Berita MMA December 2016 - Web

December 2016
Berita MMA Vol. 46 No. 12
(For Members Only)
PP 1285/02/2013 (031328)
P E R S A T U A N
P E R U B A T A N
M A L A Y S I A
MALAYSIAN
MEDICAL
International Day
of
ASSOCIATION
Persons with Disabilities

3 December 2016
MMA EXECUTIVE COMMITTEE

2016 2017
President
Dr John Chew Chee Ming
president@mma.org.my
Immediate Past President
Dr Ashok Zachariah Philip
pastpresident@mma.org.my
President Elect
Dr Ravindran R. Naidu
president_elect@mma.org.my
Honorary General Secretary
Dr Koh Kar Chai
secretary@mma.org.my
Honorary General Treasurer
Dr Rajan John
treasurer@mma.org.my
Honorary Deputy Secretaries
Dr Edwin Leo Suppiah
edwinleodr@gmail.com
Dr Saraswathi Bina Rai
binarai@yahoo.com
Schomos Chairman
Dr Vasu Pillai Letchumanan
schomos@mma.org.my
Pps Chairman
Dr Muruga Raj Rajathurai
pps@mma.org.my
Editorial Board 2016 2017
Contents
ExCo
4 Editorial
6
Presidents Message
10
From the Desk of the Hon. General Secretary
14
From the Hon. General Treasurer
16
World Medical Association
Election Committee
18
Call for Nominations (2nd Announcement)
Lead Article
20
International Day of Persons with Disabilities 2016
SCHOMOS
25
SCHOMOS Updates
PPSMMA
26
8 Pillars of Healthcare Transformation GPs Role
SMMAMS
28
Walk & Roll-A-Thon
Editor
Dato Pahlawan Dr R. Mohanadas
genmohan@gmail.com
General
30
Seminar on Career Pathway for Medical Graduates
Ex-Officio
Dr Koh Kar Chai
32
National Symposium on the Right To Health
Editorial Board Members

Assoc Prof Dr Jayakumar Gurusamy
drjkumar6@gmail.com
Dr Gayathri K. Kumarasuriar
gsuriar@yahoo.com.sg
Dr Juliet Mathew
drjuliem@hotmail.com
Prof Dr M. Nachiappan
drnachi611@gmail.com
Publication Assistant
Ms Thogaimalar Selvarajan
publications@mma.org.my
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Malaysian Medical Association. Facts contained herewith are believed to
be true as of the date that it is published. All content, materials, and
intellectual property rights are owned and provided for by Malaysian
Medical Association and its members.
35 Humour
Branch News
36
MMA Sarawak: Batang Ai Medical Camp
38
MMA Wilayah: KL to Chiang Mai
42
MMA Wilayah: Installation Night 2016
44
MMA Negeri Sembilan: Road to Future, 2016
46
Mark Your Diary
Merry
Christmas
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ISSN 0216-7140 PP 1285/02/2013 (031328) MITA (P) 123/1/91
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beritaMMA Vol.46 December 2016
exco editorial
Dato Pahlawan Dr R. Mohanadas

Editor
genmohan@gmail.com
A Thai
Experience
at roundabouts, along the roads, in
buildings and lobbies of hotels and
malls were indeed prominent, and
condolence books were available at
the tourist sites we visited.
The MMA Wilayah Family Weekend
was educational and fun, it exposed
the families to Thai traditions and
culture, with briefings by the tour
guide to the unique Thai Monarchy.
anners of such nature

welcomed us to Chiang Mai
when we were there recently
on a MMA Wilayah Branch Family
Weekend, thus demonstrating the
respect and love of the 67 million
Thais over the loss of a most revered
King of Thailand, His Majesty King
Bhumibol Adulyadej. The above
banner says it all, His Majesty was
more than a King of a Nation, he was
almost divine to the Thais.
He was born on 5 December 1927
at Cambridge, Massachusets, USA
whilst his father Prince Mahidol
Adulyadej was attending a Public
Health Course at the Harvard
University. He studied at the
University of Lausanne in Switzerland,
graduating in languages and the
sciences and returned to Thailand.
He was crowned King Rama IX of the
Chakri Dynasty at the age of 18, and
was the longest reigning monarch
till his death on 13 October 2016.
He ascended the throne on the
premature death of his elder brother,
and remained on the throne for 70
years, dying at the age of 88, after
a long illness at the Siriraj Hospital
in Bangkok. In 1989, His Majesty was
conferred the title of King Bhumibol
the Great.
Some of us who had the opportunity

of attending the Mahidol University
through the SEAMEO TROPMED
programme received our scrolls
from King Bhumibol at the University
Convocation, an event His Majesty
hardly missed. The University
is named after his father Prince
Mahidol.
Thailand has declared a year of
mourning. Black bands on the arm
or black ribbons on the clothes of
the Thais were very prominent. Large
portraits of His Majesty and banners
Unfortunately, we lost a colleague,

62-year-old Dr Bala Raja Senathirajah,
an alumni of JIPMER, Pondicherry,
a Private Practitioner and an
active member of the MMA. He
passed away at Chiang Mai on
20 November 2016 and was
cremated in Chiang Mai on 23
November. May his soul Rest in
Peace.
A good person can make

another person good,
it means that goodness
will elicit goodness in the
society; other persons will
also be good
King Bhumibol of Thailand
May His Majesty Rest In Peace: Dr Krishnan Menon, Vice Chairman Wilayah Branch signing
the condolence book together with Dr Saravanan at Chiang Mai
mooselakecartoons.com
exco presidents message
Presidents
Message
he month of November saw the surprising election

of Mr Donald Trump as President Elect of USA.
None of the pollsters got it right. While the pundits
are guessing the likely policies of the new President,
we cannot ignore the new world order with the new
President. It is all about USA with the USD climbing
while the rest of the world are pondering the isolationist
Trumpism. The Paris accord on Climate Change and
Obamacare with its high cost will certainly be reviewed.
TPP might be in hibernation during the Trumps reign but
the rest of the world will continue to find ways out of
the Great Recession, mostly by trading and infrastructure
spending. The rise of China is already self-evident with
the RM 383B development at Iskander.
Bersih 5 came and went. Private specialists are still
struggling with their tax. The various interpretations and
the confusion were the reason why we asked LHDN to
start the new tax assessment in 2017. As of now, the 9
September 2016 letter stands with the appeal for a 2016
start and is still waiting for an answer. As the deadline for
voluntary disclosure is 15 December 2016, members still
have time to do the risk management and get the paper
trails in order, before deciding on voluntary disclosure.
This should not be too difficult as I am sure no doctors
have hidden Swiss accounts!
Meanwhile I will report on the two conferences I attended
as President of MMA.
Second WVA-WMA Global Conference on

One Health
I had the distinct honour of being invited by the Japan
Medical Association to attend the Second World
Medical Association/World Veterinary Association Global
Conference on One Health held 10-11 November 2016
Dr John Chew Chee Ming

President
president@mma.org.my
johnchew23@gmail.com
in Kitakyushu, Fukuoka, Japan. The inaugural conference

was held in Madrid in 2015, and it was fortuitous that
Dr Isao Kurauchi, President of Japan Veterinary Medical
Association and Dr Yoshitake Yokokura, President of
Japan Medical Association (JMA) both have come from
the Fukuoka Prefecture of Japan. The two Presidents
having known each other for a long time and decided
to bring this important meeting to Fukuoka. Dr Yokokura
is the three-term President of JMA and has the distinct
honour to be the President Elect of World Medical
Association.
This conference brought practitioners of Animal and
Human Medicine together to improve global health under
the One Health Concept, moving it to the One Health
Approach. The Tripartite agreement of WHO/FAO/OIE
in 2010 recognised the interaction of animals, human
and the environment. The recent outbreaks of zoonotic
diseases e.g. Ebola haemorrhagic fever, Middle East
Respiratory Syndrome (MERS), Severe Acute Respiratory
Syndrome (SARS), Dengue and ZIKA have undermined
the health beyond national boundaries. In recent past,
we had Influenza, Nipah virus and EV71.
Two memorable keynote speakers gave me much
inspiration. Nobel Laureate in Chemistry 2002 Dr
Koichi Tanaka (b.1959) related how he discovered mass
spectrometric analyses of biological macromolecules
such as proteins in 1985. He was an Electrical Engineer
Graduate doing research with Shimadzu. He gave his
address before His Royal Highness Prince Akishino, with
the Minister of Health, Labour and Welfare, the Minister
of Agriculture, Forestry and Fisheries, Governor of the
Fukuoka Prefecture and the Mayor of Kitakyushu City.
There was so much regal and official presence at the
conference, underlying the government support for the
two Presidents.
The second keynote address was given by Japanese
astronaut Mr Mamoru Mohri (first space mission in 1992)
who related his experiences in space during a full house
public forum. He related his vulnerability in space and
realised that only the blue earth can sustain life. This
realisation gave rise to the importance of protecting all
the natural resources on earth, especially when he could
see a small rim of atmosphere from space.
These two pioneers with very different perspectives,
one at a micro-chemical level and the other from space
with their simplicity, humility and gratitude drew a lot
of admiration from the delegates. Ideas do come from
unexpected places.
exco presidents message
Other highlights were the projects by Japan International

Cooperation Agency (JICA) in Zambia, Kenya and
Indonesia on the study of flying foxes involvement with
Rabies-related and other viral infectious diseases. The
field work together with the laboratories support at
Japanese Universities produced a lot of new information.
JICA was also involved in the surveillance of multi-drug
resistant bacteria in Vietnam. This showed a 60% presence
of ESBL carriage rate as a result of poor hygiene, nonprescription use of antibiotics in animals and human, and
how intervention reduced the carriage rate to 35%.
Indeed I am very grateful to JMA for this unique
opportunity. It was in Kitakyushu that I had the privilege
to meet Dato Dr Quaza Nizamuddin Bin Hassan Nizam
and Dr Paul Chelliah, President and Immediate Past
President respectively of Veterinary Association of
Malaysia. We have agreed to hold joint meetings of
One Health in Malaysia to further spread this message.
Besides our Veterinarian colleagues, we have to get our
Environmental Scientists to enlighten us as well. The
water contamination with 4-bromodiphenyl ether (a fire
retardant) at Sungai Semenyih, Nilai, Negri Sembilan,
the yearly air pollution from the forest fires (haze) , red
tides, Lynas rare earth processing plant and a host of
other environmental issues should be further studied and
highlighted.
I came away inspired by the Japanese culture, the
hospitality and the thoughtfulness of my host. The pursuit
of knowledge is a value in many successful societies and
I can see this is very well supported by the Government
of Japan. This is also very much embodied in Chado,
the Japanese Tea Ceremony. Through the Way of Tea,
proponents seek the principles of Harmony, Respect,
Purity and Tranquillity. The host was always courteous,
respectful and transfers to and fro the airport was very
much appreciated.
Antibiotics Awareness Week 2016

