At
the end of the 2nd World War, when the British
returned to Malaya, tuberculosis ranked as the
biggest single killer, and the cause of the most
suffering in our country.
For the next 15 years tuberculosis
continued to be the biggest health problem in
Malaya.
By the year 1957 conservative
estimates put the prevalence of infection amongst
children at 25% at the age of 5 years, 50% at
the age of 10 years, and 75% at the age of 15
year.
Tuberculosis
is usually a disease of townsfolk or urban communities,
but in Malaya the rural areas were affected almost
as seriously as the towns.
The
prevalence of tuberculosis even among the aboriginal
population was found in surveys to be as high
as in towns.
Rural folk particularly in
Kedah and the east coast states had an incidence
almost as high as was found in slum areas of our
cities and towns. Malays,
Chinese and Indians contracted this disease with
equal facility and spread it as readily. Rich
and poor alike were prone to it.
More
than a quarter of the hospital beds were occupied
by tuberculosis patients, most of whom were in
an advanced stage of the disease. Advanced chronic
cases for whom little could be done occupied the
available beds for several years , and early
treatable cases were turned away for lack of accommodation. There was a long waiting list of in all hospitals
of tuberculosis patients clamouring for admission.
What was
appalling was the total indifference of the Colonial
Governments Medical Services to this alarming
situation.
In the absence of any
effective Government action, a band of civic-minded
community leaders decided to take upon themselves
the task of starting a country-wide anti-tuberculosis
movement, and formed the Malayan Association for
the Prevention of Tuberculosis (MAPTB).
The Malayan
Association for the Prevention of Tuberculosis
(MAPTB) was launched in Kuala Lumpur on 27th June
1948.
For
the newly formed Association the message was loud
and clear. The following actions were required
as a matter of the highest priority.
1. Provision of more TB beds
for the treatable TB patients.
(Nearly 25% of all hospital beds were occupied
by tuberculosis patients, but these patients were
advanced chronic cases. There was an urgent need
to have more beds for treatable cases.)
2. Provision of better diagnostic
facilities in the hospitals.
( In order to pick up cases of tuberculosis early,
it was necessary to have more X-ray facilities
set up in all hospital chest clinics. Mass miniature
X-ray units were also required, as they could
X-ray large numbers of patients quickly)
3.Construction of isolation
hospitals (sanatoria) for the infectious
incurable TB cases
(This would enable hospital beds to be freed for
treatable cases.)
4. Construction of sheltered
workshops for the infectious chronics.
(To give employment to chronic cases in surroundings
away from the public)
5. Provision of a TB Treatment
Allowance and Dependants Relief Scheme.
(To ensure that poor and needy tuberculosis patients
undertook their full course of treatment.)
For the next thirteen years
MAPTB was the sole champion of the anti-tuberculosis
movement in the country.
It was only by 1961 that
a National Tuberculosis Control Campaign was launched
by the Government.
Chronology of the fight against
TB in Malaysia
Before
Merdeka no organized attempt was made to combat
the spread of Tuberculosis in Malaya.
Only those who voluntarily sought treatment in
our hospitals were given treatment.
The
facilities for accommodation and treatment for
these cases in our hospitals were grossly inadequate.
All
hospitals were embarrassed by the number of cases
who sought treatment. There was a long waiting
list of cases seeking admission.
Most TB patients in hospital
were in an advanced stage of the disease requiring
long- term care.
In order to appease the public
clamour for action, experts were invited to study
the TB problem and to recommend measures for its
effective control. All their reports and recommendations
were neatly filed away and never disclosed to
the public.
During the 10 years, 1947
to 1957 the risk of healthy individuals contracting
tuberculosis increased fourfold.
In 1957, with the coming of Merdeka,
our elected Government had a greater sense of
responsibility for the well being of our people.
THE ELIMINATION OF TUBERCULOSIS
WAS INCLUDED IN THE ALLIANCE PARTY MANIFESTO.
One of the first steps taken
by the Ministry of Health after the general election
was to create the post at Federal level of a Senior
Tuberculosis Specialist who was charged with the
responsibility of studying the tuberculosis problem
in the country and drawing up a plan for its control.
With the help of Sir Harry Wunderly the chief
WHO Consultant on Tuberculosis (a recognized world
authority on Tuberculosis) a thorough study was
made of the existing resources foe the prevention
and treatment of tuberculosis.
A
report and recommendations were made to the Government
and accepted. With the blessing of Government
a comprehensive long-term plan for the control
of tuberculosis was drawn up by the Ministry Of
Health in 1960.
A separate Division of Tuberculosis
was set up at the Ministry of Health.
