"I believe in a country where hard work and merit, not privilege or background, determines success."
Tony Blair 2005

Sunday, April 13, 2008

Stuck in the past

Tengku Faris' recent pronouncement that non-Malays should never seek equality in return for citizenship smacks of arrogance and naivety of the Kelantanese Sultanate. Holding the non-Malays to ransom with regards to citizenship highlights his regressive nature and only aims to cement his future position at the helm of Kelantan and of one day, Malaysia.

Malaysia attributes its current position to all hardworking Malaysians regardless of race or religion. Ignoring this fact and derecognising the role of non-Malays in building Malaysia is tantamount to treason. The races of Malaysia is so amalgamated that the absence of one will surely weaken this mould. Therefore, threatening the non-Malays with the issue of citizenship serves to be self destructive.

Our Kelantan Crown Prince has also resurrected the issue of whether Malaysia is a secular or an Islamic country boldly declaring that Malaysia is an Islamic nation. Surely he was only playing to the sentiments of the crowd which where entirely Muslims. Being an Islamic state means that the civil courts are no longer in authority and only the Syariah Courts are recognised. This of course is not true. Such arguments are not new. An article by Dr Chandra Muzzafar highlights this problem and its arguments. Read it here.

These belligerent utterances only serves to sow uneasiness among the non-Malays driving precious human resource out of the country.

Reproduced from Malaysiakini.com
Tengku Faris: Non-Malays should not seek equality
Andrew Ong | Apr 12, 08 2:10pm
Kelantan Crown Prince Tengku Faris Petra said today that Malays had given into granting non-Malays citizenship and the latter should therefore not seek equality or special treatment.

He said this during his keynote speech at a forum titled “Malay unity is the core of national unity” organised by the newly formed Barisan Bertindak Perpaduan Melayu in Kuala Lumpur today.

Speaking to a crowd of about 1,000 people, Tengku Faris said the Malay rulers would be an umbrella to foster unity among all Malaysians, based on the Federal Constitution and the Rukun Negara.

bbpm tengku faris 120408 tengku faris“Therefore, the rakyat must unite and never raise issues regarding Malay rights and special privileges because it is a quid pro quo in gratitude for the giving in of citizenship (beri-paksa kerakyatan) to 2.7 million non-Malays into the Tanah Melayu federation.

“Thus, it is not appropriate for these other ethnic groups to have citizenship, only (later) to seek equality and privileges,” said Tengku Faris, who read from a 11-page prepared text.

However, the crown prince stressed that in an effort to unite the Malays, non-Malays also have rights that must be protected, such as in areas of religion.

As an example, Tengku Faris said non-Malays are allowed to practice their respective religions in peace. They must however do so in accordance with the law and “not be provocative towards Islam”.

“The Malay rulers are the head of the Islamic religion and Malaysia is a Islamic country (negara Islam), not secular. We have our own formula (as a country) which is different from others,” he added, drawing thunderous applause from the crowd.

‘Dominance’

He added that the effort to instil Malay unity and defend Malay special rights does not mean that other races would be ignored.

“In fact, if Malay rights and special privileges are taken care of and is not disturbed, it would ensure national harmony. It does not just benefit the Malays but all ethnic groups,” he said.

bbpm tengku faris 120408 crowdIn his speech, Tengku Faris said the 12th General Election results have shown that the Malays are being “challenged” and thus Malays unity is of the outmost priority.

“The election results have shown that the Malays are disunited and facing other ethnic groups who are more dominant politically and economically,” he said.

As the constitution provides that the Malays are the natives (penduduk asal) of Malaysia, Tengku Faris said every Malay must defend the constitution and Islam and this can only be achieved through Malay unity.

“We have to make an effort to unite. Don’t spilt up. Avoid polemics that can distance us. Ideology (and) having different interpretations does not contribute to Malay unity.

“Discussing about polemics such as Islamic state, secular state, welfare state... confuses the people... Resulting from this confusion, Malays are becoming more disillusioned,” he added.

Saturday, April 05, 2008

Trapped

Toiling for hours at a stretch, executing commands leveled from all angles and wishing one could miraculously split into two, as work appear as endless heaps. Any mistakes could attract condescending remarks. This may be a familiar scene for many of our house officers on duty.

So young in their careers, yet disillusioned at such important formative years. Shaping a skewed and hardened mentality, that medicine is a cruel game. Many mature into their senior years bent on ensuring that their experiences should not be carried into future generations of doctors. Nevertheless, when the times do come, their earlier noble pledges evaporate, only to condensate as a mould of their much feared tormenters.

Are doctors a bunch of savagers waiting to devour their younglings? Has the profession not thought them about humulity and inevitable mortality for Man? Or has the elevated sense of pride and achievement gone to their heads?

It is only my hope that I, myself, should never spiral into this rapacious trap. But somehow, I fear that at times, it may just be too tempting to bark at a mistake that we may have made many times over in the past.

Perhaps we are all trapped in a cruel world after all.

Tuesday, April 01, 2008

A bitter divorce

A recent frontpage announcement of the separation of duties between prescribing and dispensing has caused much furore especially among doctors. There is little doubt that the most affected group will be the private practitioners, who will stand to lose if they are to be denied dispensing rights.

Prescribing remains the sole domain of doctors although some pharmacists have been known to encroach onto this area, where they are certainly not trained for. Dispensing medications, however, is a battleground where each would like control of an abundant piece of real estate.

A doctor's training encompasses not only about diagnosis and treatment but certainly an allocation of hours for pharmacology in the early years. Prescribing medications without knowledge of the drugs that are being prescribed is certainly grounds for negligence. So despite the fact that the pharmacists may perhaps have a more indepth knowledge of the pharmacokinetics or pharmacodynamics of the drug, a doctor possesses the ability to correlate drug treatments with the clinical scenarios.

Uncoupling prescribing and dispensing is not about competence but rather about improving the efficiency of healthcare delivery. In a busy practice where a doctor may not have sufficient time to explain about the spectrum of side effects, a pharmacists may be of importance. A pharmacists should play a role of assisting doctors in delivering an exemplary standard of healthcare.

It is my personal opinion that doctors should be allowed to continue dispensing medications. There is no compromise in patient care by doing so. However, in areas where doctors may be overburdened, for example in tertiary care centers, uncoupling prescribing and dispensing is certainly of benefit.

Pharmacies plays in a role in allowing patients a more varied selection. Patients can be given a choice of getting the medications from the doctor or a nearby pharmacy. Such a choice should be left to the patient concerned and not muscled through via legislations.

Pharmacies remain poorly regulated where the standard of practice is suspect. Many are driven solely by profit margins, making temptations of unorthodox practices too juicy to resist. Some venture into a lucrative tradisional medical practice for which they are certainly not trained for. Even providing blood pressure and sugar checks without proper counselling may only distress patients unnecessarily. Allowing pharmacies to promote alternative healthcare or products apart from those specifically prescribed, may only confuse patients.

If dispensing rights are to be solely given to the pharmacists, then a level of service commitment needs to be in place. For example, a 24 hour service or being on call duties may be necessary in tandem with that in the medical field.

A divorce of duties now will surely be bitter. Although it appears inevitable at this time, careful thought needs to be invested and loose ends tightened up. Anything less and only patients will stand to lose.
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