The World Antibiotic Awareness Week 14-20 November
2016 aims to raise awareness of the threat of global
antibiotic resistance. The launching was done by Datuk
Seri Dr S. Subramanian with pledges by Ministry of Health,
Malaysian Pharmaceutical Society and Malaysian Medical
Association to support all the strategies to address the
threat of antimicrobial resistance in Malaysia.
The Antibiotics Awareness Week 2016 was organised
under the leadership of Datuk Dr Christopher Lee. The
launching was preceded by talks given by Prof Madya
Dr Latiffah bt Hassan on the One Health Approach to
Antimicrobial Resistance, Dato Dr Mahiran bt Mustafa on
the Emergence of Plasmid Mediated Colistin Resistance
(MCR-1), and myself on the Role of GPs in Combating
Antimicrobial Resistance.
British economist Jim ONeil in a report (2014) to the
British Parliament said that if left unchecked by 2050,
antimicrobial resistance would cost globally 10 million

deaths per year, 2-5% decline in GDPs of poor countries,
and 100 trillion USD. Many people would be trapped in
poverty and suffering in a new apocalyptic era. 28 million
people could fall into poverty. Antimicrobial resistance
(AMR) would mean prolonged ill-health, prolonged
hospitalisation and the increased cost of healthcare.
Productivity would suffer and global trade would be
reduced.
Livestock would also suffer as diseases would be
untreatable with AMR. Food sources would be more
expensive and the poor would go hungry.
WHO Director General Dr Margaret Chan warned of this
end of modern medicine as we know it where a sore
throat or a simple scratch on the knee would kill. Joint
replacements, transplant and other surgeries would not
be safe anymore. Many common infections will again
become untreatable.
We need to preserve and to prolong the usefulness of the
present antibiotics we still have available. Studies have
shown lower resistance if we use less antibiotics. Good
Antibiotics Stewardship implies appropriate prescribing,
less is more approach such as shorter duration,
de-escalate among good infection control measures.
We have to educate our patients that upper respiratory
tract infections are frequently viral which antibiotics will
not work.
Malaysia is fortunate as antibiotics is a Prescription Only
Medication (POM). We have to ensure that antibiotics
remain POM. Malaysian Pharmaceutical Societys
President Amrahi Bin Buang pledged no prescription,
no antibiotics. Many of our neighbouring countries
are not. A recent survey in Vietnam revealed how
indiscriminate use of antibiotics both in human and
animals resulted in high AMR.
A recent publication Antibiotic prescribing in public
and private practice: a cross-sectional study in primary
care clinics in Malaysia Ab Rahman et al. BMC Infectious
Diseases (2016) 16: 208 showed that antibiotics
prescribing are high in both sectors in Malaysia. Overall,
21% of encounters resulted in antibiotics being given

(6.76% in public and 30.79% in the private). What was
disconcerting was the high antibiotics prescribing for
Upper Respiratory Tract Infections, (16.8% in public
and 57.7% in the private sector). Perhaps it is timely to
highlight the MyNAG Malaysian National Antibiotics
Guideline 2014, available at:
http://www.phar macy.gov.my/v2/en/documents/
national-antibiotic-guideline-nag-2nd-edition.html
The traditional way of empirical antibiotic usage would

need to be improved. Diagnosis and susceptibility
studies would need to be faster. I hope this coming age of
precision medicine will be able to combat this scourge.
10
exco hgs
From the Desk of the
Hon. General
Secretary
Dr Koh Kar Chai

Hon. General Secretary
drcaseysurf@gmail.com
President of CMA with MMA Exco
he Malaysian Medical Association was

honoured by the visit of the newly
elected President of the Commonwealth
Medical Association (CMA) to MMA House on
29 Nov 2016. It is not always that dignitaries
from foreign and regional medical associations
vis it u s at MMA H o u se . P ro f D r Va j i r a
is on a firm footing to ensure the continued
relevance of the CMA and also to ensure its growth.
This visit will definitely spur the MMAs relationship
with the CMA.
Calling it Dj vu is wrong as it has definitely
been happening repeatedly.
~~~
Visit to MMA by Prof Dr Vajira

H.W. Dissanayake, President of the
Commonwealth Medical Association
~~~
The scenario:
8am: Someone sees an article of interest in the
media, be it the mainstream media or an alternate
media.
8.01am: With great deftness of fingers, said article
of interest is disseminated via social media. An
uproar is created almost immediately. Such is the
speed of this media. The more controversy or affront
it creates, the higher the speed of dissemination.
8.15am: Suggestions that the Malaysian Medical
Association should respond immediately starts
surfacing.
8.30am: The suggestions begin to morph into
demands.
8.45am: Lo and behold, should the demands not
be answered, the smearing starts. Office bearers
who chance upon such postings at this stage had
better rein in their replies as it will then create a war
of words.
9.00am: Not a chance for the office

bearers implicated to redeem
themselves as they would have been
tarred left and right, notwithstanding
the fact that the office bearer
implicated here may not even have
had a chance to look at his phone
since attending to his patients in the
morning.
There is this competition to see
which association is the first to
respond with a statement. Woe be
to the MMA if it loses first place to
another association. I wonder how
detrimental this kiasu mentality is
to all associations concerned.
This brings us to the matter of press
statements. When a press statement
is urgently needed, the principal
office bearer will need to be alerted
to the need of a press statement. This statement,
which comes from the highest office, cannot be
done as a knee-jerk reaction which may result in
the office or the association looking like a complete
fool. I am sure we are all aware of statements
made by some lawmakers which invited all sorts
of comments culminating with the said person
claiming a misquote by the press to save face. This
has happened before in the Malaysian Medical
Association as well.
Facts need to be gathered and an answer drafted.
The officer drafting the press statement may not
necessarily be well-versed with the issue at hand
and will need to call on the help of others to verify
on the points contained therein. All these take time,
which shouldnt be hurried.
HGS with SMMAMS, MMMC and MMA Melaka
Another point to note is that it may not appear in

the media instantaneously. Alternative media may
carry it by the same evening, and it may appear in
most mainstream media much later on, that is, if it
is at all carried.
There are two things that I have noticed in present
times.
First is that the amount of communication on social
media has grown to a barely manageable gigantic
volume that has at times hampered, rather than
facilitated, communication. There is a need to
modulate communication on this media, which at
the present moment is easier said than done.
The second is that the world has entered into an
anti-establishment era. Principal office bearers
12
exco hgs
of the Malaysian Medical Association, including

those contemplating to take up office, need to take
heed. Law makers throughout the world are under
increasing strain because of this and it is noted to
be happening in smaller establishments as well,
including the MMA.
Just take a look at what is happening in some
countries where people do not look at conventional
politicians in the same light as before. The belief in
conventions is gone and the support for so called
controversial loners to lead has surfaced. The MMA
will not be spared of this.
Office bearers of the MMA who have offered to
take up office should be willing to rise up to this
challenge of adapting to a new era and steering
the MMA on a path of continued relevance to the
medical fraternity.
Nurturing our young medical students and
encouraging them to partake in the MMAs activities
is no easy task. Getting them to join the MMA as a
student member and ensuring that they remain as
members on graduation is a continuing gargantuan
effort. The mindset of the students and indeed that
of the young doctors need to be understood before
we give the clarion call of Join MMA, we are there
for you.
The MMA needs to support activities carried out
by the Society of Malaysian Medical Association
Medical Students (SMMAMS) to allow them to
realise the significance of being part of the MMA.
Activities which allow the participation of both
the senior and junior members should be held
on a regular basis to ensure that there will be a
transitional flow of SMMAMS members to being a
full-fledged MMA member.
A recent activity carried out by SMMAMS was the
Intervarsity Debate Battle held on 26-27 November
2016 at the Melaka Manipal Medical College which
saw good participation from various varsities. It was
sponsored by not only the MMA, but also the MMA
Melaka Branch. It is hoped that our MMA branches
will get involved with SMMAMS activities on a
regular basis. Our gratitude to the Melaka Manipal
Medical College for being a gracious host to this
event.
Sole Proprietorship of a Private

Specialist Clinic
Many calls have been received from specialists
in the private sector with regards to the setting
up of a clinic as a sole proprietorship. Many

specialists have tried to register their clinics with the
Suruhanjaya Syarikat Malaysia (SSM) but have been
turned away, and rightly so.
Under the Laws of Malaysia, Act 197, Registration
of Businesses Act 1956 (Revised-1978), Part IIRegistration, Renewal and Termination of Business,
Section 4. Application, states that
This Act shall not apply to(d) any business consisting solely of the exercise of
any profession which under the provisions of any
written law can be exercised only by those who
possess certain qualifications prescribed by such
written law and whose names are registered or
otherwise recorded in manner prescribed by any
written law.
This means that the business of a medical clinic
cannot be registered with SSM unless it is to be
registered as a Sendirian Berhad (Sdn Bhd), which
the private sector specialists are shying away from.
All that is needed is to ensure that the clinic is
registered under the Private Healthcare Facilities
and Services Act (Act 586). The clinic can then be
run as a sole practitioner or with a partner or
partners. As far as the Internal Revenue Board is
concerned, if you are practising alone, you will need
to declare your income as personal, supported by
your annual accounts. For those with partners, your
accountant will do the needful by submitting your
accounts to the IRB whilst you and your partners will
need to declare your personal income based on the
divided profit and loss calculation.
Of concern here will be the differential percentage of
income tax between a personal income and income
declared under a Sdn Bhd. Another issue brought
up is the type of deductible expenses allowable as
a sole proprietor business and a Sdn Bhd. Suffice
to say that the both of these will definitely not be as
favourable as when the clinic is registered as a Sdn
Bhd. But then, many General Practice (GP) clinics
are run under the sole proprietor model, much to
the surprise of many a specialist who assumed that
GP clinics are all registered as a Sdn Bhd.
Kindly seek the advice of a qualified tax consultant
or accountant for all your further queries. What is
mentioned here is only based on the experience
of yours truly and may not be an accurate
representation of current laws and practices.
PUTRA MEDICAL CENTRE is 170 bedded hospital strategically located in the centre of Alor Setar. We would like to
invite applications for the following positions:
SPECIALISTS
Ophthalmologist
General Surgeon
Orthodontics
Nephrologist
Interventional
Radiologist
Oncologist
Dentist
Neurosurgeon
Geriatrician
Urologist
Neurologist
Gastroenterologist
Anaesthesiologist
Obstetrician And
Gynaecologist
(Malay Female
Doctor)
Rheumatologist
Endocrinologist
Pathologist /
Visiting
Pathologist
HOSPITAL POSITIONS
2 Medical Officers Pharmacist
Nursing Manager (With Post Basic Qualification)
Nursing Supervisor (With Post Basic Qualification)

Staff Nurse (With Post Basic Qualification)
Please send CV, certificates, testimonials and photo (n.r.) to:

Human Resources Department
888, Jalan Sekerat, Off Jalan Putra, 05100 Alor Setar, Kedah Darul Aman
Email: gan@putramedicentre.com.my
For enquiries
contact:
Mdm Gan (012-582 0528)
Tel: 04-734 2888
Fax: 04-734 8882
Berita MMA Editorial Board Policy

Berita MMA is an official publication of Malaysian Medical Association. The purpose
of Berita MMA is to disseminate timely information of members views, reports,
news and leisure articles that interest a broad spectrum of readership. The bulletin
is also intended to be a conduit for discussion of issues facing the medical fraternity
or highlight thought-provoking articles. Personal attacks, political statements or
innuendos are unwelcome.
Any reports of activities like MMA branch events are encouraged to have more insight
on a certain topic held; rather than the mundane line of just reporting the date of
event, venue, number of participants or chief guest present.
All articles are in English Language. Contributors of articles should make an effort to
vet through their articles or seek assistance from their colleagues to have a minimum
standard of language that is acceptable for publication. Plagiarism is frowned upon.
Submitted articles are subject to revisions and minimum language corrections by the
editor. We envisage having a diverse range of both articles and contributors. The
right to publish is at the sole discretion of the Editorial Board of Berita MMA.
The policy was approved by the Berita MMA Editorial Board on 22 April 2015.
14
exco hgt
From the Hon. General

