Java

I'll be leaving PD soon, the exact date will be on the 2nd of August. I'll be reporting to GHKL, unsure of which department. To be frank, I'm in dilemma. I haven't make up my mind for my specialty training. Is it going to be Medical or perhaps Oncology?I really don't know.

I spent about ten days last month visiting Java, Indonesia. Jakarta-Bandung-Jogjakarta-Borobudur-Surabaya. The early part of the travel was traumatic. There were 4 of us but we were reduced to 3 when one of our friend lost his passport and wallet in LCCT, Nilai. Not a very pleasant start indeed, having to fly without the person that planned the whole trip. At the end, it's onlyme, Jhaznarul and Syahir.(We are so sorry, Acap!)

It's an eye-opener trip. Even though we share the same roots (Malays), the same region (Malay Archipelago), I hardly know about Indonesia or Indonesians. When I was young, I always thought Indonesians are all poor and they are wandering across the globe to earn money. Some of them, especially in Malaysia turn up to be bandits, robbers etc for the sake of getting money to send back home.Sitting and having meals in posh Grand Indonesia in the heart of Jakarta, I think otherwise now. Indonesia is not a poor country.But she is poorly managed. When I was boarding train from Jakarta to Bandung, I can see how urbanization had ruin the charm of Java. Squatters with densely packed houses are common alongside the railway. If you compare it with areas downtown Jakarta, you must feel the tremendous social distant between the rich and poor.

I regretted that we missed the trip to Gerisik, Demak and Solo. I got a friend studying medicine in Solo. And in Gerisik, the burial place for 2 of the famous saints of Java including Maulana Malik Ibrahim and Sunan Giri. But we did manage to visit the tomb of Sunan Ampel in Surabaya.

Visitors in Masjid Sunan Ampel

Makam Sunan Ampel, Surabaya

The entrance

Masjid Istiqlal, Jakarta

House of Soemporna, Surabaya

The workers preparing the 'kretek'

Masjid Cheng Ho, Surabaya

Kraton Palace, Jogjakarta

The volcanic crater of Tangkuban Perahu

Tangkuban Perahu, near Bandung

Gedung Sate, Dutch administration building in Bandung

Borobudur, Mataram empire greatest candi

Orthopedic in PD

Since I was transferred to be in charge of the wards in January, I've been 'entrusted' to run the Orthopedic Clinic in Port Dickson Hospital. Of course, there are few more MOs but all of them are so reluctant to run the clinic (we have loads of patients down here). We have 2 session, one on Wednesday with Mr Michael from HTJS, Seremban and another one on Friday with Prof Karim or Mr Chee Kid from IMU, Seremban.

I am not really 'into' Orthopedic since my medical years. I did housemanship in UMMC and in Orthopedic, housemanship is considered 'honeymoon' period for interns. Plus, I was in Oncology Orthopedic team under Mr (now AP) Vivek. Sadly, most of the cases that referred to our clinic are not Osteosarcoma, Ostoechondroma or pathological fracture. I was fortunate enough to work in Emergency Department in Seremban before being 'pushed' to district hospital. Thus, I had experiences in dealing orthopedic trauma cases.

It was a good news from our Pengarah that PD will be opening (re-opening) her Operation Theater again. We have OT but it is not functioning simply because there are no surgeons and anesthetists around. By July or August, we'll be opening our OT for minor procedures. Simple surgical and Orthopedic procedures will be done here, instead of referring them to Seremban. Previously, all cases will be referred to our clinic and then reviewed by the specialist. If the cases need any surgical intervention, we'll refer to Seremban. Now, PD folks including patients from Pasir Panjang, Lukut, Sunggala and as far as Bukit Pelandok will not be having any difficulty to get their op done. We can do it here (for simple procedures like K-wiring or plating).

Unfortunately, that means there will be an extra burden on us, the medical officers. With only 7 people in charge of the ward, one of us will have to go to assist the surgeon during operating days. Isaac will be sent for training under anesth in Seremban. The problem is, with the OT running, we don't have enough MOs doing the job in the ward. We got MOPD on Monday and Tuesday. SOPD on Monday and Wednesday.Orthopedic Clinic on Wednesday and Friday. ENT, Ophthalmology and PSY are also having their clinics.I just don't know how we are supposed to run the clinic and at the same time looking after the patients in ward and assisting surgeons in OT. Bear in mind, there's no houseman in PD!

My boss already told me that a complete/full Orthopedic team will be established in PD.Since I was running the orthopedic clinic here, I was invited to join the team as permanent Orthopedic MO. So far, I haven't make up my mind since I'm am no good at carpentering. Anybody interested joining Orthopedic team in PD?

O&G in Malaysia

How to improve O&G Department in Malaysia? Aku pun tak tahu apa yang perlu dikatakan. Setelah 4 bulan di bahagian Perbidanan dan Sakit Puan, banyak isu-isu yang aku rasa masih tak selesai dan terungkai di tanahair. Di UM, secara keseluruhan perkhidmatan Ginekologi (Sakit Puan) sangat baik. Cuma bagiku, situasi di Labour Ward (Wad Bersalin) tidak begitu memuaskan. Satu perkara yang jelas ialah masalah facility. Wad ini bukan husband-friendly. Pesakit yang hampir melahirkan terpaksa berkongsi satu cubicle dengan pesakit lain. Jadi, sang suami semuanya terpaksa menunggu dengan penuh keluh kesah di luar wad.

