Can the Ministry of Health be Trusted?

By KTT

Well, almost  all doctors in the private sector would answer this question with an emphatic NO and perhaps half of the disillusioned medical and house officers in government service would probably also agree that this ministry’s level of trust and confidence is way down south. The public seems to harbor similar views. With the appointment of UMNO Puteri Head Rosnah Rashid Shilin to assist an already ineffective Liow, it’s bound to only get worse.

But the general public was stunned beyond belief on how low this ministry would actually go just one day before the recent tri-elections when Ismail Merican – DG and de facto Health Minister, led a “10 man panel of experts” and decided there were discrepancies in the two post-mortem reports on battered police detainee A. Kugan by Indonesian pathologist Karim Tajuddin and University Malaya’s Prashant Samberkar, therefore sowing confusion into the reports, especially that of Prashant’s meticulous findings, to the obvious delight of the Malaysian Police. Merican’s fairy tale and the destruction of medical evidence would certainly go a long way into absolving their eleven colleagues in arms at the USJ police station.

So who are these 10 “panel of experts” whom Merican managed to hobble together to do his, and possibly the government’s, bidding?

1. Dr Mohd Shah Mahmood (Chairman): Senior consultant forensic pathologist, Forensic Department Head, HKL. Mohd Shah is a UKM graduate, 1985 and did some forensic training in the UK. He is the pathologist who did the post mortem on Altantunya’s shattered, reportedly naked body. But sorry RPK, he couldn’t find that bullet hole that Rosmah put through her skull despite collecting all the pieces. He was also involved in the Highland Towers tragedy and Hanif Basree case among others.

Shah reportedly has a degree in toxicology and he may have helped Merican cook up this story about myocarditis knocking off Kugan finally before all the broken bones, broken skull and macerated muscle could. Myocarditis, either acute or chronic due either to infections or toxins can be picked up by a decent, properly trained histopathologist.

Prashant should have shipped off the samples to Australia sooner before the police raid to destroy the evidence but perhaps he was hampered by University Malaya’s notoriously lazy bureaucrats. A diagnosis of myocarditis is what pathologists usually cook up in cases of sudden death where pulmonary edema (water in the lungs) is the end feature if they want to get someone off the hook. In this case of course it’s the Malaysian police, Karim and ultimately Najib’s government.

Whatever the cause of myocarditis is, be it – viral, rickettsial, bacterial, fungus, protozoal, helminth, polyarteritis nodosa, dermatomyositis, certain chemical poisons or drugs, cardiac trauma, uremia, cardiac transplant rejection – the histopathological features are specific; provided of course  the slides are done and read by a histopathologist worth his salt. And mind you, there are enough cardiac pathologists in the world who can provide you that diagnosis. Today, the science of medicine is technologically specific and brutally precise, something that could have escaped the attention of the “10 man panel of experts”.

Merican and Shah are probably hoping Kugan’s father is not serious about exhuming the body. A sample of the heart muscle will be conclusive that there was no myocarditis provided the pathology slides are done exclusively by an independent party far away, in particular the US or Canada. Absence of myocarditis would also mean the end of Merican and co. If I were Kugan’s father, I would put guards around his grave for fear the police would actually exhume his body in the middle of the night and cut out his heart, the very last frontier of evidence that may or may not have caused his death. Absence of myocarditis would also mean the charge of murder stands leading to almost certain conviction of the eleven policemen.

2. Dr Paul Chaui Peng Sun (external) Director, Forensic Medicine Division, Health Science Authority, Singapore. Paul was Merican’s SARS (Bird Flu) buddy during the disease scare some years ago. His only other contribution seems to have been a mobile autopsy fridge. Not sure if he is qualified to comment and wonder what the Singapore Medical Council would think of him giving evidence in a case where the body has already been buried. He should have stayed home unless of course he has decided to take over Prashant’s place.

3. Prof Om Prakash Murty (external), Professor, Forensic Medicine, King Faisal University, Damman, Saudi Arabia. An Indian expatriate, he graduated from Maulana Azad Medical College, India and variously worked at the University Malaya and UITM where he did virtually nothing before moving on to his current job at the King Faisal. He appears to be into electrocution and lightning injuries but the rather surprising thing about O.P. Murthy was the complaint lodged against him at the Indian Medical Council by Mr. Raj Singh Toofan and Mr. Aamod Shashtri, General Secretary, Society of Justice. (F.No. 344/2003 Dr.O..P. Murthy was informed that he is registered with the Medical Council of India bearing Regn. No.4666, dated 6.2.1985).

