Wednesday, December 31, 2008
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Thursday, December 18, 2008
Wednesday, December 17, 2008
Tuesday, December 16, 2008
Saturday, December 13, 2008
Chaotic Thoughts from the Old Millenium
by Sim Wong Hoo
What's is NUTS? NUTS is when you want to do something and you seek approval of a higher authority. When there is no rule saying that you can do such a thing, then the standard answer is NO ...
In the US, when there is no sign on the road, it means that you can make a U-turn. When the authority do not want people to make U-turns, they will put up signs to tell you not to make U-turns.
In Singapore, it is the reverse. When there is no sign on the road, you are not allowed to make U-turns. When the authority allow you to make U-turns, then they will put up signs to give you that right.
The two different systems serve the same purpose - to better manage the traffic. They may look quite similar, just coming from different direction, but the social repercussion is significant.
In Singapore, the no U-turn without sign culture has permeated every level of our thinking and every segment of our life. This no U-turn has created a way of life that is based on rules. When there is a U-turn sign or when there is a rule, we can U-turn. When there is no sign, we cannot U-turn. When there is no rule, we cannot do anything. We become paralyzed. I call this "no-rule = no-do" phenomenon - the "No U-Turn Syndrome" or NUTS.
Singapore has prospered under a rule-based system for many years. When we were at a lower level of development, we needed many multi-national companies to come to Singapore to invest. What these MNCs needed were a very reliable group of managers and workers who could follow exactly the rules set by corporate headquarters overseas. Since they did not want their overseas subsidiaries to innovate anything, they wanted us to stick closely to the rules, no funny deals, no crazy ideas. They were here to teach us, not to listen to ideas from us.
The efficiency and no-nonsense style of the Singapore government is well-known. It has brought us prosperity and a good life. A rule-based system is essential here too to get everybody to toe the line.
But the world has changed. And it is changing faster and faster. So fast that the rules that were set yesterday are no longer valid and cannot serve our new needs. It is not a matter of setting new rules to meet the new situation because by the time new rules are formulated, they would already be out of date. It is a matter of how to survive and prosper in environments where there are no rules.
It is a matter of how to live with ambiguity. Things are no more black or white, things are in shades of gray. How do we deal with them?What is NUTS? NUTS is when you want to do something and you seek the approval of a higher authority. When there is no rule saying that you can do such a thing, then the standard answer is NO.
What is wrong with this? There is nothing wrong if we choose to be stuck in the old world of our own where nothing changes. To meet the challenge of the new world, to meet the challenge of rising to a knowledge-based economy, we have to innovate like mad.
How can we innovate when we need to obey rules to innovate? Innovate means to create things out of nothing, it means moving into uncharted territories where there are no rules. How can you innovate when you have to get approval of somebody who looks at a rule-book first? Such is the syndrome of NUTS.
NUTS is everywhere in the society including schools, offices, hospitals, parks, factories and even in our homes. Yes, in Creative (Singapore) too.
Here are some hilarious examples; they make you want to laugh and cry at the same time. I am sure you can tell me more.
NUTS #2-"Creative Resource"-needed approval?
When our corporate headquarters were completed in 1997, we needed to give it a name. The placeholder name was Creative Technology Centre. Made sense, but it was a boring name that everybody had. I wanted a special name, because we are "creative". So the usual names like, "Creative Building, Plaza, Complex, House..." were suggested on the name list. I rejected all of them.
Finally we came out with a very good name, "Creative Resource" - the source of all creativity – and everybody loved it.
But wait, before we could go ahead, we had to submit the building name for approval. What! I was shocked. I needed somebody else’s approval for the name of my own building. By some faceless committee that I did not even know existed. Imagine having the name of your baby being approved by somebody you do not know.
Hey, that is the regulation. OK, we submitted and no prize for guessing the right answer. The answer was NO. The reason given was that the name was not "Centre, Plaza, Building, Complex, House etc..." There was actually a list of approved names in the rulebook and we were only given the impression that we could name our own building.
I nearly jumped through the roof when I heard the answer. It was a very typical case of NUTS. "Resource" was not in their rule book, hence the standard answer was NO. I was not going to give up on this right. So we fought back and wrote letters to appeal. Finally, after a long process, our name was approved. Whew!
NUTS #3 - Cannot sing Singapore songs!!
