Conference Day 2

So, today is the second day of the conference and I am suffering .... for the lack of sleep. Went to visit my parents last night as my Dad is flying off to Surabaya earlier this afternoon. Had no choice but to watch Akademi Fantasia, a spin-off of British Fame Academy. Suffered through much agony.

Then came the whammy! Stayed up until 3 am to watch United play Spurs. And by God, it was well worth it! Had 4 hours sleep, went to have breakfast at mum's and then gave Dad a ride to Sentral for him to catch his flight. Attended the meeting on time, and I did not dose off. Amazing.

The talk I thought were straight to the point, relevant and interesting! Rather than treating it as a lecture, it was more of a discussion. An intimate disclosure of how the experts actually deal with their day-to-day management of their patients, rather than the run-of-the-mill 'this is what the latest guidelines say we should do'! A few pearls were shared, and the question were answered matter-of-factly. The interesting discussion was certainly about patients getting pregnant while on Glivec. The party line is certainly clear.

Ornaments at the Main Lobby, Le MeridienUnder no circumstances should they get pregnant. Unfortunately, turning the disease into a chronic disability comes with it's own social baggage. We can't tell our patients - often young - and eager to have a family to just forget about having children. I have children of my own, and I appreciate how they feel. At the same time I understand the stance of the manufacturer not wanting to declare that the drug is safe during pregnancy, because there is definite evidence of theoretical harm to babies in the first three months of pregnancy. During the discussion, there emerged some strategy in terms of how to deal with it, but it is not something I wish to bore you with on this post. Do email me for details.

The whole thing lasted until 12.30, then had buffet, which was actually rather good. Had the standard rack of sashimi of course! Endured the usual chorus of 'Wah! You eat raw fish ah?'. Hey! It's Halal what? Enjoyed it!

Then spent the rest of the day pleasing the boys back home. We went to do a bit of shopping at Great Eastern Mall and had tea at Alexis. Good bowl of salad and pizza! It was nearly 7 when we finally reached home with both Idlan and Irfan nodding off to sleep!

Again to reiterate the point, bringing the speakers into Malaysia rather than flying us out is certainly a way forward. Apparently the dinner that I missed last night - at Carcosa - was rather nice. Cultural shows and the whole nine yards! Well done Novartis!

Another Weekend .... Another Conference

It is the season now when almost every weekend, my calender were filled with conference date. And again, similar to last weekend, the organiser is using the same tact. Bring the international panel in, fill the audience with regional delegates, and another interesting meet-up. The venue this time is Le Meridien, at KL Sentral. But the meeting is certainly not on the cheap. Rumour has it that it cost USD 1000 per delegate pro rata.

There is the cost of flying the speakers and delegates in. They will need the flight and lodging taken care of. Then, there is always the conference dinner. It was KL Tower last weekend. It is Carcosa Sri Negara tonight. It may be good for the Mat Salleh and anyone who can attend. Unfortunately I am on call tonight, was it was 8pm by the time I finished my rounds.

The meeting today was concerning Chronic Myeloid Leukaemia (CML). It was a disease that was universally fatal. But the patients do not die there and then. There were basically given a probation, usually for as long as 3 years give and take. They are relatively well until towards the end when the disease will cause their bone marrow to fail, and they will need regular blood transfusion and treatment for infection. But ultimately they succumb. Around 7 years ago, a drug call Glivec was introduced. It revolutionise the treatment of CML almost overnight. Patients do not any longer need chemotherapy or other treatment with debilitating side-effects. The drug is taken orally, daily with tolerable problems. The main issue with it is the cost.

Malaysia in this sense should still count itself lucky because it still labelled as 'Third World Economy'. The drug usually cost RM 10000 per month, and the patient will need it for the rest of their life. It is almost impossible for us to afford it. Step forward the Max Foundation. It was given the task to distribute the drug at no cost to the patient by Glivec manufacturer, Novartis Pharmaceuticals to people like Malaysians. The responsibility for the patient is the promise to attend follow-up regularly, to monitor the response and to see if the disease has progressed despite treatment. The results of the monitoring are then collected and studied.

There are many people that are benefiting from this program - called GIPAP here in Malaysia. The foundation also host a patient support group for CML patient and caregiver, Max Family. I have been helping them out for many years as much as I can because I must say that they are very likely the most active cancer support group running in the country.

On a separate matter, as I mentioned in my entry last week, Malaysia can go along way in marketing itself as a conference and meeting hub. We got the facilities and the know-how. The multi-national companies will spend good money for these meetings and the clients that they invite in will have the spending power. That will only galvanise our economy. Go on Dr Ng Yen Yen. You know it makes sense.

Yes! I Got Myself the LX3

After a good few month eyeing this camera and I finally got it today. First impression, it is bulkier than I thought, but the weight felt right in the hand. Took a few pics on the way back home, via Pavilion since I went to the bank there. And these are the pics.

