Oleh/By		:	DATO' SERI DR. MAHATHIR BIN MOHAMAD 
Tempat/Venue 	: 	SHANGRI-LA HOTEL, KUALA LUMPUR 
Tarikh/Date 	: 	10/01/96 
Tajuk/Title  	: 	THE XI ASIAN PACIFIC FEDERATION 
			CONGRESS OF INTERNATIONAL COLLEGE 
			OF SURGEONS 



          Firstly, I would like to thank the organising committee
    of the XI Asian Pacific Federation Congress of International
    College of Surgeons (ICS) for inviting me to officially open
    the  congress today.  It is indeed an honour and a privilege
    for  Malaysia to be chosen to host this congress,  which  is
    convened not only for the surgery meeting, but also for  the
    World Council Meeting of the ICS.

    2.    I  am  pleased to note that eminent personalities  and
    experts  in  the various branches of surgery are meeting  in
    Kuala  Lumpur to give their views and critical appraisal  on
    surgical  techniques and management to prepare for the  next
    century.   The  congress  has  been  aptly  themed  "Surgery
    Towards the 21st Century".

    3.    Tracing  the  history of medicine over  the  past  200
    years,  the  progress that society has made can  be  closely
    linked  to  the advances in science.  Looking back  at  this
    century,  medical progress has been phenomenal  compared  to
    the days of the `Medicine Man' and the "Barber Surgeon".

    4.    Indeed, the understanding of bacterial infections  and
    their  conquest by anti-biotics; the concept  of  immunology
    and  its  far  reaching applications to  blood  transfusion,
    immunisation,  the  prevention  of  viral  infections;   the
    success of transplant surgery and the delaying of the ageing
    process;  the progress in endocrinology and its  application
    to  human  reproduction,  contraception,  the  treatment  of
    disease and menopause; and many other advances highlight the
    remarkable achievements made by society.

    5.    In  addition,  nuclear physics and  pharmacology  have
    given  us new tools to treat cancer, although cancer  itself
    remains  unconquered.   The advent of X-rays,  thermography,
    ultra-sound   and  magnetic  resonance  has  made   physical
    imaging,  fetal  monitoring and therapeutic  procedures  not
    only  possible but also successful.  In fact,  it  has  made
    surgical intervention more precise and less disfiguring.

    6.    Notwithstanding  all  these   new   discoveries,   the
    universally  accepted principle in the practice of  medicine
    is  that  investigation and treatment should be as minimally
    invasive as possible; that there should be very little pain;
    and  recovery should be rapid.  With advances in  endoscopic
    techniques, fibre optics and laser, all these have been made
    possible.

    7.    The advent of Invito-Fertilisation (IVF) in humans and
    its  success  with the birth of Louise Brown  in  1977  also
    brought  new  hopes to the management of  infertility.   The
    techniques  are  widely  reproduceable  although  they   are
    neither  simple,  nor inexpensive, nor  highly  reliable  to
    produce a baby.  IVF however does hold wider application  in
    medicine, the possibility of pre-implant, genetic diagnosis,
    gene  therapy  and  delayed conception.   The  results  from
    experiments  with embryonic cells appear promising  as  they
    may  hold the key to tissue repair and in replacing diseased
    or ageing organs.

    8.    Today,  by far the most important development  is  the
    advent  of  molecular  biology.  It has contributed  towards
    major  advances  in  the  understanding  and  treatment   of
    inherited disease and disease disposition.  The discovery of
    the  variation  of  genes and mutations in  the  process  of
    carcinogenesis  appears  not  only  exciting  but   also   a
    promising development in the battle against disease. Further
    research  in  this  direction may even  help  to conquer the
    deadly HIV virus.

    9.    As  for today, looking at the audience, I am happy  to
    see  that surgeons from all over the world are gathered here
    to  share their knowledge.  Dr. Max Thorek conceived an idea
    60  years  ago  and  founded  the International  College  of
    Surgeons,   an   institution  that  would  provide   medical
    knowledge  to all parts of the world, knowing no  boundaries
    or  prejudices.   His  dream has indeed  become  a  reality,
    probably  far  greater  and  more  promising  than  he   had
    imagined.

    10.   It  is  a  pleasure to note that in the  ICS  concept,
    leadership  positions are open to all persons regardless  of
    colour,  creed, ethnicity or politics.  Looking at the  list
    of   office   bearers,   one  can   truly   appreciate   how
    international the International College of Surgeons  is.  
    am glad that Malaysia is also ably represented.

    11.   In   achieving  the   goal  of  this   congress,   the
    participants  in  their  deliberations  should   take   into
    consideration the escalating costs of new techniques and its
    effects  on developing countries.  They have to examine  the
    ethical and medico-legal implications of the new methods and
    also to be sensitive to cultural and religious feelings.

    12.   Malaysia  is  striving  to become  a  fully  developed
    nation.   We  therefore look forward to the next millennium,
    in  particular  the  year 2020 to  achieve  this  aim.   Our
    progress shall be balanced; be it in education, industry  or
    new  technology  and shall be guided by our  beliefs,  moral
    values  and  traditions.   We  welcome  the  free  flow   of
    information  and knowledge which can contribute towards  our
    progress.   We  also support research and development.   The
    International  College  of  Surgeons  is  most  welcome   to
    participate  in  our  ever  expanding  sphere   of   medical
    education,  especially  in the training  of  young  surgical
    scientists.

    13.   Up to now Malaysia has been quite free of the kind  of
    litigation  mania  found  in many developed  countries.   We
    appreciate the need to protect patients from incompetent and
    careless  treatment  by the practitioners  of  medicine  and
    surgery.   But excessive awards made by courts have resulted
    in  doctors  either avoiding to help in accident  cases,  or
    carrying  out  unnecessary  and  costly  investigations   or
    charging  very  high fees in order to cover  high  insurance
    premium.   The  result  is that the  poor  are  deprived  of
    medical  treatment  and even members of  the  middle  income
    group   can   be  bankrupted  by  medical  bills.    Medical
    insurances have become unaffordable and even Governments are
    not  in  a  position to provide basic medical care  for  the
    people.  We hope that we will remain free of this craze.  We
    must   symphathise   with  the  victims   of   irresponsible
    practices, but the cost of this misguided sympathy, in terms
    of  deprivation of medical treatment, is infinitely  higher.
    Awarding  ridiculously high compensations does  no  one  any
    good.

    14.  It is my hope that the delegates, especially those from
    overseas, will have the opportunity to get a glimpse of  our
    country  and a chance to experience the warm hospitality  of
    our people.

    15.   On  this  note,  I have great pleasure  to  officially
    declare  open  the XI Asian Pacific Federation  Congress  of
    International College of Surgeons.