While we were preparing for the opening ceremony of Creative Resource, we wanted to have a lot of creative fun. We prepared a lot of performances by our own staff. We were very fortunate to have invited the Prime Minister, Mr Goh Chok Tong to grace the event. We wanted to show him the best creativity in us.
The opening fanfare idea was to have a big group of kids running into the building, singing a medley of Patriotic Singapore Songs. It was going to be very delightful. After the songs were arranged and recorded, at the last moment, someone in the team decided that we actually needed to seek approval from the authority because of copyright issues.
The answer came back was of course a NO. There was no rule to say that you could do a medley of Singapore songs. There was a rule that said we could sing the Singapore song in special> celebratory occasions like ours, so this was allowed.
Our people started to panic, because there was no time to change the recordings. They sought my advice. They were thinking of canceling this delightful fanfare and disappointing the kids, from our Creative O child-care centre, who had practiced so hard for this event.
I asked them why they had thought of seeking approval for a private function especially when the answer could be a No. They were afraid that the TV stations were there filming and it might have constituted a copyright infringement!
There were a few NUTS at work here. First it is my own staff who were NUTS, they were toeing the line so tightly that they felt the need to seek approval for a private function that was not controversial at all.I was sure that the PM would give his 100% endorsement.
Then we had the NUTS at the approval side who looked at the rule book and said No.
I asked them to go ahead and just do it, even violating the rejectionletter. Some of my NUTS staff must have freaked out. I told them I would bear the full responsibility. If I had to pay a $2,000 fine, I would pay it. In the worst, worst case I might go to jail for it - that would be interesting too.
In fact, the PM in his impromptu part of his speech also said, to move forward, we would have to "just do it". It was a timely message.
NUTS #4 - No Title
Recently, Creative had just spent a few million dollars investing heavily in a company. The key person in the company was needed urgently to launch a new ".com" project that could be worth a lot more in the future. In the era of the Internet, timing is everything. Then suddenly, he told me that he needed to go for reservist during the critical period. This meant that his whole team could be crippled because his leadership was not there.
I told him that there should not be a problem, as he could always apply for a deferment. In fact, the Deputy Prime Minister has told me in the Technopreneur 21 committee that, reservist duties should not hinder Technopreneurship because the affected reservist could apply for deferment and it would be considered favourably.
So the staff wrote a letter to apply for deferment. It was rejected. I told him to write an appeal, mentioning Creative’s involvement and all the relevant and valid reasons for such critically needed deferment. It was still rejected and we were running out of time.
I guess I had to step in. I wrote the letter personally again, citing all the reasons and the ".com" time-critical factors. It was still rejected. I was very upset by this. It was already the last working day before he had to go in-camp. I had to call the officer personally. I identified myself, including my role in the Technopreneur 21 committee and appealed for the fourth time. The answer was still NO. After all the reasons were given, the answer was still NO.
Well, they had liberalized then - if you were a new employee of a company, the deferment would be allowed. I argued strenuously that the key person was more than a new employee. He was a new employee of a company for which we had spent millions to acquire. No! An acquisition does not constitute the equivalent of a new employee. A new employee IS a new employee. Period. The rule book never said that the people in a new acquisition are new employees. Therefore they are not "new employees", regardless of the fact that their employee status are the same in principle. It does not matter if you are Sim Wong Hoo or the T21 chairman. NUTS is NUTS.
It almost drove me NUTS! Fortunately, I heard from some people that I would get a better chance if I were to call the unit Commanding Officer. I asked for his name and phone number and the officer obliged. I managed to track down the CO on his handphone at the very last minute. The CO was an understanding man because he was also a reservist and in the computer line. The deferment was finally granted
NUTS #5 - Creative NUTS
We had our equal share of NUTS in Creative and they really drove me NUTS because they actually happened right on my head, the CEO of the company. Such is the persistence and universality of NUTS.
First example, the time I needed some CD-ROM replicated for some last-minute projects. I knew I had time because, we had an in-house CD-ROM replication plant and it would have taken less than one day to finish the job, especially my small little job of a few hundred pieces.
But when my assistant came back, she told me helplessly that they needed a one-week lead-time. I almost jumped off my chair. This was a rush job for the CEO and they just threw back their standard lead-time at me, it was clearly written in their rule-book that the standard lead-time was one week - for a rush job. So one week was what you would get even if you were the CEO of the company, even if your job was very important.
I asked them who set the rules? They were the ones who set the rules! I was amazed how NUTS they were. Then change the rules, I told them. Finally they did it for me in two days.
