Global health 11092012 ukm
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Global health 11092012 ukm
- 1. Global Health – Why Malaysian Medical Students Should Bother? Dr. Valkuthan Rajaratnam MBBS(Mal),AM(Mal),FRCS(Ed),FRCS(Glasg),FICS(USA),MBA(USA), Dip Hand Surgery(Eur),PG CertMedEd(Dundee),FHEA(UK). Senior Consultant Hand Surgeon, KTPH Alexandra Health, Singapore
- 2. Global Health • problems that transcend national borders • best addressed by cooperative actions and solutions "The failure to engage in the fight to anticipate, prevent, and ameliorate global health problems would diminish America's stature in the realm of health and jeopardize our own health, economy, and national security." -The Institute of Medicine, America’s Vital Interest in Global Health
- 3. Global Health why bother • Humanitarian reasons • Equity reasons • Direct impact reasons • Indirect impact reasons
- 4. What’s in it for me? • Practice • Training and Education • Research • Altruism
- 5. What is in it for them? • Practice • Training and Education • Research • Altruism
- 6. Personal Experience • UG & PG ME • Service establishment , and training • Building experience • Delivering wisdom across borders • Teaching and learning different systems • Communicating and collaborating • Leaving legacy through education
- 7. Malaysian Population Total: 28.4 million Migrant Workers: 1.8 million Expats: 313,000 Illegal immigrants: estimated 450,000 to 1.2 million
- 8. Migrant Workers in Malaysia Country of Origin Indonesia Bangladesh Nepal Myanmar India Vietnam Others
- 9. Key Contributions to Global Health
- 12. Queen Elizabeth Hospital, UHB NHS Foundation Trust
- 15. Open air out patient clinic
- 16. Current make shift classroom
- 17. Residual mines and their effects A below knee amputee following land mine Injury with prosthesis
- 18. Major flash burn contracture of post axillary fold needing release and reconstruction
- 19. AO Instructional course for medics/nurses
- 21. Compressed air unit for power tools
- 22. “Portable” Xray unit using dental Xray tube
- 23. Surgery with implants and power tools
- 24. Median and ulnar nerve injury treated with sural nerve cable graft bridging gap
- 25. SSG done by member of nursing staff
- 28. IED – Improvised Explosive Device• Since 2007, IED blasts are commonest combat injury seen at RCDM • Improvised devices with evolving sophistication • Difficult to detect • Frequently placed at road side to target foot and vehicle patrols
- 29. The Team
- 30. • Unique injuries – Patterns emerging • Unique patients • Multidisciplinary care • IEDs – large zone of injury • Difficult reconstruction • Very rewarding
- 39. Life Expectancy at Birth 0 10 20 30 40 50 60 70 80 90 Years Years
- 40. Maternal Mortality Ratio (Inter agency estimates) 0 50 100 150 200 250 300 per 100 000 live births
- 41. Comparison of International Health Statistics Bangladesh Indonesia Malaysia Singapore UK USA Population in thousands 148 692 239 871 28 401 5 086 62 036 310 384 % pop. living in urban areas 28 44 72 100 80 82 Government expenditure on health as % total govt expenditure 7.4 7.8 9.2 8.0 16.0 22.4 Annual per capita govt expenditure on health (US$) 8 38 204 629 2 938 4 437
- 42. Physicians Density 0 5 10 15 20 25 30 per 10 000 population per 10 000 population
- 43. Infant Mortality Rate (probability of dying between birth & 1 year) 0 5 10 15 20 25 30 35 40 per 1 000 live births
- 44. Top 3 causes of death in Malaysia Cerebrovascular Disease 6.6% Pneumonia 7% Ischaemic Heart Disease 12.9% 124,857 deaths in 2008
- 45. Top 3 causes of death in Malaysian Men 1. Ischaemic Heart Disease 2. Road Traffic Accidents 3. Pneumonia
- 46. Hospital Beds 0 5 10 15 20 25 30 35 per 10 000 population per 10 000 population
- 47. Incidence of Polio in Malaysia Year No. of Cases 1976 39 1977 121 1978 18 1979 4 1980 5 1981 1 1982 5 Year No. of Cases 1983 2 1984 5 1985 4 1986 1 1987-1991 0 1992 3 1993-2011 0 Source, MOH Malaysia
- 48. Malaysia & Global Fight Against Polio Member of the Global Polio Eradication Initiative
- 49. Incidence of Dengue in Malaysia 0 5000 10000 15000 20000 25000 30000 35000 40000 45000 50000 2000 2010 Cases Cases
- 50. Malaysia & Global Fight Against Dengue 3 Key Areas: Funding Expertise Research
- 51. Global Health & Non-Communicable Diseases Tobacco control Inter-governmental cooperation
- 52. Global Health & Communicable Diseases SARS Inter-governmental cooperation
- 55. Open air out patient clinic
- 59. VWO Contributions to Global Health
- 60. Mercy Malaysia Programmes Malaysian Outreach Programmes
- 61. References Health imperatives in foreign policy: the case of Malaysia: Simon Barraclough & Kai-Lit Phua, Bulletin of the World Health Organization 2007;85:225-229.