Malang sekali di Malaysia, tidak seperti sesetengah negara-negara Arab, kita tiada kemudahan hospital wanita/rumah bersalin yang diuruskan sepenuhnya oleh staff wanita.Sewajarnya, kita harus cuba menerapkan idea-idea yang selaras dengan fiqh Islami dalam menguruskan pesakit-pesakit terutamanya wanita yang hendak bersalin. Sepatutnya, prioriti harus diberikan agar doktor-doktor wanita yang menguruskan bakal-bakal ibu ini dan bukannya housemen officer lelaki.

Ireland bukanlah negara Islam. Tetapi di Dublin, sepanjang pemerhatian aku di sana, kesemua kes-kes bersalin yang normal dibereskan oleh bidan-bidan yang sangat terlatih dan professional. Dan mereka semuanya perempuan. Situasi ini bagus untuk pesakit. Aurat adalah satu daerah yang sangat sensitif bagi wanita. Ketiadaan midwives atau bidan-bidan terlatih ini menyebabkan mereka terpaksa dibidankan oleh doktor-doktor lelaki seperti aku. Pasti situasi ini akan menyebabkan rasa kurang selesa dan janggal yang amat sangat pada mereka. Aku juga tumpang simpati dengan keadaan mereka. Jika aku menjadi suami sekalipun, aku tidak mahu isteri aku melahirkan anak di sini!

Di belakang wad bersalin UM, tersergam satu bangunan yang separuh siap. Khabarnya, bangunan ini sepatutnya menjadi bangunan khas untuk wad wanita, wad kanak-kanak dan wad bersalin. Sudah 5 tahun projek ini dilancarkan. Malangnya, sehingga sekarang projek ini masih tidak siap-siap. Berita yang aku dengar ialah sudah lebih 3 kontraktor yang dipilih menarik diri dari projek ini. Ini menyebabkan facilty di UM tidak bertambah baik sedangkan bilangan pesakit makin bertambah saban tahun. Masalah besar di Malaysia ialah kebanyakan projek-projek besar dianugerahkan kepada syarikat-syarikat kroni yang ada hubungan rapat dengan ahli-ahli politik tertentu. Kebanyakan kontraktor ini tidak punya kelayakan atau pengalaman. Semua projek ini di'Ali Baba'kan kepada kontraktor lain. Faktor ini yang menyebabkan banyak projek-projek besar terbengkalai. Selagi tiada amalan telus dalam pengagihan projek-projek kerajaan, selagi itulah kita akan melihat banyak lagi bangunan seperti bangunan wad wanita dan kanak-kanak UM yang sehingga sekarang tersadai. Tiang-tiangnya hanya menunggu untuk menyembah bumi.

Malaysia Oh Malaysia

Sudah lebih sebulan saya mula berkhidmat sebagai doktor pelatih di Malaysia. Terlalu sibuk dengan dunia pekerjaan menyebabkan saya langsung tak terlintas untuk memperbaharui posting di blog yang sudah 'berhabuk' ini. Pengalaman pertama berkhidmat di Malaysia sudah pasti mencatat banyak kenangan yang tak dapat dilupakan. Apatah lagi sistem kesihatan dan budaya kerja di Malaysia terlalu jauh jika dibandingkan dengan Ireland. Apa yang pasti, sedikit sebanyak saya sudah mula merindui Dublin, Ireland. Meskipun ketika di Ireland saya asyik terkenang rumah di Malaysia. Tetapi sekarang perkara sebaliknya yang berlaku.

Di Malaysia adalah teramat susah untuk mengamalkan tasawwuf. Itu sahaja yang boleh saya simpulkan setelah hampir dua bulan bekerja. Meskipun Ireland ialah negara bukan Islam, sesetengah budaya yang dibentuk oleh sistem kesihatan di sana jauh lebih terpuji jika dibandingkan dengan Malaysia. Benar, ada sahaja doktor-doktor yang baik, mulia dan melayan doktor-doktor pelatih dengan baik. Namun, merekaq bukanlah golongan majoriti. Sistem kesihtan Malaysia banyak 'menekan' doktor-doktor pelatih sehinggakan mereka dianggap sebagai golongan paling bawahan di hospital. Bekerja lebih masa tanpa henti, dijadikan sasaran kemarahan dan pelbagai umpatan dan celaan dilemparkan. Ada sahabat yang pernah mengungkapkan, "Abused junior doctor will become an abusive consultant." Kata-kata itu memang benar. Kebanyakan consultant yang pernah dibuli ketika menjadi doktor pelatih akan menjadi seorang pembuli besar setelah 'darjat'nya meningkat naik. Mentaliti dan budaya dalam sistem kesihatan Malaysia masih terlalu jauh untuk dibandingkan dengan negara-negara maju di Barat. Apatah lagi jika hendak diukur dengan neraca Islam. Saya sendiri tidak tahu samada saya akan dapat terus bertahan bekerja di Malaysia. Mudah-mudahan Allah SWT akan memberikan kekuatan.

UMMA: Healing South Central

I received a new edition of Saudi Aramco World few days ago and this story inside captured my attention. A story how a bunch of Muslim doctors during their medical years turned a health hazard area into a health center, providing treatment and care for destitutes, uninsured and 'working poor'. UMMA clinic in South Central Los Angeles is worth mentioning. Even the Congresswomen for South Central, Maxine Waters said,

"If you want to see what Muslim Americans truly represent, go to UMMA Clinic!"

Click here to read the full story