The interface were intuitive, menu were pretty straight-forward. There is a button to indicate record and playback, and the rest is as expected. What is interesting is the Ai mode which automatically predicts the theme that you are likely to need - eg: night mode, slow sync flash, sports with higher shutter speed. It will also control the ISO sensitivity. Basically it is a 'dummy' mode which is quite smart.

I used the P mode since it allows me to capture in RAW format. Coming back home, I noticed that my CS4 cannot read the file. Looking through the net, it is time to update my RAW conversion file. Then walla!

The conversion worked a treat. The pictures were sharp and the colour was just nice. The RAW conversion looks much better compared to the jpeg file the camera generates should you wish the camera to do so. Definitely worth going RAW in this one for the time being. Maybe there is a way to change the settings on the camera to allow a better jpeg picture generation without needing to go through the trouble of converting the RAW file.

I shall spend some more time during the weekend getting a feel of the camera. Definitely will need to try the video mode since it can generate HD quality clips. So watch this space. In the meantime, time to read the forums.

Happy Earth Day!

IKANO Power Center last Sunday afternoon

Today is April the 22nd. To the Communist, it is the birthday of Lenin. Since 1970, April 22nd is celebrated worldwide as Earth Day. Today marks its 40th installment. It has never ben traditionally celebrated in Malaysia although especially in the US, it usually coincide with nice spring weather and the beginning of summer. Many street parties were organised and some say it finds it's root from the 'Flower Power' days .... Peace man!

Looking through the net, it was initially championed by the appropriately named Gaylord Nelson, a US Senator from Wisconsin. Part of his thinking to save the world is to promote zero population growth. He is certain that the main root of the pollution and other effect to the environment is brought upon by the exponential growth of human population, a compelling argument.

More to the local scene, the Earth Hour certainly was still talked about. I was in IKANO last weekend and there was a small fare going on all week to promote Earth Day, but unfortunately the bulk of the program was conducted in Mandarin. I was looking around to see whether a similar KL Freeze thing is being organised again this year. I thought it was fun. Check out this YouTube video below.

There were confusion however on the actual date. The United Nations for some reason celebrate Earth Day on 21st March, on the Equinox. That's probably why the Government and other more mainstream organisation hold it then. What matters though is the spirit. Hmmm! What should I do later today? For a start I wish you all a Happy Earth Day!

Plight of Junior Doctors

I found this to be a compelling read this morning, and one hope that steps are taken to change it.

I REFER to the letter “Act fast so our doctors can do their job” (The Star,April 17) and wish to make a slight correction.

The Public Services Commission (PSC) conducts special interviews for new doctors, dentists and pharmacists three to four times monthly, and not twice weekly as stated by the writer.

Nevertheless, I agree that the interview process does not pose any delay in the recruitment exercise as the candidates can apply online and book their prefered interview appointments well in advance and the procedures is explicitly displayed on the PSC’s website:www.spa.gov.my. And, true enough, appointment letters are issued to the candidates on the same day after the interview.

The plight and frustrations of the housemen and doctors in the government service have been highlighted several times in the media and yet scant attention has been given to ease their sufferings. They are also paid a pittance in salaries and allowances.

Your news report entitled “RM6,000 a month for docs after two-year housemanship” by Izatun Shari (The Star, March 6, 2008) and comment “Good way to keep government docs and housemen happy” by V.K. Chin (The Star, March 18, 2008) were happy news, but sadly, it has not been put in place until today and remains a dream. Would the Health Ministry and Public Services Department care to clarify?

Housemen and doctors in the government service have been suffering in silence for years without proper and adequate remuneration and allowances. The conditions they work in, especially in remote locations, are pathetic and deplorable. They deserve better.

Often enough, at least two to three times per week, they are required to work on a 36-hour on-call schedule on each occasion, and they are required to get back to work again the next day after merely 12 to 16 hours’ rest.

Incredible and unbelievable work pattern that contravenes international labour standards/practices and our own Employment Act 1955 that stipulates that “no employees shall be required to work for more than eight hours per day and if overtime work is required, it shall not exceed four hours per day.”

Currently, all medical graduates must undergo the compulsory two-year housemanship and a further three years of mandatory government service before they are accorded full registration by the Malaysian Medical Council.

Although on completion of four of the five-year compulsory service, the doctors are permitted to apply to do their masters/specialisations, it must be noted that they do not get any paid study leave nor fully paid sabbatical leave to pursue their masters, which is accorded to their counterparts in the government service. Instead, they are required to continue to go to work and be on long and protracted call duties.

It must also be understood that unlike other graduates who take three to four years to complete their undergraduate studies, medical studies take between five and a half years in Malaysia, the UK, India, Australia, etc, and six-and-a-half years in Indonesia, Russia, USA, etc to compelete.

The PSC and PSD have failed to acknowledge and recognise the difference between medical graduates and other graduates. And this is the very reason that the doctors are just lumped into the general 41 salary scale together with other graduates who are spared the mandatory five-year service and their undergraduate studies take a shorter period to complete.

It is high time that the Government established a Medical Services Commission to address the various issues, grouses and unhappiness of doctors.

FRUSTRATED & BURNT-OUT DOCTOR, 
Penang.