Treasurer
I
t was a proud moment for me taking over the office of Hon

Treasurer of MMA. Having associated continuously with the
EXCO of MMA for quite some time sharing responsibilities
thereof as Member, Hon. Deputy Secretary and similar, I was all
full of hopes of supporting the EXCO in taking the Association
to the next deserving level. Little did I dream that the task ahead
was tough and demanding until I was exposed to fresh challenges
facing MMA currently. To a certain extent, gloom spread over my
hope but then resiliently I recaptured my desire and vision for the
simple truth that says when the going gets tough, the tough
gets going.
I am aware of the challenges the Hon. General Treasurer has to
invariably take on. As all of you know, it is not an easy cakewalk;
on the contrary the task is hard, demanding if not disturbing at
times, frankly enough. In the past, Treasurers have been found lost
over undue and unfair criticisms. But with all sincerity, I want to
assure every one of you that I shall do my level best not to be on
the receiving side. I shall exercise due diligence in the discharge of
my duties as well as take your counsel and advice in every difficult
situation whenever. I look forward to our collective wisdom and
expertise to steer clear our Association as your representative.
Dr Rajan John
Hon. General Treasurer
drrajan09@yahoo.com
Its my promise that I will be honest in performing my duties and

will do the very best to uphold our common interests. My hands will
reach out to all our members, no matter the situation be pleasant or
troublesome. I believe, together and together alone, we can move
mountains.
Some major areas of concern facing the current financial are the
following. In 2015, we had a budgeted income of RM 2.6M against the
account head of Commission. The actual income during that period
was RM 2.16M. The projection for this year is just RM 1.56M only, a
steep drop of RM 598K approximately a downsizing by 40% from last
years. This is mainly due the fact that one of the two major contributions
paying us Commission from Insurance, namely MMI of Malaysia, has
been terminated by MMA over issues that have taken us to the court of
law. However, an out of court settlement has been drawn out brokered
by our approved lawyers that cost us RM 183,220.21 towards lawyer
intervention.
We managed to receive approximately RM 750K from AON. There
has been an over payment of RM 280K towards income tax which we
are waiting for reimbursement from the Inland Revenue Board (IRB).
Similarly, there is an issue of payment to the tune of RM 200K towards
legal advice and representation (Income Tax Issue) for the previous year
that has recently been invoiced and has not yet been approved by the
Council. We have to set in practice healthy norms of approvals and
payments so that our fund management is clean, clear and transparent.
Another major issue is the area of doubtful debts

which has been presented during the AGM
repeatedly during the past years. MMA has engaged
forensic auditors from PricewaterhouseCoopers
to conduct a review of the provision for doubtful
debts for certain receivables and recommend the
appropriate adjustment needed to be made adjust
the provision to comply with MMA accounting
policies and applicable accounting standards. The
doubtful debts amount to RM 325,140 backdated
from 2008 to December 2014. Statutory provisions
have to be respected in regard to trailing debts
briefly detailed as below. The following are the
recommendation from the Forensic Auditors:
i.
For debtors in which the aging are below seven

(7) years and where no evidence can be identified
for the unpaid invoices, consider writing off the
balances relating to these invoices if all effort
to trace the record of services performed has
been fully exhausted.
ii. For debtors in which the aging are below seven

(7) years and where there is record of work
performed, engage the debtors personally or
appoint external debt collector for collection
efforts.
iii. For debtors in which the aging are below seven
(7) years and where invoices are duplicate, write
off the amount.
iv. For debtors in which the aging are below seven
(7) years and where invoices are duplicate, write
off the amount.
I will be presenting this report in the forthcoming
AGM in Penang for approval to write off such
doubtful debts which the amount cannot be
recovered due to lack of supportive documents.
Since taking over the HGT, I had a couple of

meetings with our accountant (PWC) regarding
the accounts. I also have frequent meetings and
discussions regarding Finance with our Department
staff. Recently the internal auditors, Prof Dr
Lekhraj Rampal and Dr Raj Mohan Annamalai did
the auditing and they were impressed with the
accounting system and practice in vogue.
I would like to take this opportunity to assure
our members and clients that we would strive
to establish strict financial discipline in our fiscal
transactions and that we are open to advice and
suggestions of our benefactors. Every effort from
our members in this direction is welcome as we face
currently difficult, if not a turbulent situation.
From the previous office bearers, a piece of advice
received is also under consideration of the EXCO.
Since the term of office is one year for the EXCO,
office bearers change every year which slows
down effective management of the Association.
By the time the new office bearers get used to the
situations, it is time to leave the charge to the newly
elect, leaving midway administrative and functional
improvements thus breaking continuity of our
policy and principles. Hence, they have suggested
a two-year term for Honorary General Treasurer. It is
like a football player entering the field but is called
back halfway through. The Treasurer needs at least
a two-year term in office to help MMA sustain their
projects and programmes effectively.
All said and done, I would reassure our members
that no stone will be left unturned in our pursuit and
that the wellbeing and welfare of the Association,
as also of our noble profession in serving the public
and our nation are of paramount importance that
will be duly taken care of, in any event.
16
exco president elect
World Medical
Association
I
Dr Ravindran R. Naidu
President Elect
flynaidumma@gmail.com
had the privilege to represent MMA at

the recently concluded WMA General
Assembly and Scientific Session, Taipei
2016. It was held from 18-23 October 2016
in Taipei, Taiwan. MMA was represented
by the President, Dr John Chew, the
Immediate Past President, Dr Ashok Philip
and myself. It was the first time I attended
and it was definitely a very good exposure
and experience and I have learnt much.
Dr Ravindran (centre) & Dr Ashok Philip (right)

with Dr Yoshitake Yokokura (left, President Elect
of WMA)
The World Medical Association (WMA) is

the global federation of National Medical
Associations representing the millions of
physicians worldwide. Acting on behalf
of patients and physicians, the WMA
endeavours to achieve the highest possible
standards of medical care, ethics, education
and health-related human rights for all people.
The General Assembly started on 19 October 2016 and ended on 22
October 2016. It is open to all constituent members of the WMA, to
associate members, to observers and to other individuals by special
invitation.
The theme of the scientific session this year was Healthcare System
Sustainability. This session took place on the 20 October 2016. The topics
presented were:
Health System Sustainability with regard to Global Migration and
refugees: The case of Germany
The Sustainability of Health Care in Aging Society, A Global View
The Role of Gatekeeper in Sustaining the Health Care
Health Care reforms in U.S.
Personal and Private Big Data: Genomes and Health records
Big data Approach in Health Care Assessment
Health IT : The Essential Infrastructure for Universal Coverage
Transforming Healthcare with Information Technology
President Dr John Chew

(seated 2nd from left) with
Dr Yoshitake Yokokura
(seated, right)
eHealth and Electronic Medical Records Problems and Pitfalls

eHealth Supporting Citizens and Healthcare Services
The interesting part of this event is the ability to meet medical doctors from
various parts of the world. There were approximately 225 members from
various National Medical Associations and 24 members from the Junior
Doctors Network from 11 countries, associate members and observers from
various medical associations.
I was indeed surprised with the presence of the Junior Doctors Network who
took part in the General Assembly and the Scientific Session. The President
of the JDN is Dr Ahmet Murt from Turkey. The criterion to join the Junior
Doctors Network is that the member should be between the ages of 25 to
35 years.
The WMA General Assembly was declared open by President Dr Tsai Ingwen of Taiwan on 21 October 2016 during the assembly ceremonial session.
It was a very quick and short affair. This was followed by the installation of
the Incoming President of WMA, Dr Ketan Desai from the Indian Medical
Association. The election for the President Elect was conducted on 22
October 2016 and Dr Yoshitake Yokokura from the Japan Medical Association
was declared as President Elect.
Most of the dinners and meals were sponsored by the Taiwan Medical
Association. A big thank you to the President of Taiwan Medical Association
Dr Tai-Yuan Chiu and his team.
Wishing all the members Merry Christmas and Happy New Year.
18
election committee
MALAYSIAN MEDICAL ASSOCIATION

4TH FLOOR, MMA HOUSE
124, JALAN PAHANG
53000 KUALA LUMPUR
MMA 1009/5
19th October 2016
ELECTION COMMITTEE
TO: ALL MEMBERS OF THE MALAYSIAN MEDICAL ASSOCIATION (MMA)
Dear Member,
NOMINATION FOR THE POST OF PRESIDENT-ELECT, HONORARY GENERAL
SECRETARY, HONORARY GENERAL TREASURER AND TWO HONORARY DEPUTY
SECRETARIES (2017/2018) OF MMA
The Election Committee of the Malaysian Medical Association hereby calls for nominations for the
post of President-Elect, Honorary General Secretary, Honorary General Treasurer and two
Honorary Deputy Secretaries of the Malaysian Medical Association for the year (2017/2018).
In compliance with Clause 7 (8), (9), (10) and (11) of the MMA Constitution, nominations are called
herewith for the above posts.
No member may offer themself / herself as a candidate for more than one of the following posts
of office bearers: President-Elect, Honorary General Secretary, Honorary General Treasurer
and two Honorary Deputy Secretaries.
Please note that the candidate for the post of President-Elect for 2017/2018 shall be a MMA member
in benefit from CENTRAL REGION. Candidates for President-Elect, Honorary General Secretary,
Honorary General Treasurer and two Honorary Deputy Secretaries must be Life or Ordinary Members
of MMA of at least five (5) years standing and who shall have served in Council or in a Branch
Committee for at least two (2) years.
The candidates for Honorary General Secretary, Honorary General Treasurer and two Honorary
Deputy Secretaries can be a life member or ordinary member in benefit from ANY Branch of the
MMA.
ALL NOMINATIONS FOR THE POSTS OF PRESIDENT-ELECT, HONORARY GENERAL
SECRETARY, HONORARY GENERAL TREASURER AND TWO HONORARY DEPUTY
SECRETARIES (2017/2018) MUST BE RECEIVED BY THE MMA ELECTION
COMMITTEE BY 5.00 PM ON THURSDAY, 2ND MARCH 2017. CANDIDATE, PROPOSER
AND SECONDER MUST BE MEMBERS IN BENEFIT.
(Candidates wishing to withdraw the nominations can do so by Friday, 10th March 2017 by 5.00
pm).
Nomination papers are available from the MMA Secretariat at the above address. Nomination
papers should be addressed to :
THE SECRETARY, MMA ELECTION COMMITTEE
4TH FLOOR, MMA HOUSE, NO. 124, JALAN PAHANG
53000 KUALA LUMPUR
Please take care to fill the Nomination Forms correctly and legibly as improper or incorrect
filling may lead to disqualification. Submission of nomination forms by fax will not be accepted.
Yours sincerely,
DATO DR P. VIJAYA SINGHAM

Secretary
Election Committee
Malaysian Medical Association
20
lead article
International
Day of
Persons with
Disabilities
2016
H
ow a society treats its disabled is the true measure of civilization Chen

Guang Cheng, a blind activist.
Prof Dr Amara NaickerNaysaduray

Consultant Rehabilitation Physician
Dept of Orthopaedics &
Traumatology
Pusat Perubatan Universiti
Kebangsaan Malaysia
asnaicker@yahoo.com
Member
MMA Selangor
Being disabled in a predominantly able bodied society brings its own

challenges. People often assume being disabled means being incapable and
thus automatically not worthy of having access to every aspect of normal life.
It is these very discriminatory ideas and attitudes, that the United Nations and
many other governmental and non-governmental agencies have been working
hard to overcome in the last few decades .
In 1992, the General Assembly proclaimed 3 December as the International
Day of Persons with Disabilities (IDPD), following the United Nations Decade of
Disabled Persons (1983-1992). Each year the UN announces a theme for IDPD.
The theme for 2016 is Achieving 17 Goals for the Future We Want, a more
inclusive and equitable world for Persons With Disabilities (PWD) in keeping
with its 2030 agenda of Sustainable Goal Developments (SDG).
While the SDGs are not legally binding, governments are expected to take
ownership and establish national frameworks for the achievement of the 17
Goals. Countries have the primary responsibility for follow-up and review of
the progress made in implementing the Goals, which will require quality and
accessible and timely data collection. Regional follow-up and review will be
based on national-level analyses and contribute to follow-up and review at the
global level.
The annual observance of IDPD aims to promote an understanding of disability
issues and mobilise support for the dignity, rights and well-being of persons
with disabilities. It also seeks to create and increase awareness of gains to be
derived from the integration of persons with disabilities in every aspect of
political, social, economic and cultural life.
This years IDPD 2016 coincides with the 10-year anniversary of the adoption of
the Convention on the Rights of Persons with Disabilities (CRPD).
CRPD is an international human rights treaty of the United Nations intended
to protect the rights and dignity of persons with disabilities. Parties to the
Convention are required to promote, protect, and ensure the full enjoyment
of human rights by persons with disabilities and

ensure that they enjoy full equality under the law.
The Convention has served as the major catalyst
in the global movement from viewing persons with
disabilities as objects of charity, medical treatment
and social protection towards viewing them as full
and equal members of society, with human rights.
It is also the only UN human rights instrument with
an explicit sustainable development dimension.
(Fig CRPD guiding principles)
The IDPD will take stock of progress since the

