Dr. Cheah’s Pages

Rape : Are we on the right track?

We have sadly seen a dramatic increase in the number of rape cases. Some are random victims while others are members of their own family. But what is the psychology behind such actions? On most occasions , only the rapist would know.

However, in most cases especially those involving family members , there are always warning signs. For example, unwanted advances etc. Some blame it on the provocative dressing by females. I believe that this is a spectrum of sexual dysfunction. We have to recognise it and treat it as a disease.

Most sex crimes are done by repeat offenders. This occurs due to the failure of the system to help these individuals. Most are only eager to banish them to lengthy prison terms. None would really offer them proper treatment and counselling especially after their jail term.

Of course, in such crimes, the individual that suffers most is the victim. Most are scarred for life, physically and emotionally. Only time will be the best healer under such circumstance. There is no word that could describe the pain that they have to endure.

There is no excuse to rape. It is a violent and despicable act. The inability to control ones hormones appears to the sole cause of such heinous crimes.

Once again, education plays an important role. Educating males to respect their female counterparts is essential. Chaunivinistic mentality should be discarded. Women should not be portrayed especially by the media as sex objects. But ultimately, the most important element is to educate males on how to cope with raging testosterone levels and the recognition of abnormal urges. They must know where to seek help. Help that guarantees confidentiality.

There is no easy answer. But we now have a problem in our hands and something needs to be done before more souls are hurt.

Meritocracy?

From Malaysiakini,

Meritocracy is still a hot topic for debates. There is certainly much controversy with regards to the selection of students. The discrepancy in standard between the matriculation and STPM appears evident despite vehement denials by the education authorities that they are of equivalent standard. But it is clear that these 2 systems are bound by different rules, curriculum and examination standards. If they are of the same standard, then why have 2 systems? Why can’t all students be measured by the same examination?

I think the answers are pretty obvious. The quota system still exists but has been “discretely” disguised. Imagine a 5A STPM student cannot qualify to do medicine. I can almost bet you that there will be many matriculation students with inferior scores getting into medicine. The Government often laments on the brain drain occuring in Malaysia. Unfortunately , they are not doing the necessary things to stem this trend. I am sure a student of Murali’s calibre will be quickly snared by other countries, in particular Singapore, which recognises talent.

Malaysia is still pretty much segregated racially and this divide is set to widen even further. We must not fool ourselves into believing that all is well. Media propagandas often paint a good picture of racial harmony but is it a true reflection of the current situation? If the basic tool for racial integration ie our education system, still appears racially segregated, how can we then expect future generations to forge a cohesive partnership between races in Malaysia?

The Government needs to be serious when implementing meritocracy. We only appear half-hearted, with certain quarters still reluctant to completely relinquish favouritism. The verdict for now is “No, there is no meritocracy as of yet”. It appears that the Government has its own definition of meritocracy, similar to their re-defining of the word democracy.

Interesting statistics

Topsy turvy world

Featured on CNN

What on earth is going on? These reality TV shows are really skirting the boundaries of sanity. Of course, we all know the objective of this ridiculous exercise. Profit making and nothing else.

It was mentioned that this idea was conceived due to the fact that Singaporeans registered a low frequency of sexual intercourse in a recent Durex survey. How would a game show increase sexual stimulus? The couples will be watched closely as they lead their normal lives.

Isn’t this voyeurism? It could have unwanted repercussions on society. It is condoning voyeuristic tendencies.

I fail to see the benefit of this game show. It is a wonder how a progressive nation like Singapore could come up with a backward and distasteful idea like this.

Bomb hoax at Hospital Mentakab

A bomb threat was received this morning at Hospital Mentakab. This caused the evacuation ,transfer of patients and the ensuing closure of the hospital for a thorough inspection by the police. After hours of searching, the threat was deemed a hoax!

