New Prime Minister Datuk Seri Anwar Ibrahim has been welcomed by many like a breath of fresh air. But can he cleanse the nation of the many ills it now suffers? It remains to be seen. MY retired brother called from Penang the other day. He had yet to get his pension and needed some cash. Why? I asked. “Anwar has won and I want to celebrate with my friends,” he cheered. He is just one of many who are anamoured of our new Prime Minister. There is also this man in Bukit Mertajam, Datuk Seri Anwar Ibrahim’s hometown, who is buying everyone meals at restaurants around town. Elsewhere, a large non-Muslim crowd gathered outside a mosque as Anwar prayed inside. And they mobbed him when he came out. Everywhere he goes, the PM is being cheered. He’s probably the most welcomed Malaysian chief executive in living memory. It’s all quite exciting, but I think the celebrations are also a bit premature. Yes, it has been a long wait for him, his supporters and those who have been rooting for him all these years. He has been the underdog, facing failure after failure, falling every time he believed he had reached the pinnacle. It’s the kind of story that would touch any heart. But it’s only the beginning. Now is not the time to put him on a pedestal. He has much to prove, and he could fall off that high horse any time, just as the last three prime ministers did. The plotting is going on. Those who do not like the idea of him being PM will do their best to bring about his downfall. It happened before in 2020 with the Sheraton Move; and even days after Anwar’s appointment, there was talk of a Tropicana Move. That has been denied, but his performance will be under intense scrutiny. There will be little room for relaxation. His first task just got done. He has named his full Cabinet, obviously done with much juggling, putting together a unity government that will keep everyone happy and yet meet his promise of a small Cabinet. If that was hard, the really herculean task awaits now. There is so much wrong with our country now – an economy in the doldrums, a ringgit that’s floundering, an education system that’s well off the mark, and a population that’s deeply divided. There’s so much to do – or undo. I say undo because Anwar himself may be responsible for some of those maladies. He was once Education Minister – way back in 1986 – and started a revolution in the system. He is the man credited with Islamisation of our schools, and the growth of religious schools, while working with then Prime Minister Tun Dr Mahathir Mohamad. Those actions have come back to bite him, say analysts. Two weeks ago, his daughter lost the Permatang Pauh seat, held by members of his family since 1980, to a tahfiz teacher. Anwar, and his Angkatan Belia Islam Malaysia (Abim), were the driving force behind such schools. The children in many of these schools are being taught to only vote for a certain party, and with Undi18 now law, there was a flood of such voters, the analysts say. With the mushrooming of religious schools, the days when children of all races laughed, played and mixed in schools seem to be long gone.
Now, schools are divisive. Even the syllabus has been questioned with Malays themselves asking why there are so many religious classes and too few teaching modern-day living skills like English, science and technology, computer know-how and things like that.
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Five years from now – if Anwar succeeds as a unifying PM – we can celebrate as a nation. For now, though, I am holding that champagne, or non-alcoholic beer as the case may be.
Rebooting the economy
Anwar says he took Finance Ministry to bring new policies
PUTRAJAYA: Prime Minister Datuk Seri Anwar Ibrahim, who appointed himself Finance Minister in his new Cabinet, is hoping to restore economic confidence through new policy approaches.
“I was not inclined (to take on the post), but I want to embark on new policy approaches and restore economic confidence among local traders as well as foreign investors.
“I will be assisted by a strong team that isn’t only civil servants, but also a group of advisers who will not burden the government’s coffers,” he said in announcing his Cabinet at Perdana Putra here yesterday.
In the follow-up press conference, Anwar said the Finance Ministry will be assisted by several advisers led by former PETRONAS president and chief executive officer Tan Sri Mohd Hassan Marican.
Meanwhile, Anwar said the new Cabinet members will be sworn in at 3pm today.
“I will have a special meeting with the ministers so I can convey several matters to them, such as new rules, direction, and new methods,” he said.
Anwar said ministers should begin their duties soon and he advised them to avoid wastage, bribes and power abuse.
“I have made it clear to the Cabinet that the unity government prioritises good governance and the need to reduce the people’s burden, as well as stimulating the economy,” he said.
The Prime Minister said his Cabinet, which comprises 28 ministers, is a clear signal to the people that the unity government, together with the civil service, will ensure its promises to the people are fulfilled.
