MINISTRY OF HEALTH PLAY GOD

KKM Play God?

Multiple myeloma is a rare form of blood cancer. My wife has been diagnosed with the disease 7 years ago. Since then she has been undergoing chemotherapy treatments for the first four years at Ampang Hospital, Kuala Lumpur, and then at Hospital Raja Perempuan Bainun (HRPB), Ipoh until now. The haematology specialists from both hospitals have more or less exhausted the types of chemo drugs used on her, at best they retard the cancer cells. Earlier on, she had stem cell treatment at Ampang Hospital and this gave respite of good health for a couple of years before relapse.

Lately, the cancer cells have become aggressive and my wife has been in and out of hospital. Now, she is much weakened. For the latest treatment, and as a last resort, the specialist at HRPB, Dr. Kamini recommended the use of Darzalex, weekly doses for the first month, subsequently fornightly and later on monthly. She had the first two doses already and the third next week.

Both of us are retired governments, my wife a former teacher and also lecturer at UKM and UITM.  I was with MARDI for 20 years. I have applied  to MARDI to pay for the expensive drug, RM12,800 for each dose of 2 vials supplied by MS Ally. Time is not on our side as the approval will take time as MARDI has to get the go-ahead from the Kementerian Kesihatan Malaysia (KMM), so for the beginning we pay first and to get reimbursements later once approved. We are confident that it will be straightforward case because MARDI has no stipulation as to the cost. Lo and behold, we got word ie. unofficially from the KMM people that they cannot approve use of the drug because it is expensive and not in their list!

Are they ignorant that the party responsible payment of the drug is MARDI not KKM. If the drug is not the list, there must be a committee to review it because the medicine world changes by the hour due to their (west) innovative research. We just relax and say they have done it all. Is to review the list something big and difficult? We are talking about saving life, not money. Is life that cheap? Let us not play god. Anyway, the drug has been on compassionate list before, why KMM pulled it back? Each cancer patient has his/her own chemo treatment regime accordingly, thus not many need to use Dovralex. This further adds to the cost .

If they do not approve (officially) then we are going to exhaust all avenues of appeal to KMM up to the Minister and even up to PM. We have nothing to loose. We perceive it as an injustice to deprive my wife getting the treatment. Nobody wants to get cancer! The Ministry must listen to reasons and approve the drug use. Thank you. I will do anything for my wife, my love. I will solo picket if needs be.  

NATURE FARMING - A SYNTHESIS

Nature Farming – harnessing latent energies of the environment

In the last two centuries, our haste towards development  and progress have resulted in widespread degradation of the earth’s ecosystem. Improper disposal of industrial and domestic wastes have polluted the soil, water, and air. In certain parts our atmosphere is partly blanketed with greenhouse gases which trap the deflected sun rays and prevent them to escape.  Land denudation, deforestration, diminishing biodiversity, burgeoning population, and not to mention wars further add to the earth’s crisis. Global climate change is a clear example of the sum effect of man’s negative follies on the ecosystem. Equitable climate means survival for all living things and preservation of the non-living.

To face the environmental challenges on the ecosystem, organisations at various levels - internationally, nationally, communally, and individually are taking remedial measures  sustainable ecosystems. Malaysia is promoting going green (biodiesel, biodiversity conservation, sustainable agriculture), renewable energy use (solar and hydro power), cutting down plastic use, and waste recycling.

Agriculture is the mainstay of this country. The practice of sustainable agriculture is viewed to be of utmost importance for economic production for the long term.  It hinges on optimising the use of resources  of the ecosystem - water, topography, fertility, weather, pest and diseases to match with arability of the crop(s) to be grown. The use of modern and appropriate technologies must go in tandem in all aspects of production, processing, and marketing.  Agricultural pollution could be minimised by judicial use of fertiliser and pesticides for example.

In organic farming (OM) system, pesticides and chemical fertilizers are not applied in the growing of crops. If used at all it will be minimal and under unavoidable situations. This environmental friendly approach is one of the ways  towards sustainable agriculture. However, it is intensive in terms of labour especially may not be suitable for large scale agriculture.

Nature farming (NF) is another approach towards sustainable agriculture. It is less intensive. The concept is to adapt crop and/or animal husbandry to the inherent  characteristics of the land. It is to harness and merge the latent energies of the diverse elements in the system to productive use. Biotic factors such as root competition, plant growth habit, storied and shade effects, animals, and abiotic such as weather, soil condition, rocks that persist in sub-ecosystem are taken advantage in the interplay and relationships they may have - neutral, synergistic, symbiotic, antagonistic. The use of diverse plant species from ground cover to tall trees to beneficial use means that it is a sort of disorganised mixed farming of the wild. However, there is order in the disorder. Also, NF is perhaps an advanced form of traditional agriculture with basic scientific concepts applied.  

The oil palm, the most efficient converter of the sun’s energy to edible oil is a good  candidate for nature farming that shows intricacies of man-animal-plant-environment relationships and energy flow. From the start, if the area is bushy with small trees, just clear (with bulldozer) the planting row and plant the oil palm seedlings. The lining may not be accurate to our liking but good enough. Within a couple of years the young palms will overshoot the tops of the bushes. The vigorous fibrous root system can cover a wide area and would soon overwhelm the root systems of lalang and grasses around it. Within three years the lalang and other undergrowths will be overshaded by the palm fronds and die off. The small trees can be gradually cut down or pollarded. If there are buffaloes grazing in the area they will help to clear the wild grasses and vines and make walking paths. They will however munch the shoot and leaves of young palms. Being fast growers, the palms will recover with new cycle of leaves and stunting is minimal. Buffaloes will scare away snakes in the area and make it safe to work. If there are muddy pools the buffaloes would wallow in them to cool off.  Their droppings add fertility to the soil that benefit the earthworms and plants. They attract leeches that suck human blood to give the ‘bekam’ effect if one gets bitten. It is a pleasant sight to see egrets land on the backs of buffaloes doing a favour looking for ticks. Monkeys and wild pigs deprived of their original habitats would pick fruits from  the low bunches.  Their tracks result in the area around the base of palm clear  allowing easy access for harvesting. Those animals deserve a share of the harvest. Cabbage from unwanted non-bearing palms can be harvested and cooked. Fresh leaves and pellets made from the fronds provide feed to goats, sheep, and cattle.

As a plantation crop, the oil palm has been much criticised for environmental destruction by the west. They may have a point. It is the planters to be blamed. At any scale of operations, riparian reserve should be left undisturbed to allow water catchment and wild animals to live. The mega FELDA Lahad Datu oil palm scheme left nothing for orang utan haven.  It has caused irreversible damage to the riverine system, biodiversity, environment, and people inhabitants of the jungle.