Conventions adoption in 2006 and will emphasise
efforts toward universal ratification of the CRPD, ideas
for the continued advancement of the goals of the
convention, and reflect on the challenges that remain
toward the full realisation of the CRPDs goals.
This years objectives include assessing the current
status of CRPD and SDGs and laying the foundation
for a future of greater inclusion for persons with
disabilities.
World Report on Disability 2011

World Report on Disability, 2011 by World Health
Organization (WHO) and the World Bank estimates that
about 15% of total population of a country comprises
persons with disabilities. The global disability
prevalence is higher than previous WHO estimates,
which dates from the 1970s that suggested a figure
of around 10%. This global estimate for disability is

on the rise due to population ageing and the rapid
spread of chronic diseases, as well as improvements in
the methodologies used to measure disability.
The report does recognise that the disability
experiences resulting from the interaction of health
conditions, personal factors, and environmental
factors varies greatly. While disability correlates with
disadvantage, not all people with disabilities are
equally disadvantaged. Women, children and older
people with disability tend to be more vulnerable.
The disabling barriers identified in this report include
inadequate policies and standards, negative attitudes,
lack of provision of services, inadequate funding,
problems with service delivery, lack of accessibility,
lack of consultations and involvement of the disabled
person in decision making and lack of data and
evidence.
This report also makes recommendations to address
the various barriers. The evidence in this report
suggests that many of the barriers that people
with disabilities face are avoidable and that the
disadvantages associated with disability can be
overcome. Implementing the recommendations will
require the involvement of different sectors such as
health, education, social protection, labour, transport,
housing and different actors such as governments,
civil society organisations (including disabled persons
organisations), professionals, the private sector,
disabled individuals and their families, the general
public, the private sector, and media.
Types of Disability
A disability may be physical, cognitive, mental, sensory,
emotional, developmental, or some combination of
these. A disability may be present from birth or occur
during a persons lifetime. Disability is an umbrella
term, covering impairments, activity limitations and
participation restrictions. An individual may also
qualify as disabled if he or she has had an impairment
in the past or is seen disabled based on a personal or
group standard or norm.
The seven categories of disabilities:
visual impairment
hearing impairment
speech impairment
physical disabilities
learning disabilities
mental disorder
multiple disabilities.
22
lead article
Disability Services in Malaysia

Registration of PWDs is important to enable the
government to recognise and identify the disabilities in
order to plan and formulate appropriate programmes
for the development for persons with disabilities.
However in Malaysia this registration is voluntary and
thus small recorded numbers (only 436,317 in 2012).
In 2008 the Persons with Disabilities Act (PWDA) act
was passed in the parliament as part of its obligations
under CRPD.
The PWDA protects and promotes the rights of
PWD through registration, protection, rehabilitation,
development and well-being. The Act recognises
importance of accessibility to physical, social,
economic cultural environment, health, education and
information and communication in enabling PWDs to
fully participate in society.
As part of the Act, building by-laws were amended
making it compulsory for buildings to provide access
and facilities for disabled people. Existing buildings
were allowed three years to make the necessary
modifications to comply with these new requirements.
The National Council for Persons with Disabilities
was established in July 2008, as the provisions under
Section 3 of the Disabled Persons Act 2008. The
Council is chaired by the Minister of Women, Family
and Community Development. Its primary aim is
to monitor and implement the national policy and
plan of action relating to PWDs, and also to make
recommendations to the Government on all aspects
of PWDs (e.g. support, care, protection, rehabilitation,
development and well-being of PWDs). This council
has six committees responsible for transportation,
quality life care, registration, universal design and built
environment, employment and education.
Other services that are also available for persons

with disability in Malaysia which are mainly provided
by private and non-governmental organisations that
seeks to assist in areas such as :
Disability resource and information
Special education/ community rehabilitation
Employment training & services
Communal services
Assistive-based technology as well as devices and
equipment
Disability determination
Residential and nursing homes
Home nursing
Rehabilitation
Sheltered workshops
Disabled Persons Services by the

Social Welfare Department :
Registration of the disabled persons
Facilities and privileges for persons
with disabilities financial, equipment,
healthcare benefits, tax exemptions,
educational, transport, housing,
employment .
Job coach
Disability equality training
Community-based rehabilitation
Care centres and welfare organisation
Aid for assistive devices (actual cost);
The government continues to actively seek to work with

these charity and non-governmental organisations as
well as the private sectors to help support the various
programs for people with disability especially in the
areas of healthcare, education and employment
Disabled worker allowance of RM300 per

month for those who earn below RM1,200
per month;
The Problem: What It Means To Have

A Disability?
Launching grant of maximum RM2,700

one-off for business start-ups;
Often a person is considered disabled when a

bodily function is compromised. This usage has
been described by some disabled people as being
associated with a medical model of disability. The term
function is often used to refer to physical impairment,
sensory impairment, cognitive impairment, intellectual
impairment, mental illness and various types of
chronic disease which also extends to the eventual
manifestation of the various impairments in the aging
population too.
Financial assistance provided by the

Social Welfare Dept for PWDs are:
Special aid to the caregivers of the disabled

and chronically ill who are bedridden of
RM300 per month; and
Special aid to the disabled who are unable
to work of RM150 per month.
Persons with disabilities, the worlds largest minority,

tend to be marginalised in all aspects of life, generally
have poorer health, lower education achievements,
fewer economic opportunities and higher rates of
poverty than people without disabilities.
Studies have shown that amongst key challenges
faced by Malaysian people with disabilities at work are
discrimination and exploitation, suggesting that equal
employment and training opportunities to integrate
people with disabilities into the mainstream workforce
should be the way forward, given that they are a pool
of untapped human resources. (TA Tiun Ling, 2013).
Another by Kamarrudin et al explored the Malaysian
scenario on access and facilities for PWDs by reviewing
relevant legislation, guidelines and literatures that
examined the access and facilities provided in public
buildings . It recognized that the lack of awareness of
the Universal Design concept has resulted in the
provision of physical access and facilities for PWDs
which are not entirely to their benefit. Suggesting
further an access audit to be compulsorily implemented
by a third party in any public building in order to make
sure the effectiveness of the access and facilities
provided.
Whilst these studies highlight problems with building
designs and employment, many more bring to
light the lack of access to other equally significant
domains such as education, healthcare, information
and communications technology (ICT), transportation
and justice.
Challenges Faced By Persons With

Disabilities In Malaysia May Be
Summarised As:
1) From legislative standpoint
In Malaysia, since registration with the National
Welfare Department is voluntary, the registration
numbers are low as compared to WHO estimates,
wherein we should have 4.5 million PWD based on
15% of 30 million population instead of 436,317 as
recorded by the welfare department (2012). These
apparently low numbers pose challenges not
only in problem identification but also in service
planning and delivery.
Inadequate understanding on the requirement
of the laws, regulations and guidelines by
implementers pertaining to the needs of persons
with disabilities
Inadequate awareness on the rights and needs of
persons with disabilities among policy makers and
service providers at ground level.
Insufficient inclusion of PWD in the planning and
legislation processes
Ineffective implementation by service providers

and enforcement by the authorities.
Negative perception of the public at large
pertaining to the ability of persons with disability.
2) Person with disability perspective
Limited access to public transport leading
challenges in accessing healthcare education,
employment which often leaves the person with
disabilities with insufficient funds for personal
needs as well as that of caregiver for those who are
more severely disabled.
3) Society
Attitudinal barriers such as discriminations,
exploitation, misconceptions, poor understanding
and awareness of disability or sometimes just plain
indifference to issues that doesnt directly affect
oneself or family.
The Solution: Inclusive Society and

Development
The Convention on the Rights of Persons with
Disabilities (CRPD) recognizes that the existence of
barriers constitutes a central component of disability.
Thus accessibility and inclusion of persons with
disabilities are fundamental rights recognized by
the CRPD.
Evidence and experience shows that when barriers to
their inclusion are removed and persons with disabilities
are empowered to participate fully in societal life, their
entire community benefits. Barriers faced by persons
with disabilities are, therefore, a detriment to society
as a whole, and accessibility is necessary to achieve
progress and development for all.
So whilst there have been considerable effort and
directives from the government to its various agencies,
the continued existence of barriers to access such as
the built environment and public facilities, remains the
limiting factor to active participation of PWDs in social
and economic activities and often leaving them very
dependent on others.
Thus accessibility to education, employment,
economic opportunities, transportation, healthcare,
and community participation is all a MUST and NOT
an option. It is also apparent that legislation and
policies alone are insufficient without planned,
effectively co-ordinated implementation and service
delivery. It is clear that not only the person with
disability but the government, public sector and
society need to come together in acknowledging
and addressing the numerous challenges faced by
the PWD.
24
lead article
How Can You Commemorate IDPD
2016 In Your Local Community?
The difficulties in accessing public

transportation
Mr D, (A wheelchair user with spinal
cord injury with paraplegia), 2015
Although the government has made efforts
to be inclusive in areas of public transportation
and new wheelchair accessible buses have
been introduced in the last few years, existing
services have not been adapted nor upgraded.
Many bus and train stations are not yet fully
accessible to people with limited mobility.
Potholes, drain covers, cracked sidewalks and
curbs can all be problematic. Pavements, which
also serve as sitting areas, create obstacles for
wheelchairs. Thus traveling can be a frustrating
or even hazardous experience for a person with
disabilities. Taking a taxi is an expensive option
and seldom available as often taxi drivers
refuse to transport wheelchair users.
The celebration of International Day for Persons with
Disability here, particularly sets out as a reminder to
legislators to look back at how far have they have come
in implementing the much-needed disability friendly
laws, for the disability groups and non-governmental
organisations working together with the government
machineries to ensure appropriate enabling of access,
for the society at large to recognise and appreciate
the contributions of the people with disabilities to the
community through their work and achievements in
the area of academics, sports, business and, most of
all for the people with disabilities themselves through
community participation to get to experience the full
development of potential and self-worth through the
celebration of their abilities.
In Malaysia governmental and non-governmental
organisations such as hospitals, academic faculties,
welfare depts, disability groups, charity organisations
and even some private organisations run programs to
commemorate this event by organising conferences,
roadshows, wheel-a-thons, talent shows etc, taking
advantage of these platforms to advocate for equal
opportunities, create more awareness as well as
celebrate achievements.
This year will be particularly meaningful with the
achievements of persons with disabilities in the field
of Paralympic sports amongst others.
Include: Observance of the Day provides

opportunities for collaborative and inclusive events by
all stakeholders Governments, the UN system, civil
society and organisations of persons with disabilities
to focus on issues related to the inclusion of persons
with disabilities in society and development, both as
beneficiaries and agents of change.
Organise: Hold forums, public discussions and
information campaigns in support of the themes of
IDPD 2016 to discuss and share ways of including and
empowering persons of all abilities to develop and be
fully included in their local communities.
Celebrate: Plan and organise performances
everywhere to celebrate the contributions made by
persons with disabilities as agents of change in the
communities in which they live. Celebrate persons with
disabilities by creating opportunities to help realise
their potential, be it through music, sport, academia
or interpersonal skills.
Take Action: A major focus of IDPD is practical action
to realise the objectives of the Day for persons with
disabilities and their communities. So, highlight best
practices and think about making recommendations
to your local political leaders, businesses, academic
institutions, cultural centres and others. Work to
ensure that your activity leaves a legacy and brings
about lasting change.
It is often said that people are often not handicapped
by their disability but by their social environment,
making it clear that it is everybodys responsibility
to strive to enable persons with disabilities to live
independently and participate fully in all aspects of life
and development.
Happy celebrating International Day of Persons
with Disability 2016, making it meaningful for
someone with a disability.
References
1. Laws of Malaysia Act 685, Persons With Disabilities Act 2008. (Online
Version of Updated Text of Reprint, 1st July 2014)
2. http://www.disabilityaccessconsultants.com.au/a-disabled-friendlymalaysia/
3. http://www.who.int/disabilities/facts/Infographic_en_pdf.
4. http://www.who.int/disabilities/world_report/2011/report/en/
5. http: // www.jkm.gov.my / jkm / uploads / files / JPOKU / Kemudahan dan
Keistimewaan OKU di Malaysia.pdf
6. TA Tiun Ling, LENG Khoo Suet. Challenges Faced by Malaysians with
Disabilities in the World of Employment. Disability, CBR & Inclusive
Development.2013;24(1): 6-21.
7. H. Kamarudin, N. R. Muhamad Ariff , W. Z. Wan Ismail , A.F. Bakri , Z. Ithnin.
Malaysian Scenario on Access and Facilities for Persons with Disabilities:
A Literature Review. MATEC web of conference (2014). Article available at
http://www.matec-conferences.org
schomos
Schomos
Updates
T
25
Dr Khiritharan Mannie Rajah