The last prime minister who also served as a finance minister was Datuk Seri Najib Razak.
Anwar had served as finance minister and deputy prime minister to then premier Tun Dr Mahathir Mohamad before being sacked in 1998.
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.An endoscopic image of a normal, healthy colon.>>
It’s not always easy to identify whether the patient has CD or UC, although UC is more common than CD.
“If the doctors don’t know, these patients are placed in the IBDU (IBD unclassified) category,” says Prof Ida, whose youngest IBD patient is 12 years old.
“You’ll be surprised at how many people wait for a year or two before getting treated – the inconsistent pattern of pain often confuses patients and it is normal for them to lose up to 20kg.
“They may go to the general practitioner, get some antibiotics and don’t seek further help.
“Or after several episodes, they finally decide to go to a specialist – maybe all diseases are like that in Malaysia – hence, awareness is very important.
“What they don’t realise is that if the disease is not treated, there is an increased risk of developing colon cancer.”
UC patients can also experience back and knee pain, skin rashes, and liver abnormality – every system can be affected – while CD patients tend to have specific areas affected.
The IBD specialist explains: “The whole gastrointestinal tract is very long, and in a lot of cases, when a CD flare-up happens, it tends to be in the predominant location, i.e. the common location, which is the lower right side (terminal portion of the ileum) – almost the same area as the appendix, which initially raises the suspicion of appendicitis.”
She adds: “There is some old data that shows patterns where if you get IBD once, you will never get it again, but from my experience, it’s rare.
“The disease will recur without treatment.
“It’s not a cure, but with treatment, you can remain in remission.”
Therapy for life
Treatment involves two therapies: induction and maintenance.
This endoscopic image shows deep longitudinal ulcers in the colon of someone with CD >>
The induction therapy is intended to act fast to provide symptomatic relief, with the mainstay being steroids.
Prof Ida says: “It’s cheap, it works and it works fast, but there are long-term side effects – it thins your bones and causes obesity.”
She notes that the energy boost from the steroids also makes some patients feel better.
However, she adds: “Your adrenal glands that are producing your own steroids are suppressed with chronic steroid use and we have seen patients with Addison’s crisis, where the body is not able to produce steroids any more.
“We never want to give steroids as long-term therapy – we try to stop it within three months.
“If you taper it down and don’t give time for the other immunosuppressive drugs to work, especially slower-acting ones, the symptoms will return, so it’s a balancing act.”
For maintenance, a new group of drugs called biologics work well and have a good safety profile.
The drawback: they’re expensive and range from RM20,000 to RM50,000 annually.
“That’s the difficulty I face with my IBD patients,” Prof Ida laments, “because I’ve to think of costs all the time, especially for the ones without insurance.
“For this reason, I take part in a lot of clinical trials as that allows me to put patients on free drugs.
“Usually, when we get the drugs, we’re already on phase three trials and there are not many concerns as we are not guinea pigs.
“Or we seek funds from charities, non-governmental organisations, etc – that’s the reality.
“The Health Ministry hospitals also have their own free quota, e.g. five patients a year – the rest have to pay.”
For those on clinical trials, the good news is that they can get free drugs for quite a long while.
One of Prof Ida’s patients took part in a landmark IBD study and got free drugs worth about RM48,000 a year for a decade.
Most clinical trials entail a three-month induction and 12-month maintenance timeline.
Every patient usually wants to know when he or she can stop treatment; they think the diarrhoea should resolve with a course of antibiotics.
“The concept of long-term treatment is difficult for them to understand.
“I guess it’s hard when you’re young and have to be on drugs forever, but older people are more accepting,” she says.
“The patient’s function is very much affected as IBD occurs amongst young professionals in high-performing jobs, hence I try to normalise their lives as much as possible.”
For those who don’t succeed with medical therapy, they have to undergo surgery to resect their bowel.
In the past, the figure was 70%, but with better medications these days, the figure has gone down to about 20-30%.
What about foods?
“Before, we didn’t really know what to tell our patients in terms of diet, except to have a low-fibre diet, because when your colon is inflamed, the bowel is narrowed, and if you take too much fibre, it may block your passage.
“Now, we’re looking at anti-inflammatory diets, although we’re still far from anything concrete.