Notas del editor
- Source: Dept of Statistics, Malaysia except the illegal immigrant numbers which is cobbled together from news reports
- Malaysia’s contribution largely in tandem with own national health agendaHence key areas focus on polio eradication, dengue, tobacco control and migration issues (e.g. SARS and impact of illegal immigration on Malaysia)Malaysia has donated US$25K for research on diseases of poverty TDR, the Special Programme for Research and Training in Tropical Diseases, is a global programme of scientific collaboration that helps coordinate, support and influence global efforts to combat a portfolio of major diseases of the poor and disadvantaged, including dengueSource – Dept of Statistics MalaysiaPolio outbreak Malaysia 1992 imported wild polio virus from South Asia10th Session of the IslamicSummit Conference of the Organization of the Islamic Conference(OIC) aimed at eradicating polio, OIC Member States are nowfollowing up the resolution with concrete financial contributions.In August, the Government of Malaysia provided US$1 million tothe global effort to eradicate polio – the funds will support synchronized,mass polio immunization campaigns in October and November in25 countries across west and central Africa, 17 of which are OICMember States. Some 80 million children will be vaccinated against thedisease with multiple doses of the oral polio vaccine.The Rotary club of the Lakeside Campus of Taylor’s UniversityCollege in Malaysia raised 10,000 Malaysian Ringgit(US$ 3,236) through their ‘Pedal Away Polio’ bicycle race.More than 200 cyclists competed in the event, each payingRM40 (US$ 13) for the right to compete. The rest of the fundscame from a crowd moved to donate by the news that RM10is enough to immunize three children. - Dan Nixon/Rotary 2010
- Bangladesh – 65yrs Indonesia – 68 yrs Malaysia – 73 yrs Singapore – 82 yrs UK – 80 yrs USA – 79 yrs
- Majority of maternal deaths in Malaysia are due to foreigners who come in through Sabah and the illegal immigrants - outgoingpresident of the Obstetrical and Gynaecological Society of Malaysia (OGSM) Dr Krishna Kumar Hari Krishnan. For Malaysian women, post-partum haemorrhage is no longer a problem given the health programmes put in place to address it but mothers could die of other causes and medical disorders like complications caused by diabetes or hypertension. (Source – The Star, 7 June 2012)Bangladesh – 240 Indonesia – 220 Malaysia – 29 Singapore – 3 UK – 12 USA - 21
- WHO is the source for all this chart and all the bar chartsThis can be done as bar charts to make it easier to read – but then more slides for you to wade through
- Bangladesh – 2.95 Indonesia – 2.88 Malaysia – 9.41 Singapore – 18.33 UK – 27.43 USA –24.22
- Bangladesh – 38 Indonesia – 27 Malaysia – 5 Singapore – 2 UK – 5 USA – 7
- Source – Dept of Statistics Malaysia
- Source – Dept of Statistics Malaysia
- Bangladesh – 3 Indonesia – 6 Malaysia – 18 Singapore – 31 UK – 33 USA – 30
- Polio vaccination part of Malaysia’s National Immunisation Schedule since 1972.Polio outbreak Malaysia 1992 imported wild polio virus from South AsiaDeclared Polio free by WHO in 2000
- Global Polio Eradication Initiative was launched in 1988 – coalition of national governments, World Health Organization (WHO), Rotary International, the US Centers for Disease Control and Prevention (CDC) and UNICEF. To date >2 billion children immunised under the programme, saving more than 5 million children from life-long paralysis or death.Polio-endemic countries reduced from 125 to three - Nigeria, Pakistan and Afghanistan. Malaysia has given >US$2 million to WHO’s global polio eradication initiative.