The inquiry concerned a hanging. OP Murthy didn’t turn up for the hearings on the two occasions the Medical Council of India called him up as he gave them the excuse that he was at that time working at the University Malaya. His colleagues in India had to do the cover up for him.

4. Dr Phang Koon Seng, Consultant Histopathologist, HUKM. Graduated locally in 1976. Another of Merican's buddies from UM. Worked all his life at UKM in chemical pathology and histopathology. Never really made it to the top and remained Lecturer at HUKM for many years. He retired eventually and started work at a private lab, Lab Link, whose licensing depends on the MOH. Yep, he needs to play ball.

5. Datuk Dr Bhupinder Singh, Senior Consultant Forensic Pathologist, Head Forensic Department, Penang GH. This long serving government pathologist who graduated also from Maulana Azad Medical College, India surprisingly sold all his Sikh principles and sat together with a guy like Merican very well knowing that there is no specimen he could actually comment on. He disgraced himself by commenting and opinionating on the two medical reports, clearly something beneath his capabilities. He has now condemned himself to being less then professional in the eyes of the public.

6. Datuk Dr Jeyanindran Sinnadurai, Senior Pulmonary and critical care physician, Head, Department of Medicine, HKL. Ahh yes, Jeyanindran, the not so clever rich boy who walked into medical school at UKM a bit late courtesy of his father Tan Sri Sinnadurai. Jeyaindran flunk repeatedly all his postgraduate Membership examinations and in fact exhausted his attempts. He was saved when the Irish came to his rescue and let him sit their fairly “easy” examinations and hey presto he becomes a physician. In fact, a chest physician. He continued treating asthma patients for a protracted period at GH Klang before he moved to the A&E department at GHKL where he is currently based and treats mainly VIPS including sometimes Chua Soi Lek. Not credible. How he is qualified to comment on Kugan’s death is indeed mind boggling.

7. Ass. Prof Dr Shahrom Abd Wahid, Senior Consultant Forensic Pathologist, Forensic Department, HUKM. A 1982 graduate of UKM, he has mainly been a lecturer at UKM and his involvement in criminal cases has been limited although he is designated as a forensic pathologist at UKM. Shy and timid, Shahrom would do anyone’s bidding, especially Merican’s.

8. Dr Mohd Suhani Mohd Noor, Consultant Forensic Pathologist (Histopathologist), Forensic Deaprtment. Head, Sultanah Bahiyah Hospital Alor Setar. Graduated only eight years ago and devoid of experience, Suhani has no buisness being in this committee.

9. Dr Tan Chwee Choon, Senior Consultant Nephrologist, Nephrology, Department Head, Tengku Ampuan Rahimah Hospital, Klang. A graduate of L.N. Mithila University-Darbhanga Medical College, Laherisari, India in 1985. If you are wondering where the heck this medical college is, fret not, for it is in the state of Bihar renowned for its lawlessness and Laloo Prasad Yadav, where Dr. Tan without a doubt would have noticed how cheap life actually is. Post mortems there are a luxury and inquiries virtually unheard of. He has been a kidney specialist for the last decade at GH Klang, a town also known for crime but not to the scale of Laloo’s Bihar. Perhaps he was roped in because he had to dialyze many Indian car thieves in Klang who ended up with kidney failure following the frequent beatings these guys get at the hands of the police and triads or both. Or maybe he picked up something in Bihar itself.

10. Datuk Dr Zaki Morad Mohd Zaher, Consultant Nephrologist, Ampang Putri Specilaist Centre, KL (Independent observer from MMC). Of the entire lot, Zaki is the only one who has decent credentials. A graduate of UM in 1975, a member of the Academy of Medicine and a respected nephrologists, it’s truly amazing why someone like Zaki would even want to come near any of these jokers who have credentials far below his. Reportedly he is there as a member of the Malaysian Medical Council, a now tainted organization, used shamelessly by Merican to please his political masters.

What has happened here in the Kugan case is clearly damaging to the image of the medical fraternity in Malaysia. Fabricating, tampering, falsifying or destroying medical evidence and subsequently justifying these actions in public by a play of words to the unsuspecting layman is a crime unto itself and is demoralizing to anyone connected to healthcare in this country.

All this talk of medical regulations, rules, acts and laws mean nothing if there is an absence in the conscience of medical authorities to stand by principles and do the right thing. This episode will forever be quoted in the annals of Malaysian healthcare for many years to come. In particular, Merican and his colleagues’ sordid roles in this affair has brought disrepute to a profession many have known to be noble in this country. Will anyone in Malaysia now trust the Ministry of Health, a doctor or a pathologist? The damage done could be irreparable.

KTT