“My paediatric colleagues practise entero-nutrition (delivered into the digestive system as a liquid) for six weeks, but maintenance is difficult as you can’t be on liquid nutrition for the rest of your life,” says Prof Ida.
She suggests, however, that patients try to reduce pro-inflammatory foods, such as those with high fat content.
When it comes to herbs, she says turmeric might help, but the dose has to be right.
“If you have a bad case of UC, you still need biologics as turmeric is not going to save you.
“Everyone is also asking about probiotics.
“Not all probiotics in the market are medical grade, but if my patients want to take it and it makes them feel better, I don’t stop them.
“Our gut consists of trillions of gut microorganisms and taking a tablet or two a day is not going to touch the diversity or repopulate the microbiome.
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The line-up of three taikonauts for Shenzhou-15 manned spaceflight mission, Zhang Lu, Fei Junlong, and Deng Qingming (from left to right). Photo: VCG
China on Monday unveiled the line-up of three taikonauts for Shenzhou-15 manned spaceflight mission that is set to be launched on Tuesday night. The trio led by mission commander Fei Junlong with two space newcomers Deng Qingming and Zhang Lu are going to conduct a direct handover in orbit with the Shenzhou-14 crew at the China Space Station in construction, which shall mark a first in China's aerospace history.
The upcoming Shenzhou-15 crewed spaceflight mission is not only the anchor-leg launch mission at the China Space Station construction stage, but also is the first one to embark on the next operational stage, Fei, the 57-year-old veteran taikonaut who visited the space as the mission commander in the China's Shenzhou-6 mission in 2005, remarked at a press conference on Monday at the Jiuquan Satellite Space Launch Center in Northwest China's Gansu Province.
The crew will carry out more experiments in orbit, operate, maintain and repair relevant equipment and above all execute even more challenging extravehicular activities, or known as spacewalks, with more complicated paths to take on, Fei said on Monday.
The Shenzhou-15 crew has undergone great amount of specific training, which made them very confident to deliver all the set goals and to successfully complete their space run, Fei said.
Deng Qingming, 56, is among the first batch of taikonauts trained in China that includes the country's first astronaut Yang Liwei and also his mission commander Fei in the Shenzhou-15 mission. He has served as a backup for nearly 25 years, in missions such as the Shenzhou-9 and 10, but never got the chance to fly. This will be his first time ever in space.
Zhang Lu, 46, also a new face, was selected in the second batch of taikonauts trained in China in 2010.
Mission insiders told the Global Times on Monday that the two crews of six taikonauts will carry out the space station handover in a face-to-face manner for the first time in the country's manned space history and that is not only of symbolic significance but also carries great practical values to the overall development of the country's first permanent space outpost.
Sources with China's astronaut training system, told the Global Times on Monday that such feat would enable the predecessor Shenzhou-14 to introduce and share what their work and life would be like inside the space station with the new Shenzhou-15 crew directly, boosting the continuity and efficiency of the handover.
It would also help save the resources to set the space station combo from occupied state to unoccupied one and then back again. And the handover will be more target-oriented, especially for those ongoing experiments and space station maintenance work, the sources said.
Having six taikonauts simultaneously onboard the China Space Station in construction, would also verify its performance under the full load condition, which would lay groundwork for future tasks where more payload technicians are needed for more complicated experiments, Song Zhongping, a space watcher and TV commentator, told the Global Times.
By plan, the handover will last for a week or so, and after that, Shenzhou-14 crew will return to the Dongfeng landing site on Earth.
As the temperature drops to somewhere near minus 20 C in Jiuquan around this time of the year, the launch of Shenzhou-15, which is via a Long March-2F rocket from the Jiuquan center, also faces a special challenge of extremely low temperature.
According to the China Academy of Launch Vehicle Technology (CALT), the developer of the Long March-2F rocket, Shenzhou spacecraft had only been launched twice in unscrewed condition during the Shenzhou-1 and 4 missions in late November. Shenzhou-15 would be first one to be carried out with taikonauts onboard in the cold weather.
However, the CALT explained that they have taken such unique challenge into consideration. They have also confirmed the two sets of the temperature system inside the rocket's nose cone, to make sure that the temperature of the propellant of the return and propelling module meets the launch condition.