There were several of such examples within Creative. And the managers sometimes fought with me because that was the only way they could ensure the quality of the products. Quality is good when we are shipping products to customers. But when we need to rush, it is always during the early stages of engineering run, where we need a lot of samples to test. Quality then becomes secondary and time is primary. Staff with a NUTS mentality would not have the flexibility to do such a switch, unless you make another rule. And you can only live within the new rules.
NUTS #6 - More Creative NUTS
The second example in Creative has to do with customer support. Creative pride ourselves as a company that provides the best technical support. All our staff know that. We have 400 people in Oklahoma USA, just listening to phone calls alone. We have a small technical/customer support team in Singapore serving only the small Singapore market. The team is hardworking and dedicated to the company. In general, their service is good and efficient - when there are rules.
There was once when I received a customer's letter addressed to me complaining about our customer support department (CSD) with regards to a missing CD from our product. Our CSD insisted that the customer get the CD from his dealer who sold him the PC with our product. And the customers attached the letters of exchange.
It was such a minor issue but I felt customer satisfaction was most important. So I wrote a small note and asked them to give him the CD and be done with it. CD-ROMs are very cheap anyway.
A few weeks later, I received another letter from this furious customer complaining that our CSD wanted to charge him like $15 for the CD because it was the responsibility of the dealer to give it to him. And he attached even more letters for me to read.
I was very upset this time because, what could have been a very simple and pleasant customer support issue, costing the company less than $1 for the CD-ROM if people in CSD had just given it to him in the first> place, now potentially cost the company a bomb:
Firstly, the CSD's time to write all those letters of exchange, they are way, way over $1. But because of NUTS, our CSD people did not see it. They are just trying to follow rules when there are no rules in such situation.
Secondly, the CEO's time. I had to read about ten letters two times to figure out the gist of it all. It must have cost the company thousands> of dollars. And even after my first instruction to just give him the CD-ROM, they still went into a cat and mouse chase to try to ask him to pay $15. Someone in CSD probably set the rule that if a customer wanted an extra CD-ROM, it would cost him $15 - that is it, regardless of the plight of the customer.
Thirdly,the most expensive part - the harm it had done to our brand name. A potentially unhappy customer would hurt the company way beyond the customer. He would tell all his friends not to buy from the company.
But people with NUTS mentality could not see beyond the rules. They could not see that a $1 CD-ROM was much, much cheaper than their own time, their CEO's time and the value of the brand name.
I had to call all the three persons involved in this case to my office and explain to them very slowly about our principle of customer support. You could not fault them for dedication, they were trying to make an extra $15 for the company. Not seeing the big picture of how much more it would cost the company. I had told them that for us, the customer’s interest is always in the #1 position. I told them that they were the "customer"s advocates" - they had to be fighting with me for their customer’s interest, rather than the other way round.
Finally, I told them to call up the customer directly, apologize and give him the CD-ROM he wanted and ensure that the customer was 100% satisfied. If the customers are not satisfied - we should not take their money.
We are moving faster and faster into many uncharted territories, where there are no rules. We do not want to be paralysed by waiting for the rule to be formulated before moving - it will be too late. We have to discard our NUTS mentality and learn to live in a new world where there are no clear rules.
Not that it will be a cowboy lawless land. There will be broad guiding principles such as common goals, objectives and basic integrity to follow. The rest, we have to look at the big picture and decide what is the best way to do a job, to achieve our goals.
Sim Wong Hoo
Excerpt from "No U-Turn Syndrome (NUTS)"
Chaotic Thoughts from the Old Millennium
Wednesday, December 10, 2008
— Carl Zuckmayer: German dramatist
Consider this fact: Seventy percent of lottery winners end up squandering away their winnings.
The reason: They had tremendous luck yet no discipline. But when you live with discipline, you'll almost always win the lottery. It will come some day in the future through your career and personal achievements. Find your discipline that will also find your luck.
There was a blind girl who hated herself because she was blind. She hated everyone, except her loving boyfriend. He was always there for her. She told her boyfriend, 'If I could only see the world, I will marry you.'
One day, someone donated a pair of eyes to her. When the bandages came off, she was able to see everything, including her boyfriend.
He asked her, 'Now that you can see the world, will you marry me?' The girl looked at her boyfriend and saw that he was blind. The sight of his closed eyelids shocked her. She hadn't expected that. The thought of looking at them the rest of her life led her to refuse to marry him.