Hon. Deputy Secretary,
National SCHOMOS
khiritharan@gmail.com
he month of October had two major headlines

related to the medical fraternity in Malaysia. During
the 2017 budget announcement, the Prime Minister
touched on the subject of appointing doctors on contract
basis, namely house officers.
If well executed, this move will ensure that the quality

of medical doctors improves and this will benefit the
public in the end. MOH also should inform the medical
graduates regarding the non-clinical job opportunities
available within civil service.
Contract Doctors
SCHOMOS do hope that relevant stakeholders will be

consulted in timely manner to draw the guidelines for the
above process as there is about four years for the system
to take place.
To recap the system, a medical school graduate will

be hired as a contract house officer, whereby they are
required to complete two years of housemanship, with
an additional allocation of one year taking into account
the possibility of extension. Upon successful completion
of housemanship, they will be hired as medical officers
on contract basis for two years, before being hired on
a permanent basis. In the event the contract medical
officers are not eligible to be hired on a permanent basis
due to various reasons, then they would have to seek
employment in the private sector.
Added to this system is the fast tracking of house officers,
whereby house officers who have completed part 1 of
parallel pathway (MRCP, MRCOG, etc) will be absorbed
as permanent medical officers in 16 months.
Among the pros of this system is that this will address
the backlog of house officers waiting to start work and
ensuring these doctors will have adequate training and
knowledge.
However, the question that remains on the incoming
house officers minds are whether they will still be
employed by the government at the end of their contract.
This move will be taking place at the earliest by January
2017. These measures indicate a clear signal to doctors
that jobs are no longer secure.
Also MOH must come up with clear guidelines on what
are the criteria for the house officers to be absorbed
into the civil service. The process should be transparent
and fair.
Grade UD56
Also in the 2017 budget, the government had introduced
new grade UD56 for specialist promotion. This is a good
move. MMA recommends that this position is reserved
to specialists who have served for three to five years after
gazettement before being promoted to JUSA.
For specialists who have served more than six years,
JUSA should be given as promotion.
If the specialists who have served more than six years
after gazettement are still given a promotion UD56, such
a move would not reduce the brain drain and migration
to the private sector will be inevitable. Then, the move
may be considered as another stumbling block and delay
towards JUSA promotion for deserving candidates.
For members information, SCHOMOS just submitted a
letter on latest online survey on JUSA promotion carried
out in July 2016. It was addressed to top administrators
of Ministry of Health (including the minister) and JPA.
It contained dissatisfaction voiced by many deserving
candidates who were side-lined in the promotion as
well as eligible candidates who participated in the
online survey. It also contained suggestions to make
the promotion process to be more transparent and
consistent. We hope relevant authorities will look into it
seriously as soon as possible.
26
ppsmma
8 Pillars of
Healthcare
Transformation
GPs Role
Dr Thirunavukarasu A/L Rajoo

drarasu@cahayaclinics.com
Life Member
MMA Wilayah
h e D i re c t o r G ener a l of Hea lt h
Malaysia, Datuk Dr Noor Hisham
Abdullah in a recent Meet the GPs
Dialogue organised by one of the medical
association, shared the Eight Pillars of
Healthcare Transformation. Two of the pillars
are also Harvards recommendations on
transformation agenda (strengthening PHC
and VHI):
Prevention is better than cure. The public
need to be empowered to improve and
take charge of their own health, as health
is everyones business.
Strengthening the role of primary care as

the gate keeper and the front-liner, as
we move forward to bring healthcare to
the community.
Human capital development remains at the centre of
our efforts to strengthen our healthcare system.
Optimisation of health infrastructure.
Reengineering of work process to ensure efficiency,
where we can use innovations to improve the way we
do things by looking back at how we can make things
work better, faster, cheaper, smarter and with better
outcome.
Capitalising on ICT development by making use of
the available technologies, applications, telemedicine
& social media for the benefit of health.
Public-Private partnership and integration to work
together in many facets of healthcare to collectively
improve our healthcare.
Voluntary Health Insurance (VHI) whereby it is a nonprofit based initiative, with better and longer coverage
for health. This is to ensure the sustainability of our
health system in the long run.
Prevention is better than cure

It clearly shows that General Practitioners (GPs) have
a huge role to play. Despite a lot of marketing and
campaigning on prevention is being done by various
NGOs for decades, the number of Non-Communicable
Disease (NCD) is still on the rise.
Healthcare professionals, particularly general

practitioners, provide long-term and continuous care to
patients, and often develop an ongoing relationship with
them which can lead to an increased sense of respect
and trust. Doctors are not only aware of their patients
medical conditions and concerns, but also very often the
circumstances of their lives, and that of their families.
One-to-one counselling done within the four walls of the
GPs clinics will surely bring a better result. The personal
touch and the long term doctor-patient relationship will
definitely yield better results slowly but surely. Most of
the patients are comfortable seeing the same doctor and
in some instances, the entire family medical records are
with the same family doctor. So the GPs will surely be
able to play a more proactive role in preventive medicine.
Doctors command a high level of respect and credibility in
the eyes of the public. This gives doctors the opportunity
to promote good health and prevention in the broader
community.
The forms of preventative care that the general
practitioners regularly provide include:
Immunisation at all stages in the lifespan;
Screening and early identification for:
~ healthy child development;
~ communicable diseases, particularly for teenagers

and at-risk groups, and
~
c hronic conditions, including hypertension,
diabetes, cardiovascular conditions, as well as
promotion of screening for certain cancers.
Preventative advice and counselling about general
health and specific health risks which is targeted to
the patients age, gender, family history and current
health status;
Educating patients, improving health literacy and
improving patients capacity to maintain their own
health.
Funds should be allocated to the private GPs and their
outcome should be measured and incentives given if they
can keep the population in a certain area/zone healthy.
GPs as gate keepers & optimisation of

health infrastructure
According to the MoH statistics, 90% of the primary care
clinics are in the private sector and the remaining 10%
are in the public sector. Around 80% of the cases seen
in GP practice are simple acute illness where else 80%
seen at public sector primary care clinics are NCDs. This
is the sector that the MoH would like to tap the existing
GP Clinics to manage at an affordable cost. The private
GP clinics are well distributed with a very good track
record as the gate keeper since independence. There are
more than 7000 registered private clinics compared to
1000 in the public sectors. Our biggest competitor are
the heavily subsidised MoH facilities, whereby for similar
services to those of the GP clinics only cost patients RM1
at public clinics. However, patients still choose private
facilities because of:
Re-engineering of work processes,

capitalising it & public private
partnerships
Integrated Health Information system and Tele Primary
Care should be established between the private
healthcare facility and public facilities. At the moment,
all this data are kept in silo and multiple new records are
being created in different facilities.
The public and private sector can be integrated with ICT.
Since most of the private clinics have their own clinical
management system, an IT platform or switch should be
built for the management systems to communicate with
each other.
This integration will surely reduce wastages, doctor
shopping and make the practice more transparent
and sustainable. The long waiting time to get an
appointment and to see a specialist with travelling time
can be addressed with tele-consulting. It also allows
join management of patient, real-time consulting with
concept of borderless healthcare. This will improve the
disease surveillance system by providing alert and autonotification system. The data can be used to study the
trend of the population and also the diseases.
Voluntary health insurance
The quality of care, affordability and accessibility.
While it is still at the planning stage, we strongly believe

it will be set up with foundation being Good Governance,
Accountability and Transparency not only on paper but in
practice. The GPs will surely have huge role to play by
keeping the cost low and yet maintaining quality of care.
We hope the ministry will engage the GPs via stakeholders
meeting to understand about the GP practice in terms of
costing and also the system so that it will be sustainable.
Long operating hours (after office hours, weekend

and even 24 hours)
In summary
Shorter waiting time

No appointment/walk in
Easier to get treatment by doctors
Better interpersonal quality
Clinics are well equipped more so with stricter
regulations.
Government should allocate funds for GPs to upgrade
their facilities and also to attend various CPDs to keep in
touch with the current medical development. Currently
the GPs are being burdened to upgrade their facilities
and attending this CPDs with self-funding and not to
mention loss of income when they need to close their
practices or get replacement locums while they are away.
The doctors and the clinics should be attached to the
government hospitals, and communication platforms
should be established for continuity of care. The doctors
can also be re-trained by designated hospitals in terms
of performing certain outpatient procedures and also
performing ultrasound. This will surely take the burden of
the public facilities.
At least 210,000 patients are patronising the private

healthcare clinics daily, more than 6.3 million visits
a month and 75 million visits a year. The private GP
clinics are well developed in Malaysia with a good track
record since independence, not only providing mainly
curative services and but also preventive services. The
well-distributed network of clinics can work with, and
complement, the public healthcare sector in addressing
the lacuna that exist. The data collected are scattered in
silo and need to be integrated via a healthcare information
system. More stakeholder engagement should be held
frequently to understand both the systems with a timeline
and to create a sustainable, affordable, accessible, and
equitable system while maintaining the quality of care.
As long as the foundation is based on Good Governance,
Transparency and Accountability, many more pillars can
be established successfully.
28
smmams
Walk & Roll-A-Thon 2016
he sky was clear, light blue painted the horizon. Not a sign of one or two,
big or small, white fluffy clouds, floating across the sky. And the wind,
the wind is like nothing but calm air. There were waves of participants
in pink, chattering around with each other at Laman Tiba 2, MAEPS, Serdang.
Hian Chuan Kai

Hon. Assistant Secretary
Perdana University
SMMAMS
hianck28@gmail.com
It was the first ever walkathon organised by the student representative council
(SRC) of Perdana University, together with SMMAMS known as the Walkand-Roll-athon 2016. Aimed for charity, this meaningful event was to create
awareness of cancer among medical students and the public. As such, the
money collected was fully donated to the National Cancer Society Malaysia
(NCSM).
According to estimates, there are about 90-100,000 people in Malaysia living
with cancer at any one time. The National Cancer Registry of Malaysia (NCR)
records 21,773 Malaysians being diagnosed with cancer but estimates that
almost 10,000 cases are unregistered every year. Therefore, much focus has
to be targeted to reduce the risk factors for cancer and understanding the
psychological viewpoint of cancer patient. NCSM is an important platform to
educate, care and support all cancer patients in one way or another.
Walk-and-Roll-athon was kicked off in the morning by Celebrity Fitnesss Zumba
session at 8am. Participants had a wonderful time warming up, following the
tempo of the Pop music. After a brief speech given by the director of the
bathed in a golden hue by the gentle sunlight

and the water was as clear as crystal. The breathtaking scenery captivated every participant.
event, Ms Farah, the walkathon finally began.

