Oleh/By : DATO' SERI DR. MAHATHIR BIN MOHAMAD Tempat/Venue : SHANGRI-LA HOTEL, KUALA LUMPUR Tarikh/Date : 07/02/90 Tajuk/Title : THE OPENING OF THE "XI WORLD CONGRESS OF CARDIOLOGY PRE-CONGRESS SYMPOSIA ON INTERVENTIONAL CARDIOLOGY & ECHOCARDIOGRAPHY" Yang Berhormat Datuk Ng Cheng Kiat, Minister of Health; Dr. Kenneth Chin, Chairman, Pre Congress Symposia; Distinguished Guests; Ladies and gentlemen. I would like to thank the organising committee for giv- ing me the honour to address this gathering and to officiate the opening of this Eleventh World Congress of Cardiology Pre-Congress Symposia on Interventional Cardiology and Echocardiography. I am sure the efforts of the Interna- tional Society and Federation of Cardiology and the National Heart Association of Malaysia to hold this Symposia in Kuala Lumpur will be fruitful. For me I am doubly honoured to meet the specialists in this cardiac field as I had success- fully undergone a cardiac surgery about a year ago at the Kuala Lumpur General Hospital. I was 'saved' by God's will and treated with tenderness by your fellow Malaysian spe- cialists and nursing staff. With that sentiment I take this opportunity to bid 'selamat datang' to all of you especially our foreign guests. Ladies and gentlemen, 2. Medical technology has made tremendous advances in the last few decades. These have contributed greatly towards improving the health status of the society at large. Ad- vances in our diagnostic and therapeutic capabilities, through new technologies such as lithotriptors, CT scanners, ultrasound and lasers amongst others, have been truly im- pressive and have captured the imagination of our public. 3. Simultaneously, advances in cardiology have resulted in the development of non invasive procedures like echocardiography and recently the addition of newer modalities in echocardiography with doppler techniques and colour doppler have improved further our diagnostic capabil- ities. There has also been new invasive interventional pro- cedures like angioplasty and valvuloplasty which increases our capabilities in providing treatment. These advances in cardiology are surely very much welcomed by all. What more heart diseases have been a major cause of death and disabil- ity in developed countries and increasingly becoming one of the leading causes of death in developing countries. 4. It is therefore timely and appropriate to hold this Pre World Congress Symposia on Interventional Cardiology and Echocardiography. I hope this Symposis, attended by inter- nationally acclaimed experts in the relevant fields, will successfully discuss current concepts, current indications and future directions in the various fields of cardiology which will be of great benefit to mankind. Ladies and gentlemen, 5. The Malaysian Government is sparing no effort in spreading the knowledge on heart diseases among its populace. At the same time the Government itself is contin- uously developing facilities and services to heart patients in this country. The Kuala Lumpur General Hospital provides consultative cardiology and cardiothoracic services, invasive and non invasive procedures and heart surgery. Similar services are also available at the University of Malaya Hospital. 6. Resulting from economic and social development experi- enced by our country, more and more Malaysians are able to pay for their medical needs. Consequently the growth of private medical facilities in cardiology and cardiothoracic services is very encouraging. The great demand for these services has resulted in the setting up of 3 private hospi- tals providing such services. 7. The Malaysian Ministry of Health is aware of the in- creasing needs and greater expectation of the public for specialist care in cardiology. To respond to this need, the Government is improving our capability by training physi- cians and paediatricians in cardiology so as to provide sim- ilar services outside Kuala Lumpur. At present, other than at the Kuala Lumpur General Hospital, comprehensive non invasive services in cardiology are also provided at 3 state capitals in this country -- the Queen Elizebeth Hospital in Kota Kinabalu, Kuching General Hospital and the Kuala Terengganu General Hospital. 8. It is encouraging to note that more and more Malaysians, including VIPs, are having greater confidence in the capability of our cardiac specialists. If most of the surguries were performed overseas as recent as two to three years ago, it is just the opposite now. The confidence of course is welcomed for the sake of medical development in Malaysia. However this can mean an increase of cases to be handled by our medical officers and to some extent shortage of facilities. Hence, the government is determined to train more medical officers in this field and to increase the ex- isting facilities. 9. In line with this determination, the Malaysian Govern- ment is building in Kuala Lumpur a new cardiothoracic centre of international standard equipped with the most modern equipments and staffed by the relevant specialists. This centre will be the national referral centre providing cardiology and cardiothoracic surgical services. It will provide training facilities for doctors and para-medics in the field of cardiology and cardiothoracic surgery. Besides playing an active role in health education in order to edu- cate the public in the prevention of cardiac diseases, it will also involve itself in cardiac rehabilitation programme. I would consider this as a major development in cardiology and cardiothoracic services in Malaysia. Ladies and gentlemen, 10. In our efforts to increase our capabilities in diagno- sis and treatment, we must also give more attention to the preventive aspects of cardiovascular diseases. It should not be forgotten that prevention is important and concerted efforts should be made to prevent heart diseases. A number of risk factors have been identified as contributing to the development of cardiovascular diseases. These include high blood pressure, high level of cholesterol in the blood, smoking, obesity and lack of exercise. 11. In Malaysia, a recent national and health morbidity sur- vey showed that 14% of the adult population had hypertension. The same study showed that 40% of men were smokers, and 36% of them were heavy smokers. Other studies have shown that cholesterol level is high among Malaysians especially among executives. 12. The successful control of cardiovascular diseases re- quires an integrated approach involving a number of govern- ment ministries and agencies. The Ministry of Health alone cannot carry out the primary prevention programme to de- crease the whole range of risk factors. In this strategy, medical leadership is important but the task is beyond the medical profession alone. It is therefore important for other relevant government agencies to cooperate with the Ministry of Health in the efforts towards prevention of cardiovascular diseases. It should be reminded that one of the messages from the World Health Organisation is that in- dividuals should take personal responsibility for their own health, and this includes preventive aspects of cardiovascular diseases. 13. The Malaysian Government is planning to start a programme to reduce morbidity and mortality from cardiovascular and related diseases. Three major strategies have been identified. The first strategy is through the community approach where the community is encouraged to adopt healthy life styles. This will result in the general reduction of the various risk factors. The second strategy is through the high risk approach where high risk individ- uals would be identified through various screening mech- anisms. This would enable early detection and proper management of such groups. The third strategy is through the secondary or preventive approach whereby those who are known to be suffering from heart diseases would be treated, counselled and rehabilitated so that morbidity and mortality can be minimised. Early detection of cardiovascular prob- lems in childhood and adulthood are also being undertaken. Ladies and gentlemen, 14. This year is Visit Malaysia Year and I would like to welcome all guests to our beautiful country. I hope inspite of your busy schedule you will still find time to see some of the interesting places in the country. 15. Once again I thank the organising committee for invit- ing me to officiate the opening of this Symposia. And now I declare open the "IX World Congress of Cardiology Pre- Congress Symposia on Interventional Cardiology and Echocardiography".