Her boyfriend left in tears and days later wrote a note to her saying: 'Take good care of your eyes, my dear, for before they were yours, they were mine.'
This is how the human brain often works when our status change. Only a very few remember what life was like before, and who was always by their side in the most painful situations.
Life Is a Gift
Today before you say an unkind word - Think of someone who can't speak.
Before you complain about the taste of your food - Think of someone who has nothing to eat.
Before you complain about your husband or wife - Think of someone who's crying out to GOD for a companion.
Today before you complain about life - Think of someone who died too early on this earth.
Before you complain about your children - Think of someone who desires children but they're barren.
Before you argue about your dirty house someone didn't clean or sweep - Think of the people who are living in the streets.
Before whining about the distance you drive - Think of someone who walks the same distance with their feet.
And when you are tired and complain about your job - Think of the unemployed, the disabled, and those who wish they had your job.
But before you think of pointing the finger or condemning another - Remember that not one of us is without sin.
And when depressing thoughts seem to get you down - Put a smile on your face and think: you're alive and still around.
Tuesday, December 09, 2008
This is a poem written by a teenager with cancer in New York Hospital. This young girl has 6 months left to live, and as her dying wish, she wanted to send a letter telling everyone to live their life to the fullest, since she never will.
She'll never make it to prom, graduate from high school, or get married and have a family of her own.
It was sent by a medical doctor.
Have you ever watched kids
On a merry-go-round?
Or listened to the rain
Slapping on the ground?
Ever followed a butterfly's
Or gazed at the sun
into the fading night?
You better slow down..
Don't dance so fast.
Time is short.
The music won't last.
Do you run through each day
On the fly?
When you ask How are you?
Do you hear the reply?
When the day is done
Do you lie in your bed
With the next hundred chores
Running through your head?
You'd better slow down
Don't dance so fast.
Time is short.
The music won't last..
Ever told your child,
We'll do it tomorrow?
And in your haste,
Not see his sorrow?
Ever lost touch,
Let a good friendship die
Cause you never had time
To call and say,'Hi'
You'd better slow down.
Don't dance so fast.
Time is short.
The music won't last.
When you run so fast to get somewhere
You miss half the fun of getting there.
When you worry and hurry through your day,
It is like an unopened gift....
Life is not a race.
Do take it slower
Hear the music
Before the song is over.
For centuries, people have recognized the power of luck. To investigate scientifically why some people are consistently lucky and others aren't, Richard Wiseman advertised in national periodicals for volunteers of both varieties. Four hundred men and women from all walks of life responded.
Over a 10-year period, Wiseman interviewed them, asked them to complete diaries, questionnaires and IQ tests, and invited them to his laboratory for experiments. He found that lucky people get that way by applying some basic principles:
• Seizing chance opportunities
• Creating self-fulfilling prophecies through positive expectations
• Adopting a resilient attitude that turns bad luck around
For example, he gave lucky and unlucky people a newspaper, and asked them to determine how many photos were inside. On average, unlucky people spent about two minutes on this exercise -- but the lucky people only spent seconds.
On the paper's second page, in large type, was the message "Stop counting: There are 43 photographs in this newspaper." Lucky people tended to spot the message. Unlucky ones didn't.
Halfway through the paper, was a message that read: "Stop counting, tell the experimenter you have seen this and win $250." Again, the unlucky people missed it. The lucky people saw what was there, rather than just what they were looking for.
Lucky participants also put effort into adding variety to their lives, tended to be more optimistic, and were happier and more satisfied with their lives.
The good news is that when Wiseman described the techniques to help participants react like lucky people, 80 percent reported being happier and luckier after just one month.
One unlucky subject said that after adjusting her attitude, her bad luck actually vanished.
The bottom line? Thoughts and behavior affect the good and bad fortune you encounter. The most elusive of goals -- an effective way of taking advantage of the power of luck -- is actually available to everyone.
Sources:Reader's Digest November 19, 2008
Monday, December 08, 2008
A friend of mine opened his wife's underwear drawer and picked up a silk paper wrapped package: 'This, - he said - isn't any ordinary package.'
He unwrapped the box and stared at both the silk paper and the box. 'She got this the first time we went to New York , 8 or 9 years ago. She has never put it on, was saving it for a special occasion. Well, I guess this is it. He got near the bed and placed the gift box next to the other clothing he was taking to the funeral house, his wife had just died.