The desire to walk for cancer was burning in the
soul of every participant.
The MAEPS exhibition park which is one of the
largest exhibition park and showground resides
on a 130 hectares land belonging to the Malaysian
Research and Development Institute (MARDI).
Along the 5km trail, the whole landscape was
bathed in the warm glow of the rising sun. Palm
trees swayed gently in the breeze in the warm
tropical sunshine along the Perdana University
campus. The pond beside MAEPS Bistro was
Many booths were set up by the volunteers to

raise funds for cancer. Some of the examples
were Rat Race which is sort of like an amazing
race, cupcakes decorating competition, colouring
contest, face painting, henna drawing and creative
poem writing competition on cancer. Apart from
that, there were also singing performances
presented by students simultaneously going
on. SMMAMS had a booth near the entrance of
the event hall and some medical students were
enthusiastic enough to join as member, while
others were enquiring about the upcoming
conferences and interesting events by the MMA
or SMMAMS.
The walkathon was coming to an end when the
sun climbed towards its zenith. Wonderful prizes
were given away to the winner for each event
as well as to the lucky draw winners. Before the
end of the event, everyone was reminded by
Ms Indira Menon, the Marketing Director from
National Cancer Society Malaysia (NCSM) to be
mindful of cancer patients who require love, care
and support both physically and emotionally.
30
general
Seminar: Career Pathway

for Medical Graduates
T
Datuk Dr Athimulam Nadason
Chairman
Medical Education Committee
Life Member
MMA Melaka
he MMA Committee on Medical Education is organising for the 8th time

a seminar for the benefit of medical graduates and medical students. We
have invited the best speakers of different specialities to highlight the
masters programs and whether there is a demand for such specialities in public
and private sectors. The keynote address will be given by Dato Dr Haji Rohaizat
bin Hj Yon, Deputy Director of Medical Development Division, Ministry of Health,
and he will narrate the current situation of medical specialities in Malaysia and
in which there is a demand and where it is surplus. He will speak on the courses
offered locally and overseas for sub specialities.
The chief guest will be YB Dato Seri Dr Hilmi Bin Haji Yahaya, Deputy Minister
of Health. There will be some eminent speakers talking on recognised overseas
specialist courses.
The chairman of the committee is Datuk Dr Athimulam and members are
Dato Dr P Vijaya Singham, Assoc Prof Dr Chandran Rajagopal, Dr Tharmalingam,
Dr Liew Boon Seng, Dr Thevaraajan Jayaraman, and Prof Dr Selvam.
The Seminar will be held on Saturday, 15 April 2017 from 8.30am 5pm at Hotel
Grand Season, KL. There will be also a panel discussion.
The registration fee is RM130 for MMA members and RM150 for non-members.
For further details, please contact Ms Jasmeet Kaur at medic_edu@mma.org.my
or call 03-4041 1375.
32
general
National Symposium on
the Right To Health
Dr Rosvinder Singh
Medical Official
Social & Preventive Medicine Department
University of Malaya
Kuala Lumpur
salukan@hotmail.com
he MMA Committee on Health and

Human Rights was formed consequent to
a resolution passed at the 39th MMA AGM
in Penang (1999).
Presidents for information. This will also be made

available on the MMA website.
This year the committee is having a stakeholders
round-table forum to capture and prioritise issues
related to the right to health. Members of the
committee 2016/17 are Datuk Dr Teoh Siang
Chin (Chairman), Dr Mary Suma Cardosa, Dr
Kasturi K I Maniam Nair, Dr Sharon Gopalan, Dr
Kamalanathan Sappani and Dr Thong Kok Wai.
The name was changed to MMA Committee on

the Right to Health at the Miri AGM to reflect and
align with global trends and nomenclature.
We hope that all members of the MMA will be

aware and interested in the issues raised and
hopethey can be an advocate for the RTH intheir
daily professional and personal activities. A brief
report is presented by Dr Rosvinder Singh.
In April 2016, the committee headed by the past

chair Assoc Prof Dr Xavier V. Pereira organised
a symposium which featureda faculty of
distinguishedand experienced speakers.
Right to health are we there yet?

A reflection of a young mind.
Although it could have been better,the quality of

the presentations and passionate andreasoned
debate made the sessions interesting and
significant.
We have alsocapturedan in-depth report which
will be circulated to MMACouncil and Past
More than half a century ago the milestone

Universal Declaration of Human Rights became
the benchmark of an individuals right to attain the
highest standards of health care. Right to health
is acknowledged as an obligation under the
international human rights convention. A rapidly
developing country such as Malaysia has been
an advocate of universal health coverage. Since
Panelists from left: Dr Thong Kok Wai (Malaysian Physicians for Social Responsibility, MPSR), Dr Shaari bin Ngadiman (Ministry of Health),
Mr Richard Towle (United Nations High Commissioner for Refugees, UNHCR), Datuk Dr Khaw Lake Tee (SUHAKAM) and
Assoc Prof Dr Xavier V Pereira
Following this was the highlight of the symposium

which was the panel forum discussion on the
population with health vulnerabilities. A panel
representing various NGOs, WHO, as well as the
Ministry of Health chaired the forum. Four major
population groups with health vulnerabilities
were addressed, their plights highlighted and
discussed by different speakers representing
each of the group of population.
YB Dr Jeyakumar Devaraj
independence there has been a tremendous

change in the landscape of health care provision
in Malaysia. Vast improvement has been achieved
in terms of access, health care cost and latest
technologies and services. Despite the progress,
the question of equity and quality of health care
services has always been put forth to the service
providers, legislative bodies as well as policy
makers.
On 23 April 2016 a great initiative was taken
by the Malaysian Medical Association (MMA)
to organise a symposium to address this issue,
and to enlighten stakeholders on the concern
revolving around the Right to Health. The full
day symposium held at Sunway Putra Hotel,
Kuala Lumpur was attended by many experts
from NGOs such as WAO (Womens Aid
Organization), PT foundation and the Centre for
Orang Asli Concerns (COAC), representatives
from the Ministry of Health, WHO, UNHCR and
Bar Council as well as medical professionals.
The day started with the introduction in to
the history of health rights and speakers from
the law and medical fraternity highlighted the
rights of patients as well as the responsibilities
of the physicians. The session continued with the
WHO representative presenting on the universal
health coverage and the achievements of it in
Malaysia.
The event was officiated by YBhg Dr Shahnaz
binti Murad, Deputy Director General of Health
(Research and Technical Support). She addressed
the key issues among the marginalised population
in the context of right to health.
The vulnerable population and the plights of

each was discussed as below:
i) Migrant population issues and the plight
of migrant workers has long been highlighted
in Malaysia. The existing problem faced by
the country is the influx of undocumented
migrant workers. Their access to existing
health care services is an issue to be looked
into. Most of these migrant workers originate
from countries that have high prevalence
of infectious diseases such as Tuberculosis.
Statistics from the National Respiratory
Institute has also shown the rising number
of recorded MDR (multi-drug resistance) TB
among the migrant population. Another
population that is co-existing among us are the
refugees fleeing dangerous territories seeking
protection in Malaysia. The health protection
that is provided to this sub-set of population
is a question for concern. The recent policy
directives that has increased the health
care costs for the migrant population is of a
major worry. The increased cost of healthcare
services for the migrant population will have
an impact on their health-seeking behaviour;
of particular concern is the possible negative
repercussions on the local population as
migrants with untreated infectious diseases
could be walking the streets or sharing spaces
with us. While the National Respiratory Institute
still advocates and provides free medications
to migrants infected with tuberculosis, there is
still a grey area where there may be a conflict
with the existing policy directives; there is
also the question of how well the information
is disseminated to the affected migrant
population. Health screening and health care
34
general
protection of undocumented migrant workers

is also another alarming area to look into. The
welfare of migrants who suffer from industrial
injuries is often neglected which results in
deportation and tremendous psychological
impact. Overcrowding and poor living
conditions of these migrant workers has been
highlighted several times. The question was
raised as to the accountability of employers
and enforcement by the relevant government
bodies in guarding the welfare of these
migrant workers, many of whom perform
jobs in the 3D (dangerous, difficult and dirty)
sector.
ii) Lesbian, Gay, Bisexual, Transgender (LGBT)
The marginalization, criminalization and
selective prosecution of the LGBT population
has been making the headlines in recent
days. The demonizing effect this has on the
LGBT population has been hampering the
efforts of outreach programmes to spread
the awareness of HIV and other STDs, as
well as safe sex practices. The opinion of the
representative of the Ministry of Health was
that the right to health of this subpopulation
was not an issue and healthcare services
are very accessible to them; but health
practitioners and LGBT activists differed in
opinion about this. The question raised was
whether the medical fraternities and the
legal bodies failed to educate and spread
the awareness of what constitutes the LGBT
community and how the biological and
physiological changes form the individual?
This community had to be approached with
sensitivity and understanding; acceptance
and acknowledgment would play a major role
in driving a positive health attitude among
the LGBT population.
iii) Mental Health A rapidly growing problem
among populations around the world as
well as Malaysia is mental health illness. A
prediction and a projection of mental health
problems has shown that by 2030 it could be
the number one cause of morbidity around the
world. The community-based treatment and
rehabilitation approach is gaining momentum
around the country. The reduction of beds and

duration of stay at the government mental
hospitals is evidence of the success of this
community-based rehabilitation. However,
the stigma towards the mentally ill patients
is still a matter of concern which drives
patients to suppress their issues and hinders
them from seeking help and treatment. An
approach of mental health services that are
more confidential and less stigmatizing and
provision of stress management or counselling
should be extended to the other vulnerable
populations such as migrant workers and
refugees could be the way forward in dealing
with this population.
iv) Orang Asli The indigenous population
has been an important part of Malaysian
history and development; they tell of the
story and origins of people from this region.
The government over the years has taken
much effort to approach and provide the
community of indigenous people with
the basic necessities in life. Health care is
also widely available for this subset of the
population, however the issue of accessibility
and trust towards the health care services
had always been a battle. As urbanization
takes its course, more and more indigenous
populations are losing their homeland which
affects their daily routines and livelihoods. This
group of people should be approached from
a multidimensional perspective, by gaining
their trust and improving infrastructure in
terms on transportation or outreach programs
without damaging their delicate ecosystem.
In conclusion, the right to health is a necessity
to every living human being. There are several
vulnerable population groups who deserve equal
rights when it comes to provision and access
to healthcare. Health care services in line with
universal health coverage should be restructured
to be highly accessible, affordable, available,
acceptable, and lastly, non-discriminatory. An
overall coverage of the entire population can
prove to be a global good for the nation and
minimise the barriers to achieve a healthier
society.
general
Humour
35
Compiled by,
Dato Wira Dr LR Chandran and
his team of jokellectuals, Alor Setar
Till Death Do Us Part?