However, such can be seen positively! It can expose weaknesses in the emergency procedures and similarly, remind the hospital management that drills are an important component of any hospital administration. When faced with a crisis situation , the staff have to function like a well-oiled machine. There is little room for errors under such dire circumstances. Are our hospitals able to perform well in Emergency situations? Perhaps this hoax was a test and a subtle reminder as to the work that needs to be done to improve existing protocols and procedures.

Bomb hoaxes have become increasingly frequent in Malaysia. Even the Twin Towers was not aparred from this attack. There is a need for a system that could reduce or discourage such mischief. Targetting hospitals is unwise and reflects a disturbed mind. It offers no strategic political points and the hospital itself poses no threat. A hospital is a sanctuary for the sick and thus should be respected as such. I believe that the perpetrator is mentally unstable and requires professional help. But can our police find him?

Waiting Time Debate

In the NST today,

This is an unfair report and extremely one sided. I am pretty sure there will not be any patients voicing satisfaction. It is a biased news report. Even Mastura Jamil was only waiting up to an hour. That is pretty good. Even popular private hospitals like SJMC have long waiting lines. Why are people not complaining then?

Perhaps the answer lies in this letter in the NST,

I agree that sometimes patients abuse the system. I have worked in the Emergency and have seen many cases which are non-urgent but they insist on going to the Emergency. These patients will voice their displeasure when told to wait or to go somewhere else. I still remember as the only emergency doctor on call on a weekend and with many emergency cases, there is little time and hardly any patience to see trivial cough and cold cases. Are we to be blamed then for long waiting lines? I hardly think so.

Patients have become increasingly demanding. The unrelentless and at times unreasonable pressure from the press does no favours as well. I suggest that patients and the press look in a broader perspective not just measure efficiency in terms of waiting times. We need the press to educate the public on the reasons for such a long waiting line. We cannot do magic and we need help to solve this matter.

Ultimately the above letter spells it out, we need more doctors in government service. We need to seal the leak of doctors going into private practice. There is only one way, make doctors feel more appreciated.

Perhaps we need to celebrate Doctors’ Day too!! Why not?

The continuing misery of doctors

In the NST letter section,

This reflects a sorry state of affairs involving our Health Ministry and the Jabatan Perkhidmatan Awam(JPA). Some policies just defies logic. It displays the haphazardness in the current administration. Welcome to Malaysia , I say.

Medical Officers here are poorly treated and the benefits does little justice to the profession. The compulsory service is, sad to say, not universally practised. The evidence of cronyism is abundant. The traces of racial devide still lingers. The writer of the letter was obviously deluded by the parents-in-law in saying, “being a doctor here is great”. This is far from the truth especially if you have to deal with the Health Ministry.

Contract doctors in Malaysia have been known to perform poorly due to, in most instances ,the language barrier. On many occasions as well, the practices differ due to the differing disease demographics in their home country. What puzzles me is that we are recruiting these doctors without first subjecting them to a stringent standard. It seems that the Government would like to make their path as easy as possible,thus to make Malaysia a more attractive destination. I beg to differ. I think that if doctors from overseas would like to practice here, they should be subjected to a common standard. This is the pre requisite in many other countries eg US, Canada and UK. Why are we treating foreign doctors better than we treat our own? Why does the Government have money to splash on these doctors when they are reluctant to increase the salary and thus keep more doctors in the service and probably attract more Malaysians back from faraway countries?

Despite vehement denials, there is an obvious lack of transparency and meritocracy in the current administration in Malaysia. If I had known these , I would not have returned myself. And my advice to those overseas, stay there!

Leading by example?

In the star,

Any anti-smoking initiative is commendable. However, how effective and reliable are these screening methods? Or will it be a futile exercise and a waste of university funds? As to my knowledge, there is no effective way of determining if a person is smoking or otherwise, except through a breathanalyzer which detects carbon in the breath of an individual. Even this will not be accurate as pollution can also result in a false positive test. Social smokers can hardly be detected. Even smokers that abstain prior to entry into the university will escape the net.

