Oleh/By : DATO SERI DR MAHATHIR BIN MOHAMAD
Tempat/Venue : SHANGRI-LA HOTEL, KUALA LUMPUR
Tarikh/Date : 13/02/2003
Tajuk/Title : THE 11TH ANNUAL MEETING OF THE
ASIAN SOCIETY FOR
CARDIOVASCULAR SURGERY
Versi : ENGLISH
Penyampai : PM
It is both a pleasure and an honour for me to
address this assembly. It is a pleasure because I can
take this opportunity to welcome all of you to Malaysia,
the host for the 11th ASCVS. I do hope that besides
participating in the scientific deliberations, you will
also experience the hospitality that is, I believe
characteristic of Malaysians. It is an honour because it
gives me an opportunity to meet with people whose
knowledge and skills means so much to me in particular
and the sick and the old in general.
2. I have accepted the invitation of Dato Dr. Yahya
Awang, Dato Dr. Mohd. Azhari Yakub and the rest of the
organising committee with pleasure because I value the
leadership that they have shown, both in organising this
conference and in the field of cardiac care in Malaysia.
3. Conferences of this kind, in my opinion, should not
only discuss techniques and developments but should help
us re-focus on the broader concerns of health, both in
our own communities and in the world as a whole. The
health of humanity is not as it should be considering
the advancement in our knowledge of the human body and
the state of modern medical science and technology. And
this is because for most people the cost is too high.
We seem to prefer spending huge sums in developing new
ways to kill people rather than saving them. We shall
not wipe out AIDS, tuberculosis, malaria, or any of the
other infectious diseases that plague the developing
world because too little money is being spent on
research to cure or prevent these diseases. These are
diseases of the poor who will not be able to pay for the
cost of research through high prices. But research on
impotency and its cure promises more returns. So vast
amounts are dedicated to the problems of the rich who
are the people keen on restoring their virility. The
poor are resigned to eventually lose their drive and to
fade away.
4. Treating heart diseases, whether medically or
surgically is still very costly. I have often wondered
if I had not been the Prime Minister when I had my
attack, whether I would be here today.
5. Reflecting on the theme of this Conference which is
"Cardiovascular Surgery in Asia: The Coming of Age", I
think it is fair to say that cardiac surgery in Malaysia
has certainly come of age. In less than 20 years since
the first open heart operation was performed in this
country, I understand there are now 4000 cases yearly
nationwide of which 2500 heart operations are done at
tertiary referral centres, such as the National Heart
Institute (Institut Jantung Negara). From arterial
switches in the Neonate to coronary bypass in the
Octogenarian, the spectrum of services provided is very
comprehensive.
6. There are many milestones that have been achieved
in cardiac surgery in Malaysia, in particular at the
National Heart Institute. Soon after IJN was
operational in 1992, mitral valve repair was introduced
in 1993. In 1995 it saw the introduction of Ross
procedure, REV procedure in complex congenital heart
condition and use of the radial artery as a coronary
artery bypass conduit. IJN mirrored closely the current
trend of doing bypass surgery (CABG) on the beating
heart; the first MIDCAB was done in 1996 followed by
Beating Heart Multivessel CABG the following year
(1997).
7. This institute has the biggest experience for
thoracic aortic aneurysm surgery in this region. From
surgery to the ascending aorta to the most complex
surgeries of the arch of the aorta and descending aorta;
these operations have become routine surgeries at this
Institute which makes it the leading centre in this
region for the treatment of this devastating ailment.
Heart transplantation has been a reality since 1997 and
I believe that lung transplantation will soon no longer
be a dream.
8. The Government has gone to great lengths to assure
every individual equal access to cardiac care and today
no Malaysian needs to leave our shores to obtain
treatment for heart diseases.
9. I speak now as a heart patient who had undergone
surgery. Cardiac surgery is, as we all know, a highly
complex operation, combining the best of technology and
human skill. Both cannot be undervalued. But surgery
is not just a matter of applying skill and knowledge to
cure a patient, in particular the heart patient. The
surgeon has to empathise with the patient. He must
understand the worries of the patient and the family.
He or she has to be there and figuratively to hold his
hand as he goes through the operation and to be there,
when he wakes up with an assurance that everything is
going to be all right. The human touch on the part of
the surgeon is all important.
10. As for medical science, we are fortunate that there
have been tremendous advances in the control of
infection, in anaesthesia, in post operative care, in
the design of surgical apparatus and the operating
theatre. The sophistication of all these will come to
nought if the surgeon and his team are not adapt at
using them. We can buy all these equipments and drugs
but producing the surgeons and the ancillary staff is
far more challenging. It is more so for Government
owned hospitals which cannot pay the high salaries which
the private sector can afford. We are building a large
number of ultra modern fully-equipped paperless
hospitals costing billions of dollars. But we may see
them as White Elephants because we cannot staff them.
As one who resigned from Government service to set up my
own clinic, I know that Government can never match the
attractive remunerations in the private sector. Should
the Government increase the pay, the private sector can
more than match it. That is the dilemma of the
Government. I see no end to the dilemma because the
more doctors that we produce and train, the bigger is
the demand for their services as the standard of living
rises. The problem is aggravated by richer countries
offering better compensation.
11. However we are happy that on the whole the medical
services in Malaysia have improved tremendously and in
the field of cardio-vascular surgery we can be quite
independent and relatively we are less costly.
12. With that, it gives me great pleasure to formally
declare open the 11th Annual meeting of the Asian
Society for Cardiovascular Surgery.
Sumber : Pejabat Perdana Menteri
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