On their way to get married, a young Catholic
couple was involved in a fatal car accident. The
couple found themselves sitting outside the Pearly
Gates waiting for St. Peter to process them into
Heaven. While waiting they began to wonder could they possibly get married in Heaven?
When St. Peter arrived, they asked him if they
could get married in Heaven. St. Peter said, I
dont know. This is the first time anyone has
asked. Let me find out, and he left.
The couple sat and waited for an answer for
a couple of months. While they waited, they
discussed at length, the pros and cons if they were
allowed to get married in Heaven. Should they really
get married? What would happen with the eternal
aspect of it all? What if it doesnt work?
Are we stuck in Heaven together forever?
the couple wondered.
Another month passed. Then, St. Peter finally
returned, looking somewhat bedraggled and
confronted them.
Yes, he informed the couple, You can get
married in Heaven.
Great! said the couple. But we were just
wondering, what if things dont work out?
Could we also get a divorce in Heaven?
St. Peter, red-faced with anger, slammed his
clipboard on the ground.
Whats wrong? asked the frightened couple.
OH, COME ON NOW!!!
St. Peter shouted. It took me
three months to find a PRIEST
up here! Do you have ANY idea
how long itll take to find a
LAWYER?
Mechanic vs Cardiologist
Ah Chong, a mechanic, was removing a cylinder
head from a Harley-Davidson when he spotted
his regular customer, a heart surgeon. Feeling
cheeky, Ah Chong shouted, Hey Doc! Can I ask
you a question?
Surprised, the doctor walked over to Ah Chong
who straightened up, wiped his hands on a rag
and asked, So Doc, look at this engine. I also
can open hearts, take valves out, fix em, put in
new parts and when I finish this will work just
like a new one. So how come I work for kacang
putih while you get the big bucks? You and I are
basically doing the same work what!
The doctor just smiled and whispered to Ah
Chong, Try doing it with the engine running.
__________________
Mechanic vs GP
A GP was complaining to Ah Chong, Your fee
costs more than what I make per consultation.
Ah Chong shrugged and replied nonchalantly,
Ya-lah doc, but you only have to work with the
same model which hasnt changed since Adam.
We have to keep up-to-date with all the new
models from different makers.
__________________
Overheard at a Dentists
Patient: How much did you say it would cost
for a tooth extraction?
Dentist: RM200.
Patient: What? RM200 for a few minutes
of work?
Dentist: Well, I can pull it out very slowly if
you like.
36
branch news sarawak
Batang Ai Medical Camp

Dr Yiaw Yeong Huei
yiawyh@live.com.my
Life Member
MMA Sarawak
The first sampan to cross the river! The person sitting in front of the green T-shirt boatman
was the head of the second longhouse.
he Batang Ai Medical Camp (24-25 Sept 2016) is a life experience that I shall
never forget!!
A week before the camp, my colleague shared a WhatsApp message stating that
a thrilling adventure awaits at the rural medical camp. I was quite worried when
I signed up as Batang Ai is situated deep in the jungle and is difficult to access.
On the first day at 8.00 am sharp, we all gathered at one of the organisers home.
Everything else that happened after that was the first in my life. There were five
4WD cars parked along the roadside filled with camping equipment as well as
cooking utensils. Here, I met new friends, the warriors namely Dr Aliyah and
two medical students, Rajeev and Caroline.
After a three-hour journey, we arrived at the first longhouse, Kesit. This longhouse
is made of wood and bricks. The people were friendly and welcomed us with a
hearty lunch. The dental team joined us here to serve the villagers. We did health
screening for a total of around 40 villagers. Most of their problems were gastritis,
headache, muscle ache and upper respiratory tract infection. We spent a fruitful
afternoon which ended with broad smiles from everyone.
The true expedition started after a 30-minute car ride from the first longhouse,
when our 4WD cars turned into a side road which was actually a pathway to
transport logs from the logging camps. It was a dusty, rough and bumpy ride
past several hills and valleys. We finally reached our final destination, Kampung
Stamang which is surrounded by the beautiful Borneo rainforest with a river
flowing through the jungle.
Part of the medical team in the midst of setting things up.
Almighty Batang Ai Medical Camp convoy. All cars are equipped

with radio communication gear.
who had a painful swollen left elbow for the last

two months. Even though she had to use a walking
stick, she still worked in her pepper farm. She told
me of the difficulty in getting medical care as the
nearest Healthcare Centre with an X-ray facility is
2-3 hours boat ride away and the journey is too
strenuous in her frail condition. Another villager
told me that very ill family members would just
succumb on the longboat as they travelled to
seek medical treatment. It brought tears to our
eyes when we heard such heart-breaking stories
and made us resolve to serve them better.
Night clinic session.
The generator came to a

stop at 11pm, plunging
us all into darkness. The
illumination of the stars in
the clear night sky was a
sight to behold. We even
saw a few falling stars
passing by and made
wishes for ourselves and
the longhouse dwellers.
There is a clinic situated

right opposite the
longhouse. This 41-door
longhouse was built 15
years ago, complete with
floor tiles and modern
toilets. To reach the
longhouse, we had to
take a short journey on
The next morning, we
a traditional longboat.
left the longhouse after
We were invited into the
a light breakfast. Saying
longhouse by the Tuai
goodbye was not easy but
Rumah and welcomed
we learned an important
The children in the longhouse queuing up for some snacks.
with the Iban traditional
lesson from this visit
dance Ngajat while
A P P R E C I AT I O N . T h e
waiting for our dinner. The friendly villagers invited us
friendship, experiences and motivation gained were
to join them in the dance. It was fun!
invaluable.
At 9.00 pm, we started the second round of health
screening for the villagers. We checked the blood
pressure and glucose level for the villagers. One patient
that I will always remember was this 80-year-old lady
Today, Give A Stranger One Of Your Smiles,

It Might Be The Only Sunshine He Sees All Day
Quoted inP.S. I Love You, compiled by
H. Jackson Brown, Jr.
branch news wilayah
38
KL to Chiang Mai
Arrival at Chiang Mai
e started our journey on 18 Nov 2016 morning at KLIA. There

were 30 in our group including the Travel Company Manager
who joined us on this trip to Chiang Mai/Chiang Rai. The group
ranged from six-year-olds to 70-year-olds. It was the very first overseas
trip organised by MMA Wilayah.
Day 1
Dr Ravi Venkatachalam
Organising Chairman
Treasurer
MMA Wilayah
ravimahes@gmail.com
and
Dr Balachandar Krishnan
Co Organising Chairman
PPS Chairman
MMA Wilayah
drbala.7181@gmail.com
As soon as we landed at the Chiang Mai Airport, we were given a warm

welcome with jasmine flower garlands. Immediately, we were brought
to a traditional Thai lunch, after which we visited the famous Doi Suthep
Mountain temple. Though we could have climbed the 309 steps to the
temple, the majority opted to ride the funicular train to reach the temple
grounds. Within the site are pagodas, statues, bells, a museum, and shrines
around a magnificent golden Stupa. Many aspects of the Wat (temple)
draw from boththe BuddhismandHinduism culture. There is a model
of theEmerald Buddhaand a statue of the Hindu GodGanesh as well.
City views of Chiang Mai from the top of the temple were beautiful and
we took lots of snapshots. It gets dark at about6pmand we proceeded
to a Cultural Thai Dance show cum Khantoke Dinner. The dinner was
served on Khantoke trays which are short round tables with legs made
from wood, hence the name. The Lanna (Northern Thailand) people eat
glutinous rice which is sticky, sweet and waxy. We enjoyed dining on
this new menu while enjoying the cultural dance show. Our hotel was
right beside the night bazaar, which was rather

convenient for many of us. Some would rather
visit the local pubs and others went for traditional
foot massages.
Day 2
After breakfast, we proceeded to visit
the Mae Teng Elephant Camp which
was an hours drive away. There were
plenty of activities arranged for this
day. The able ones did bamboo rafting
and it was a very thrilling experience
when a few of us were given the
opportunity to steer the raft through
the calm river waters. Then we went
for the famous elephant show where
we saw a couple
of really
talented
elephants
p a i n t
impressive
paintings. The
paintings were
later sold with
the proceeds going toward
the elephant conservation
efforts. After a buffet lunch at
the camp, the following activity
was a rather bumpy ride on an
elephant where it crossed the river and walked
us through the river, up a hill and down the hill as
well. It brought us to the long neck tribal village
where we saw the womenfolk having long necks.
These women are small-time entrepreneurs and
most of us bought souvenirs from them after some
bargaining. From there, we took a bullock cart
ride back to the exit. The next stop was a snake
show which was quite wild and interesting. A few
of us who disliked snakes opted to stay away.
The monkey show at the next spot was equally
interesting. Then at the Orchid and Butterfly
Farm, everyone enjoyed the lovely sight of the
orchids and their myriad colours, shapes and
sizes. Some were trying to catch the butterflies
but were unable to do so. Our last stop was
to the 3D Museum. This was a very impressive
place with really realistic paintings. There were
two young children in the group who had the

greatest fun by posing for photos everywhere.
After that, we were taken to a nice Thai Restaurant
for our dinner where we had the famous Ruby
Chestnut dessert. Back to the hotel and after
freshening up, we went off on our own in many
directions for foot reflexology, night bazaar
shopping, etc.
As I was returning to the
h ot e l , t h e re ce p ti o n i st
rushed me to the room of
another member, Dr Bala
Raja Senathirajah, who was
having difficulty in breathing
and apparently, his roommate
had already called for the
ambulance. Within minutes, the
ambulance arrived and took Dr
Bala Raja to a private hospital in
Chiang Mai. Unfortunately,
he went into cardiac arrest
and CPR commenced, but
he was unable to be revived.
We sadly paid our last
respects to Dr Bala Raja,
informed his relatives, did
all the necessary paper
work and formalities were
arranged as per the travel
insurance. It must have been Dr Bala Rajas
unspoken wish when joining the family trip, as
the MMA Wilayah family was there to attend to
his needs during the last hours of his life. May his
soul Rest In Peace.
Day 3
We proceeded to check
ou t a f t e r b re a kf a s t ,
and we announced Dr
Bala Rajas sad demise
and said a minute of
prayers in silence
before continuing
our journey to Chiang
Ra i wh i ch i s a b ou t
a t h re e -h ou r d r i ve
away. Though this was
Dr Bala Raja passed away on

20 Nov 2016 at Chiang Mai
40
branch news wilayah
unexpectedly sad moment, we took it

in a positive sense as we felt Dr Bala
Rajas wish to be in the extended family
environment came through in the last
moments of his life.
En route we stopped over at Mae Kajan
hot spring where all of us had a chance
to dip our feet and legs in the nice hot
stream, we then proceeded to Chiang
Rai town. A must-stop attraction is
the famous White Temple. The White
Temple is also known as Wat Rong
Khun, a unique temple that stands out
because of its distinctive white colour
and the use of pieces of glass in the
plaster which causes it to sparkle in
the sun. The white colour signifies the
purity of the Buddha, while the glass
symbolises the Buddhas wisdom and
the Dhamma, the Buddhist teachings.
At dusk, we reached the Thai-Burma
(Mae Sai) border and walked up to the
border. Here, we can find bazaars full
of gems, precious stones and detailed
jewellery. Our final stop was the Golden
Triangle (Thai-Laos-Burma) border in
the late evening where we enjoyed
the fresh cool breeze by the river-side.
We continued to the hotel for dinner
and had fellowship night in one of
the rooms.
The long neck tribal village
3D Museum, Chiang Mai
Day 4
The final day of our trip was free and easy, so everyone
woke up leisurely and gathered around the breakfast tables
and had long chit chats. The resort had a good ambience
which rubbed off on us. We had a closing speech by the
Organising and Co-Organising Chairman, followed by a
few members who wanted to share their experience and a
couple of song performances in the coach before reaching
Chiang Rai Airport. We had to transit at Bangkok Airport
before reaching our tanahair, Kuala Lumpur. Well, we
sure made lots of memorable moments and had lots of
cherishing as well as sad moments during the journey.
Dr Ravi Venkatachalam, his wife Maheswary, their daughter Aishwarya

& Dr R. Ravindran with his daughter Prassena
Chiang Rais
wer
golden clock to
Hot s
pring
White Temple
Dato Pahwalan
Mohanadas &
Datin Thilaga
Singh
r Jastur
tam Kau
& Dr Pri
Dr K Balachandran
& his wife Uma
thana
Chandrava
Dr Selvarajah Sathaya & Dr
Dr Krishnan Meno
n & his wife Geeth
a Nair
Wat Phra That Doi Suthep

42
branch news wilayah
MMA Wilayah
Installation Night 2016
MMA Wilayah Branch. From left to right: Dr Thana, Dr Krishnan, Dr Saravanan, Dr Ravi, Dr Katheeja, Dr Koh, Dr Selvarajah, Dr Balachandran,
Assoc Prof Dr Sanjay Rampal, Dr Hardip, Dr Thirunavukarasu
es, it is that time of the year again. MMA Wilayah