So what is the purpose? I strongly feel that it will be an absolute waste of money and manpower. I understand the intentions of Prof Datuk Dzulkifli but such methods just will not work. It will only create a greater sense of defiance among the student population. Moreover, I think he should first look into his faculty before enforcing such rules on students. I am quite sure there will be smokers among his current faculty members!

Education remains the main tool in our fight against tobacco smoking. Ultimately, the individual will have to decide what is best for himself. Using peer approach is underutilised and needs greater emphasis. I think even patients with coronary heart disease, chronic obstructive lung diseases and cancers caused by tobacco smoke should step forth to educate the young. This usually sends a powerful message that smoking tobacco does have real and dire consequences.

I do applaud the ongoing “TAK NAK” campaign. It is costly but necessary.

So to USM, I am sure there will be no public backlash but is this the best method?

PAS : A Path of Desperation

In the Straits Times,

Is PAS getting that desperate? And how will allowing non-Muslims in the party rebut claims of chauvinism in the party?

PAS is fundamentally an Islamic party. Its fight politically is motivated by religious issues. Thus this latest move of allowing non Muslims to join the party, contradicts the very core of its beliefs. It makes a mockery of their constitution.

PAS lost heavily in the latest general election. The heavy defeat was unexpected. They are still finding it difficult to accept such heavy defeats, prefering instead to blame the Election Commission of election fraud. The voices of the people sent a clear message to PAS. Its policies are no longer acceptable. It is archaic and at times foolish.

So this latest move reflects a sense of desperation. The support of the party has eroded with its main support coming from Kelantan, which is also weakening. They are bleeding badly and they need to stop it fast. But are non Muslims going to be the answer?

Private Wing Debate Continues

In the Star

The animosity between the government and private sector is evident from the above news report. I think the Government would fear more from losing doctors, than the private sector of competition arising from private wings in Government hospitals. The biggest worry from the setting up of such a private wing is whether patients that can ill afford the payment be given an equal quality of service from doctors especially the specialists. The fear is that the disparity between the quality of such services will widen the already worsening gap between the rich and the poor.

It will cause confusion. In the current system, there are many patients who can ill afford to pay even the lowest of charges. Will these patients now be neglected as the specialists concentrate more on making more money? Who will then attend to these patients? How much time will these specialists or doctors spend on poor patients? Will there be a difference in the quality of service ie better services for patients that pay?

I feel that we are heading in the wrong direction. The Government it seems is avoiding the responsibility of increasing the renumeration of doctors. Bottomline is doctors need a different and higher payscale. A payscale that reflects the sacrifice given in under graduate training, in active duty, in post graduate training and so forth. We need to feel a sense of appreciation from the Government. We are like any other employees. We need to know if we are being appreciated. One way is by means of a better payscale.

We need to set up a nationwide insurance scheme similar to Medicare in the United States. It will be a challenge but I think there is where the answer to better medical services lies. The setting up of private wings in Government run hospitals will only widen gaps in social stratas in Malaysia. At this moment, only the middle and upper groups can afford insurance schemes and thus the right to medical services in the private sector. Poor citizens should be afforded that right to choose as well.

We need to work as a team with better cohesiveness. Creating animosity between the same group of professionals does not augur well for the profession.

MMA: Still toothless

In the NST

It appears that the MMA is backpeddling. Why are they not seeking an increase in the salary scale in addition to allowances? It is the salary scale that does no justice to the profession. By the above statement, the MMA is suggesting that they are satisfied with the salary scale. Moreover, how can the president of the MMA correct what the Health Minister was trying to say?

This reflects the chaotic natiure of the MMA. It is a body riddled with politics and internal rife. It remains directionless with lack of leadership qualities. It remains meek when it has to stand firm. Ultimately , they fight not for the welfare of all doctors but a select few.

I am deeply disappointed with this recent turn of events. It only displays confusion in the ranks of the MMA. I believe this occurs because those holding positions in the MMA are no longer with the government service and thus are no longer subjected to hard labour. This reflects in their reluctance to go all the way in their fight to improve the renumeration of doctors.

The MMA is paralyzing itself. I can only sigh in disgust!