He turned to me and said: 'Never save something for a special occasion. Every day in your life is a special occasion'.
I still think those words changed my life. Now I read more and clean less. I sit on the porch without worrying about anything. I spend more time with my family, and less at work..I understood that life should be a source of experience to be lived up to, not survived through.
I no longer keep anything. I use crystal glasses every day... I'll wear new clothes to go to the supermarket, if I feel like it.I don't save my special perfume for special occasions, I use it whenever I want to.
The words 'Someday...' and ' One Day...' are fading away from my dictionary. If it's worth seeing, listening or doing, I want to see, listen or do it now.. I don't know what my friend's wife would have done if she knew she wouldn't be there the next morning, this nobody can tell.
I think she might have called her relatives and closest friends.She might call old friends to make peace over past quarrels. I'd like to think she would go out for Chinese, her favorite food.
It's these small things that I would regret not doing, if I knew my time had come.<>
Each day, each hour, each minute, is special. Live for today, for tomorrow is promised to no-one.
Wednesday, December 03, 2008
Paul Joseph Watson
The man who predicted the 1987 stock market crash and the fall of the Soviet Union is now forecasting revolution in America, food riots and tax rebellions - all within four years, while cautioning that putting food on the table will be a more pressing concern than buying Christmas gifts by 2012.
Gerald Celente, the CEO of Trends Research Institute, is renowned for his accuracy in predicting future world and economic events, which will send a chill down your spine considering what he told Fox News this week.
Celente says that by 2012 America will become an undeveloped nation, that there will be a revolution marked by food riots, squatter rebellions, tax revolts and job marches, and that holidays will be more about obtaining food, not gifts.
"We're going to see the end of the retail Christmas... .we're going to see a fundamental shift take place - putting food on the table is going to be more important that putting gifts under the Christmas tree," said Celente, adding that the situation would be "worse than the great depression".
"America's going to go through a transition the likes of which no one is prepared for," said Celente, noting that people's refusal to acknowledge that America was even in a recession highlights how big a problem denial is in being ready for the true scale of the crisis.
Celente, who successfully predicted the 1997 Asian Currency Crisis, the subprime mortgage collapse and the massive devaluation of the U.S. dollar, told UPI in November last year that the following year would be known as "The Panic of 2008," adding that "giants (would) tumble to their deaths," which is exactly what we have witnessed with the collapse of Lehman Brothers, Bear Stearns and others.
He also said that the dollar would eventually be devalued by as much as 90 per cent.
The consequence of what we have seen unfold this year would lead to a lowering in living standards, Celente predicted a year ago, which is also being borne out by plummeting retail sales figures.
The prospect of revolution was a concept echoed by a British Ministry of Defence report last year, which predicted that within 30 years, the growing gap between the super rich and the middle class, along with an urban underclass threatening social order would mean, "The world's middle classes might unite, using access to knowledge, resources and skills to shape transnational processes in their own class interest," and that, "The middle classes could become a revolutionary class."
In a separate recent interview, Celente went further on the subject of revolution in America. "There will be a revolution in this country," he said. “It's not going to come yet, but it's going to come down the line and we're going to see a third party and this was the catalyst for it: the takeover of Washington, D. C., in broad daylight by Wall Street in this bloodless coup.
And it will happen as conditions continue to worsen." "The first thing to do is organize with tax revolts. That's going to be the big one because people can't afford to pay more school tax, property tax, any kind of tax. You're going to start seeing those kinds of protests start to develop." "It's going to be very bleak. Very sad. And there is going to be a lot of homeless, the likes of which we have never seen before.
Tent cities are already sprouting up around the country and we're going to see many more." "We're going to start seeing huge areas of vacant real estate and squatters living in them as well. It's going to be a picture the likes of which Americans are not going to be used to.
It's going to come as a shock and with it, there's going to be a lot of crime. And the crime is going to be a lot worse than it was before because in the last 1929 Depression, people's minds weren't wrecked on all these modern drugs - over-the-counter drugs, or crystal meth or whatever it might be. So, you have a huge underclass of very desperate people with their minds chemically blown beyond anybody's comprehension. "
The George Washington blog has compiled a list of quotes attesting to Celente's accuracy as a trend forecaster.
"When CNN wants to know about the Top Trends, we ask Gerald Celente."
- CNN Headline News
"A network of 25 experts whose range of specialties would rival many university faculties."