Persekutuan (WP) Branch recently hosted its Annual and
Installation Night 2016 on Saturday, the 15 October 2016.
The full house event kicked off at 1830 hours and ended at
midnight. Certainly, medical professionals do not practice what
they preach when it comes to an early bed time!
Dr Hardip Singh Gendeh
hardip88@gmail.com
Committee Member
MMA Wilayah
~~~
The annual event kicked

off with merriment and
camaraderie followed
by feasting
~~~
The evening affair that hosted 250 guests was held at the Corus
Hotel, Jalan Ampang with dinner prepared by the well-liked
Ming Room. It was a nine course Chinese cuisine for our taste
buds to savour. The evening was attended by senior and junior
medical professionals from hospitals and community-based
medical services. Members of the healthcare industry, family,
friends and healthcare volunteers were also present to share in
the merriment.
The MMA WP Branch would like to extend its heartfelt thanks
to the many organisations that have supported our night and to
all guests for making it a memorable one. Also

present were President of the MMA Dr John
Chew Chee Ming, Immediate Past President Dr
Ashok Zachariah Philip, and President Elect Dr
Ravindran Naidu.
The chief guest was Dr Wan Mansor, the acting
State Director of Jabatan Kesihatan Wilayah
Persekutuan (JKWP), who represented the
Ministry of Health Malaysia. Dr Mansor in his
speech touched about the implementation of
E-House Office for a more transparent house
job application and also the engagement of the
Ministry of Health with MMA on the Fee Schedule
which should be in the final stages of approval.
The MMA Wilayah Branch chairman, Dr Thana
Sehgaran was draped with the presidents medal
from outgoing chairman Associate Professor
Dr Andrew Tan Khian Khoon. In his inaugural
speech, Dr Thana thanked Associate Professor
Dr Andrew and the previous committee for
their contributions to the branch and called the
2016-2017 working committee to the stage to
complete the installation.
The evening provided a platform for many
healthcare professionals to share their wisdom
and opinion, besides discussing issues pertaining
to the healthcare industry over dinner. Among hot
topics discussed were taxation issues in relation
to healthcare professionals, healthcare costs,
and the training and welfare of junior doctors
in Malaysia. Despite its seriousness, discussions
were jolly, buoyant and cheery with the flare of
merriment. The band, music machine, lucky draws
and on-stage performance led us to midnight!
With the annual and installation night over, the
countdown has already began for the next MMA
WP Branch events; namely the MMA WP family
trip and its 13th Primary Care Symposium (PCS)
that will take place on 18 19 February 2017.
See you there!
44
branch news negeri sembilan
Road to Future, 2016
SCHOMOS committee members with Datin Dr Fadzilah Hasan

Standing (left to right): Dr Farhana, Dr Sentilnathan, Dr Ashok, Dr Tang Jeat Liang, Dr Jonathan, Dr Vidyamalini
Sitting (left to right): Dr Selvaganapathi, Datin Dr Fadzilah Hasan, Dr Prasannah
D
Dr Vidyamalini
r.vidyamalini@gmail.com
Member
MMA Negeri Sembilan
ecisions! Decisions! Decisions! In life there are many decisions to be taken by

each one of us and our medical field should not be forgotten. As a doctor,
there comes a time when we will have to decide our future career paths
and how to progress, more so if one is a young doctor who has just started his
or her journey in this field. Hence, SCHOMOS Negeri Sembilan committee came
up with an idea to have a program to enlighten these young doctors on ways to
pursue their dreams and choose their career pathways and we named it ROAD TO
FUTURE 2016.
This one-day event event was held on 4 October 2016 at Auditorium Gemilang,
Hospital Tuanku Jaafar Seremban. Road To Future was directed mainly for house
officers and junior medical officers who were still undecided and confused about
their future. Invitations were sent out to the district and tertiary hospitals and
primary health care clinics. Approximately 80 participants mostly comprising of
house officers and even several IMU medical students attended the event.
The event started off with registration at 8am. Our MMA Negeri Sembilan ViceChairman, Dr Andrew Solamadan, was at hand to welcome our guest of honour,
Dr Ariffin Bin Mohamad, the Director of Hospital Tuanku Jaafar, Seremban.
Dr Ariffin then proceeded to deliver his welcome speech which was very informative
as well for the participants. Next, Chairman of Negeri Sembilan SCHOMOS,
Dr Selvaganapathi gave the audience a brief introduction about SCHOMOS MMA
and its benefits.
Without further delay, the event took off with the topics we had planned for the
day. They included talks on how to approach and prepare for the local Masters
programme by Dr Sentilnathan (third year Surgical Master medical officer) and
Datuk Dr Hj Rohaizat (Senior Deputy Director of Medical Development Division)

seen interacting few participants. With him is Dr Selvaganapathi Ganeson,
Chairman of SCHOMOS NS
Dr Ariffin Bin Mohamad, Director of
Hospital Tuanku Jaafar, Seremban
Dr Andrew Solamadan, Vice Chairman of MMA NS presenting the

token of appreciation to our guest of honor
available alternative pathways to pursue a career in the medical

field by Datuk Dr Hj Rohaizat (Senior Deputy Director of Medical
Development Division). A brief introduction was given on the
medicolegal aspects of medicine by Datin Dr Fadzilah Hasan
(MMC member) who is also the Chairman of PPS MMA NS, and
last but not the least, an introduction to clinical research by Mr
Mahadevan Deva Tata (Head of Negeri Sembilan CRC). The
crowd stayed enthusiastic throughout the talks.
Mr Mahadevan Deva Tata, Head of CRC

Negeri Sembilan
At the end of the event, all participants were satisfied with the
information obtained. The participants went back with a better
understanding about their future careers. As the organising
committee, we were thrilled that the event was a huge success.
The event also saw several new membership signups for MMA
NS. We hope to make this as an annual event for SCHOMOS
MMA Negeri Sembilan.
46
mark your diary
YEAR 2017
JANUARY
WATTZUPDOC SYMPOSIA SERIES ON PRIMARY CARE
MEDICINE
Date
: 21 22 January 2017
Venue : Le Meridien Kuala Lumpur
Contact : Ms May / Jess
+6012-638 8128/+6012-631 3436
Email
: clev.info@yahoo.com
February
13TH PRIMARY CARE SYMPOSIUM MMA WILAYAH
PERSEKUTUAN BRANCH
Date
Venue
Contact

Email
Website
: 18 19 February 2017

: To be confirmed
: Dr Selvarajah +6019-387 5767
: Miss Josephine +6016-223 8079
: mmawilayah@yahoo.com
: mmawilayah.org.myw
Medical Certificate in Clinical Hypnosis

Date
: 25 February 2017
Venue
: Medical Faculty, University of Malaya, KL
Tel
: +603-7960 6449 / +6011-2662 4623
Email
: nfo@hypnosis-malaysia.com
Website : www.lcch.asia
MAY
7th ICOH Cardiovascular Diseases and Work
Environment International Conference
Date
: 3 5 May 2017
Venue
: Varese, Italy
Organiser: ICOH Scientific Committee on Cardiology (SCC) in
Occupational Health
57th mma agm
Date
Venue
: 18 21 May 2017

: St Giles Hotel Penang, 183, Jalan Magazine, 10300
Georgetown, Penang
Contact : Dr Hooi Lai Ngoh (Co-Organising Chairman)
Tel
: 04-2266699, 2270376, 2276318
Fax
: 04-2292379 (office hours) and 04- 2294940 (all hours)
Email
: 57agmmma@gmail.com
July
12th Liver Update 2017
Date
Venue
: 20 23 July 2017

: Connexion Conference & Event Centre,
Bangsar South City, Kuala Lumpur.
Contact : Dr Kanchana Devi Ayasamy
Organiser : Malaysian Liver Foundation (MLF)
Tel
: +603-7842 6101 Ext 305
Fax
: +603-7842 6107
Email
: kanchana@loveyourliver.org.my
SEPTEMBER
April
ENDOSCOPY 2017
Date
: 7 9 April 2017
Venue : 13th Floor, Menara Selatan, UMMC, Kuala Lumpur
Organizer: MSGH
9TH MMA SABAH PRIMARY CARE CONFERENCE
Theme : Expanding the Horizon of Primary Care
Date
: 22 23 April 2017
Venue
: Grand Ballroom, Pacific Sutera, Kota Kinabalu
Organiser : MMA Sabah Branch
Contact : Ms Elsie / Florita
Tel
: +6012-805 5009 / +6016-838 0769
Email
: mmasbhgpc@gmail.com
Inaugural World Congress in Anti-Aging,
Aesthetic, Regenerative, Nutritional and Exercise
Medicine (WAAARNEM)
Date
: 28 30 April 2017
Venue : Sheraton Imperial Kuala Lumpur
Contact : SAAARMM Secretariat: Jessie/Vani/Victoria
Organiser : 14th Malaysian Conference and Exhibition &
7th International Congress on Anti-Aging,
Aesthetic and Regenerative Medicine
Tel
: +603-4041 0092/+603-4041 6336
Fax
: +603-4042 6970/+603-4041 4990
Email
: info@saaarmm.org
5TH ASIA PACIFIC CONFERENCE ON PUBLIC HEALTH

Date
: 10 13 September 2017
Venue : Riverside Majestic Hotel, Sarawak
Organiser: College Of Public Health Medicine,
Academy Of Medicine Malaysia
NOVEMBER
10th International Joint Conference on
Occupational Health for Healthcare Workers:
Date
: 28 30 November 2017
Venue : Khon Kaen, Thailand
Website : www.ohhcw2017.org

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December 2016

Berita MMA Vol. 46 No. 12

(For Members Only)

Persons with Disabilities

MMA EXECUTIVE COMMITTEE

From the Desk of the Hon. General Secretary

From the Hon. General Treasurer

World Medical Association

Call for Nominations (2nd Announcement)

International Day of Persons with Disabilities 2016

8 Pillars of Healthcare Transformation GPs Role

Walk & Roll-A-Thon

Seminar on Career Pathway for Medical Graduates

National Symposium on the Right To Health

Editorial Board Members

MMA Sarawak: Batang Ai Medical Camp

MMA Wilayah: KL to Chiang Mai

MMA Wilayah: Installation Night 2016

MMA Negeri Sembilan: Road to Future, 2016

Mark Your Diary

VersaComm makes no guarantees or representations whatsoever

beritaMMA Vol.46 December 2016

Dato Pahlawan Dr R. Mohanadas

anners of such nature

beritaMMA Vol.46 December 2016

Some of us who had the opportunity

Unfortunately, we lost a colleague,

A good person can make

beritaMMA Vol.46 December 2016

exco presidents message

he month of November saw the surprising election

Second WVA-WMA Global Conference on

Dr John Chew Chee Ming

in Kitakyushu, Fukuoka, Japan. The inaugural conference

beritaMMA Vol.46 December 2016

exco presidents message

Other highlights were the projects by Japan International

Antibiotics Awareness Week 2016

antimicrobial resistance would cost globally 10 million

21% of encounters resulted in antibiotics being given

The traditional way of empirical antibiotic usage would

From the Desk of the

Dr Koh Kar Chai

President of CMA with MMA Exco

he Malaysian Medical Association was

Visit to MMA by Prof Dr Vajira

beritaMMA Vol.46 December 2016

9.00am: Not a chance for the office

HGS with SMMAMS, MMMC and MMA Melaka

Another point to note is that it may not appear in

beritaMMA Vol.46 December 2016

of the Malaysian Medical Association, including

Sole Proprietorship of a Private

beritaMMA Vol.46 December 2016

up of a clinic as a sole proprietorship. Many

Nursing Manager (With Post Basic Qualification)

Nursing Supervisor (With Post Basic Qualification)

Please send CV, certificates, testimonials and photo (n.r.) to:

Berita MMA Editorial Board Policy

beritaMMA Vol.46 December 2016

From the Hon. General

t was a proud moment for me taking over the office of Hon

Its my promise that I will be honest in performing my duties and

~ communicable diseases, particularly for teenagers