transplants? What about mixed heart-lung transplants? What about islet cell or pancreas transplants? Are there any hospital that do all this in Malaysia? In spite of everything, one can not count on an ailing affected person with finish stage coronary heart failure or lung failure to outlive abroad journey in quest of an organ donor.

How current was the final process carried out and what number of have been carried out during the last 12 months? If the specialists had not executed sufficient, did the directors, policymakers, or fund suppliers trouble to search out out why, and rectify any faults significantly and promptly? What are the numbers of procedures executed, in comparison with different nations?   

If we take the case of Hospital Selayang for example, some doable solutions to the problems raised could also be discovered, if we have now the need to mirror, examine, and discover a resolution.

In terms of the nationwide organ transplant programme, which wants a full crew of skilled clinicians, anaesthetists, radiologists, immunologists, laboratory scientists, specialist nurses, and donor and recipient coordinators to develop and function, will probably be a problem to draw personnel, however it’s way more difficult to encourage professionals to construct their careers within the programme.

Regardless of ratifying the World Well being Group (WHO) guiding ideas on cell, tissue and organ transplants, and adopting the decision on the World Well being Meeting, some Members of Parliament and State Assemblypersons have discovered it simpler, if not essentially cheaper, to have their kidneys transplants executed abroad. 

On the capability of the IMR to spearhead the nationwide vaccine manufacturing plan, we should always query their state of readiness and the assist it receives to satisfy necessities akin to adequately skilled workers members, laboratory reagents, scientific gear, and analysis funding.

Dengue is endemic and has taken the lives of many Malaysians properly earlier than the Covid-19 pandemic. What occurred to the IMR subject trial involving genetically modified mosquitos, launched by the then deputy director-general of well being in December 2010 , when 6,000 sterile male mosquitoes had been reportedly launched within the jungles close to Bentong, Pahang? 

On the usage of genetically modified Wolbachia mosquitos, has anybody checked the funding and progress of the programme? Other than funding and technical assist from the College of Glasgow, the College of Melbourne, the British Wellcome Belief, and the Institute for Behavioural Analysis, how will the contract subject and lab scientists assist their households, provided that their paltry RM2,000 earnings is properly beneath the nationwide poverty line?

After we did our first nationwide survey on continual kidney illness in 2012, the analysis finances for the urine take a look at kits for albuminuria was sourced from the Postgraduate Renal Society of Malaysia (an NGO with members made up of nephrology clinicians within the MOH).

Given the perennial workers and budgetary constraints, we should always ask if the IMR is able to performing simultaneous HLA cross-matches and tissue typing if we have now 4 obtainable kidneys from two concurrent deceased organ donors (two kidneys from every deceased donor), to be matched with eight potential kidney recipients, ought to such a process be required after working hours, or on weekends or public holidays? 

After the primary stable organ transplant carried out in 1975, we’re nonetheless fighting 70 to 100 kidney transplants a yr for the two,000 to three,000 appropriate new sufferers, out of seven,000 to eight,000 new finish stage kidney illness sufferers yearly, as reported by the Nationwide Renal Registry.

And when transplants proceed to be carried out efficiently in public hospitals in Singapore, Thailand, South Korea, Vietnam, Hong Kong, Europe, and North America, the one MOH liver transplant centre at Hospital Selayang and the principle kidney transplant centre at Hospital Kuala Lumpur (HKL) have stopped performing transplants from the third quarter of final yr.

HKL just lately solved the dearth of working room and ICU beds (reserved for Covid-19 sufferers) by arranging sufferers to endure live-donor transplants in two non-public hospitals, paid for with a grant supplied by the MOH.

This befell when there are two present public transplant amenities, particularly the Nationwide Transplant Useful resource Centre (NTRC) that coordinates and facilitates deceased organ donors and organ retrieval in numerous hospitals in Malaysia, and the Nationwide Kidney Transplant Centre (NKTC) on the Institute of Urology and Nephrology, Hospital Kuala Lumpur. 

Not a single transplant has been carried out for greater than a yr in these two amenities, and except we rectify the deficiencies and supply the required assist for them to restart their transplant programmes and redouble their outputs.

Why are VIPs and their kin persevering with to fly abroad for medical remedies and procedures? Why ought to VIP orthopedic sufferers journey abroad for simply neck or again ache remedy?

Why can’t we have now one of the best well being care amenities and providers in public hospitals, for you, for me, for the Prime Minister, for the royals, for everybody?

Dr Ghazali Ahmad is a marketing consultant nephrologist who beforehand labored in a number of Ministry of Well being hospitals and has carried out collaborative scientific and epidemiological analysis. He’s the present president of the Asian Society of Transplantation and the previous president of the Malaysian Society of Nephrology, Malaysian Society of Transplantation and Postgraduate Renal Society Malaysia.

• That is the private opinion of the author or publication and doesn’t essentially symbolize the views of CodeBlue.