Global Health – Why Malaysian Medical Students Should Bother? Dr. Valkuthan Rajaratnam MBBS(Mal),AM(Mal),FRCS(Ed),FRCS(Glasg),FICS(USA),MB A(USA), Dip Hand Surgery(Eur),PG CertMedEd(Dundee),FHEA(UK). Senior Consultant Hand Surgeon, KTPH Alexandra Health, Singapore
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Global Health – Why Malaysian Medical Students Should Bother?
Dr. Valkuthan RajaratnamMBBS(Mal),AM(Mal),FRCS(Ed),FRCS(Glasg),FICS(USA),MBA(USA),
Dip Hand Surgery(Eur),PG CertMedEd(Dundee),FHEA(UK).
Senior Consultant Hand Surgeon, KTPH Alexandra Health,
Singapore
Global Health
• problems that transcend national borders• best addressed by cooperative actions and
solutions"The failure to engage in the fight to anticipate, prevent, and ameliorate global health problems would diminish America's stature in the realm of
health and jeopardize our own health, economy, and national security."
-The Institute of Medicine, America’s Vital Interest in Global Health
• Practice• Training and Education• Research• Altruism
What is in it for them?
• Practice• Training and Education• Research• Altruism
Personal Experience
• UG & PG ME• Service establishment , and training• Building experience• Delivering wisdom across borders• Teaching and learning different systems• Communicating and collaborating• Leaving legacy through education
Malaysian Population
Total: 28.4 million
Migrant Workers: 1.8 million
Expats: 313,000
Illegal immigrants: estimated 450,000 to 1.2 million
Migrant Workers in MalaysiaCountry of Origin
Indonesia Bangladesh
Nepal Myanmar
India Vietnam
Others
Key Contributions to Global Health
Queen Elizabeth Hospital, UHB NHS Foundation Trust
Open air out patient clinic
Current make shift classroom
Residual mines and their effects
A below knee amputee following land mineInjury with prosthesis
Major flash burn contracture of post axillary fold needing release and reconstruction
AO Instructional course for medics/nurses
Compressed air unit for power tools
“Portable” Xray unit using dental Xray tube
Surgery with implants and power tools
Median and ulnar nerve injury treated with sural nerve cable graft bridging gap
SSG done by member of nursing staff
IED – Improvised Explosive Device• Since 2007, IED blasts are
commonest combat injury seen at RCDM
• Improvised devices with evolving sophistication
• Difficult to detect• Frequently placed at road
side to target foot and vehicle patrols
The Team
• Unique injuries– Patterns emerging
• Unique patients• Multidisciplinary care• IEDs – large zone of injury• Difficult reconstruction
• Very rewarding
Regular Royal Visitors
be different
make a differenc
e
Life Expectancy at Birth
Bangladesh
Indonesia
Malays
ia
Singa
pore UKUSA
0102030405060708090
Years
Years
Maternal Mortality Ratio(Inter agency estimates)
Bangladesh
Indonesia Malaysia Singapore UK USA0
50
100
150
200
250
300
per 100 000 live births
Comparison of International Health Statistics
Bangladesh Indonesia Malaysia Singapore UK USA
Population in thousands
148 692 239 871 28 401 5 086 62 036 310 384
% pop. living in urban areas
28 44 72 100 80 82
Governmentexpenditure on health as % total govt expenditure
7.4 7.8 9.2 8.0 16.0 22.4
Annual per capita govt expenditure on health (US$)
8 38 204 629 2 938 4 437
Physicians Density
Bangladesh
Indonesia Malaysia Singapore UK USA0
5
10
15
20
25
30
per 10 000 population
per 10 000 popu-lation
Infant Mortality Rate(probability of dying between birth & 1 year)
ReferencesHealth imperatives in foreign policy: the case ofMalaysia: Simon Barraclough & Kai-Lit Phua, Bulletin of the World Health Organization 2007;85:225-229.