- The Economist
"Gerald Celente has a knack for getting the zeitgeist right."
- USA Today
"There's not a better trend forecaster than Gerald Celente. The man knows what he's talking about." - CNBC
"Those who take their predictions seriously ... consider the Trends Research Institute
- The Wall Street Journal
"Gerald Celente is always ahead of the curve on trends and uncannily on the mark ... he's one of the most accurate forecasters around." - The Atlanta Journal-Constitution
"Mr. Celente tracks the world's social, economic and business trends for corporate clients."
- The New York Times
"Mr. Celente is a very intelligent guy. We are able to learn about trends from an authority."
- 48 Hours, CBS News
"Gerald Celente has a solid track record. He has predicted everything from the 1987 stock market crash and the demise of the Soviet Union to green marketing and corporate downsizing." - The Detroit News
"Gerald Celente forecast the 1987 stock market crash, 'green marketing,' and the boom in gourmet coffees." - Chicago Tribune
"The Trends Research Institute is the Standard and Poors of Popular Culture."
- The Los Angeles Times
“If Nostradamus were alive today, he'd have a hard time keeping up with Gerald Celente."
- New York Post
So there you have it - hardly a nutjob conspiracy theorist blowhard now is he? The price of not heeding his warnings will be far greater than the cost of preparing for the future now. Storable food and gold are two good places to make a start.
Thursday, November 27, 2008
He argues that our feel-good, politically correct teachings have created a generation of kids with no concept of reality who are set up for failure in the real world.
RULE 1 - Life is not fair; get used to it.
RULE 2 - The world won't care about your self-esteem. The world will expect you to accomplish something BEFORE you feel good about yourself.
RULE 3 - You will NOT make 40 thousand dollars a year right out of high school. You won't be a vice president with a car phone, until you earn both.
RULE 4 - If you think your teacher is tough, wait till you get a boss. He doesn't have tenure.
RULE 5 - Flipping burgers is not beneath your dignity. Your grandparents had a different word for burger flipping; they called it opportunity.
RULE 6 - If you mess up, it's not your parents' fault, so don't whine about your mistakes, learn from them.
RULE 7 - Before you were born, your parents weren't as boring as they are now. They got that way from paying your bills, cleaning your clothes and listening to you talk about how cool you are. So before you save the rain forest from the parasites of your parents' generation, try "delousing" the closet in your own room.
RULE 8 - Your school may have done away with winners and losers, but life has not. In some schools they have abolished failing grades; they'll give you as many times as you want to get the right answer. This doesn't bear the slightest resemblance to ANYTHING in real life.
RULE 9 - Life is not divided into semesters. You don't get summers off, and very few employers are interested in helping you find yourself. Do that on your own time.
RULE 10 - Television is NOT real life. In real life people actually have to leave the coffee shop and go to jobs.
RULE 11 - Be nice to nerds. Chances are you'll end up working for one.
Monday, November 24, 2008
This account below, by a West Malaysian doctor, about the plight of the poverty stricken Sabah villagers, is so touching, and so shocking at the same time, that I cannot resist posting it here for all who are interested to read and to know, that Sabahans are well and truly being left behind by the mainstream Malaysian and State Governments, political Parties and politicians!
By: Another Doctor Sep 8, 08 5:11pm
I refer to the Malaysiakini article Kota Marudu needs more than wireless Internet. I read Dr Hams letter and cannot help but agree with many of his observations.
I worked in Sabah for over seven years as a house officer and medical officer. After my housemanship, I was sent to Ranau to serve in the district hospital. What Dr Hams described in Kota Marudu is not something isolated to that district alone in Sabah.
It is an often repeated story in the whole of Sabah. My first introduction to the poverty in Sabah came during my first months there, when a sweet 70-year-old lady from Kota Marudu was sent to the Queen Elizabeth Hospital with deep jaundice. She lived alone in a small village off Kota Marudu and noticed the jaundice about a month before.
She had no money for the taxi fare and so waited a month to sell off her chickens to have enough money to pay RM50 for the transport to Kota Marudu Hospital. She had to walk two miles to get to the road to get to the taxi. Having been born, bred and educated in Peninsular Malaysia, I was shocked.
When she arrived, she was septic and had a gallstone lodged in her common bile duct. The stone was duly removed but she was found to have a heart problem that required a pacemaker. We arranged for her to get a permanent pacemaker but she refused. When I pressed her for her reason, she told me that she couldn't afford to buy batteries for the pacemaker, having sold off her chickens. Once I explained to her that the batteries would last for years and we would provide them, she agreed to the pacemaker.