- Dengue cases in Malaysia: 2000 – 7,103 2010 – 46,171 (134 deaths)
- To date, Malaysia has donated US$25K to TDR, WHO’s Special Programme for Research and Training in Tropical Diseases, is a global programme of scientific collaboration that helps coordinate, support and influence global efforts to combat a portfolio of major diseases of the poor and disadvantaged, including dengue.Feb 2012, Malaysian dengue experts joined other international experts at a WHO & Pakistan Government 3-day international workshop on improving dengue in Pakistan. The country had an outbreak in Punjab in 2011 killing 311 people.Involved in international trials involving the genetically-modified Aedesaegypti OX513A mosquito strain (OX513A).Itwas originally developed at the University of Oxford, which founded and part-owns Oxitec, a UK company and under the inviation of MoH, Oxitec transferred its lead strain of Aedesaegypti OX513A to the Institute for Medical Research Malaysia (IMR) for independent evaluation in 2006. Since then, the IMR has successfully evaluated this new control technology under laboratory and semi-field conditions. The technology has also been evaluated by reputed institutes around the world including the Institut Pasteur in Paris, France, and the WHO Collaborating Centre for the Ecology, Taxonomy and Control of Vectors of Malaria, Filariasis & Dengue at the IMR and so far, the results have been very encouraging.
- Smoking incidence in Malaysia: 43.9% of men, 1.0% of women and 23.1% overall (4.7 million adults) Global Adult Tobacco Survey Malaysia, 2011) Major contributor to IHD & CVD deathsMalaysia has played a regional role in assistingthe development of WHO’s Framework Convention on Tobacco Control to try to reduce smoking rates in ASEAN countries.Tobacco issues prompt bilateral agreements (e.g. with Thailand)
- SARS – 2003Highlighted the impact of global travel on transmission of infectious diseases and need for international cooperation.Prompted Malaysia to work with other countries including Singapore, Thailand, Brunei and China.
- International: projects in Myanmar, Sudan, Pakistan, Afghanistan and Sri LankaHumanitarian Aid – Bangladesh floods, Aceh (2003/2004)Disaster Relief – primary healthcare inrefugee camps in Darfurmore than 5,000 volunteers, Mercy Malaysia is actively involved in numerous projects in countries like.Cleft Lip & Palate Project – Malaysia & Bangladesh
- 1997 an MOU signed on health cooperation.19th meeting of the Thailand–Malaysia Border Health Goodwill Committee, which in 2006discussed issues including the smuggling of illegal and counterfeit drugs, infectious diseases, maternal and child health,and the human resources development.Health cooperation and bilateral agreements with Thailand on illegal drugs, counterfeit cigarettes and people smuggling.
- Dec 2003 (post SARS), Malaysia and Brunei Darussalam started holding bilateral health meetings. They agreed to establish workinggroups for future joint projects and for a memorandum of understanding to strengthen and formalize future cooperationon health. A year later, the health ministers instigated joint cooperation not only on communicable diseases but also laboratory facilities,health surveillance, food safety, tobacco control and the cross-border movement of patients
- Mercy MalaysiaProgrammes: Rotary Club – Polio Eradication international agenda Primary Healthcare Services Malaysian clubs raise $$$Cleft Palate RepairCataractsReproductive HealthHumanitarian AidDisaster Relief
- You don’t have to travel overseas to help - health inequalities exist in Malaysia tooMobile clinics in remote parts of Sabah, Sarawak and Peninula Malaysia provide Primary Healthcare Services including dental care, reproductive health, treat cataracts and Cleft Lip & Palate Project. Areas includeNur Salam centre & the OrangAsli settlement in BelumCataractsReproductive Health