Ranau town itself has roads and is on the main highway between Sandakan and Kota Kinabalu. It developed primarily as a result of the Mamut Copper Mines in the district. However, highway in this context means a two lane road with frequent landslides and potholes, with a two-hour drive to Kota Kinabalu.
Outside Ranau, transportation becomes a problem as tarred roads disappear to become gravel or crudely marked logging trails. Anyone who has worked in Sabah would have the same stories to tell, of extreme poverty and poor transportation.
During my 2 years in Ranau, I've heard and seen it all, patients with cerebral malaria, a condition unheard of in Peninsular Malaysia, coming in after 48 hours to the hospital from places like Kaingaran and Karagasan, with relatives having to push the 'pirate taxi' through the mud, spending RM50 on fare during the monsoon season, the equivalent of 2 months income, this too when petrol was only around RM1.20 a litre in Ranau.
Patients having to delay treatment for life threatening conditions because a bridge washed away along the trail (I won't even call it a road) to Tambunan. Emergency surgery such as caesarian sections, appendectomies and even ectopic pregnancies had to be performed in our little district hospitals by Medical Officers with little more than 4 months housemanship experience.
Medical emergencies such as myocardial infarctions, which in Peninsular Malaysia would be managed in a Coronary Care Unit setting, had to be managed in the district hospital level. I'm grateful however, that my staff in that hospital were the best I've ever had the pleasure of working with and were dedicated enough to want to make a difference in their patients' lives.
But poor transportation does not only affect the access to healthcare. Having no roads to be able to transport their agricultural produce for sale means that these people are stuck in a never ending cycle of poverty. At most, some of them get RM20 to RM50 by selling their produce to middlemen to be sold at the monthly tamu or market at prices that are perhaps only 10 percent of the value of the goods.
These innocent people are also preyed upon by traveling cloth merchants, mostly foreigners, who offer them 'easy payment schemes' to buy cloth for clothes, and when they cannot pay for the cloth and the interest accumulates, they end up having to marry their daughters to these men, who often have wives back home in Pakistan.
One of the cases I could never forget was of the family who came to Ranau Hospital just as I was leaving, a family who had failed crops, were hungry and unable to get food. The father collected some toad eggs and fed them to the whole family in a desperate attempt to stave off hunger.
When they arrived at our little emergency room, one of the children were dead and two passed away within 10 minutes of arrival in our casualty unit due to poisoning.
Education is a problem in parts of Sabah outside major towns like Kota Kinabalu at the moment. Many children would be lucky to be able to get to a school or even afford to get to one. Most of my patients outside Ranau were lucky to even have a primary school education and a vast number of women marry in their teens.
I've had 14 year olds delivering babies in Ranau, most of them have never ever stepped foot in a school. The education level is so poor that many women feed their children condensed milk thinking that it's better than breast milk. But at the heart of it all, these mothers want the best for their children but are not empowered with the knowledge to help them.
Major towns in Sabah have electricity courtesy of the Sabah Electricity Board, but smaller villages have either diesel generators or rely on candles or lamps when night falls. How can children study in these conditions?
Like many doctors in the districts, I had to learn Dusun to communicate better with these patients who could speak little else.
Forty five years after the formation of Malaysia, the promise of a better life for these poor Dusun, Murut and Rungus patients in the districts of Sabah is a pipe dream at best. How can our politicians claim to have brought development to the state and have neglected these poor people, many of whom still wear the cheap t-shirts and caps given free by political parties from many elections ago.
How can I claim to be proud of Putrajaya with it's beautiful bridges and lamp posts and the Petronas twin Towers when our fellow Malaysians in Sabah are so neglected?
The cycle of poverty and illiteracy one sees in the districts in Sabah brings despair to the heart. Eradication of poverty must tackle the real issues of education and transport and not just handouts to poor people.
By all means, declare Sept 16th a public holiday, but remember it in it's real context, where we made a promise to our brethren in Sabah and Sarawak to treat them as equals in Malaysia, and give them the development they've been long denied.
Wednesday, November 19, 2008
Tuesday, November 18, 2008
Watch the video where you go through a Perceptual test, and maybe learn that apparently some of us miss the obvious when we have too many things going on.
It may signal to us to not take on too many things at once. Multi-tasking is overrated. Focus is more important.