A National Tuberculosis Control
Campaign was officially launched in 1961 to eliminate
tuberculosis as a public health problem in Malaya,
and funds were made available for this programme
under the 2nd National 5year Plan for the period
1961-1965.
At long last the serious
problem of Tuberculosis started to be tackled
seriously.
MAPTB..... the beginning.
On 29th September 1947, a
number of concerned citizens from Kuala Lumpur
and other States met together at Majestic Hotel
to discuss the terrible scourge of Tuberculosis
that was spreading all over the country. Each
of the persons who came for the meeting had experienced
great difficulty in securing treatment for persons
suffering from Tuberculosis.
Mr. Khoo Teik Ee (who later
became the first President of MAPTB) managed to
secure an appointment with Lady Newboult at "Carcosa".
At this meeting At this meeting Lady Newboult
agreed to interest the Central Welfare Council
on the need for voluntary Anti-TB activities to
augment Governments efforts against TB.
It was then decided to set
up an association (sponsored by the
Central Welfare Council) to assist in the fight
against TB.
Launch of the Malayan Association
for the Prevention of Tuberculosis
On 27th June 1948, a public
meeting was held , and the "Malayan Association
for the Prevention of Tuberculosis (MAPTB)"
was officially launched.
Launching of State Associations
Between 1948 and 1952 all
the States had their own Anti-TB associations.
Some states like Perak and Johore also established
branches at District level.
Here and there
Some anecdotes of MAPTB activities
in the past:
Johore
Launched in 1948. By 1949 had established branches
at districts level.
Established a Tuberculosis sanatorium in Tampoi
in 1965 (137 beds).
Established the Johore Anti-tuberculosis Rehabilitation
Organization (JARO)
(Tun (Dr.) Ismail was the founder chairman.)
Penang
Launched in 1950.
In 1974 MAPTB Penang started their own Moblie
X-ray services.
Kedah
Launched in 1950.
Dr. Mahathir bin Mohamed (then a Senator) was
Chairman from 1959 to 1974.
Established the Johore Anti-tuberculosis Rehabilitation
Organization (JARO)
(Tun (Dr.) Ismail was the founder chairman.)
Perak
Launched in n. Perak also established active district
branches.
Established a TB Rehabilitation Centre in Batu
Gajah in 1951. By 1971 it had to be closed as
the TB situation had improved greatly, and there
were no patients seeking admission into the center.
In 1975 the complex was rented out to the Help
Services Center for the rehabilitation of drug
addicts.
Pahang
Launched in 1950.
Sabah
Launched in 1952 (SABATA)
Special Note
Dato Sir Clough Thuraisingham was the longest serving President of the MAPTB
(28years).
A Diagnostic Center established
by MAPTB in Setapak in 1963 was named after him.
It had both Static as well as Mobile (mass miniature)
X-ray units and played an very important role
in the early diagnosis of TB patients.
One of the major activities
of MAPTB (Federal and States) in the early days
was to launch a major propaganda campaign informing
the public about Tuberculosis , how it was spread,
and how the public could play a vital role in
combating this problem.
A large amount of publicity
was disseminated through the press in all the
different languages.
MAPTB (with Government approval)
started a public lottery to obtain funds for its
activities. It used the monies to:-
|
Build TB
wards in Government hospitals, and provide
the hospitals with X-ray machines, and laboratory
equipment to diagnose TB patients. |
|
|
|
Build sanatoriums
for long term treatment and isolation of infectious
chronic cases. |
|
|
|
Start a
Treatment Allowance and Dependants Relief
Scheme to ensure that TB patients would continue
prolonged hospital treatment. |
During those early days
over 3 million ringgit was provided by MAPTB from
the monies received from lotteries fund to help
finance the above projects.
MAPTB is happy to note
that TB has started to decline in some States,
with an overall improvement since year 2000 as
follows :
1995 |
11,778 |
1996 |
12,902 |
1997 |
13,539 |
1998 |
14,150 |
1999 |
14,908 |
2000 |
15,057 |
2001 |
14,830 |
2002 |
14,389 |
|
However, in some States (
Perlis, Kedah, Selangor, Malacca, Pahang and Kelantan
) TB continues to be on the rise.
The Malaysian Association
for the Prevention of Tuberculosis at National
and at State level have drawn up a plan of action
aimed at informing the public of this growing
problem. This plan has been endorsed by the Ministry
of Health.
The plan of action basically
involves the following:-
1. Informing the public of
the signs and symptoms of Tuberculosis.
2. Encouraging those with
such signs and symptoms to seek early medical
advice and treatment if necessary.
3. Educating those diagnosed
as having tuberculosis to realize that they must
undertake the full course of treatment, as advised
by the doctor, to ensure full recovery.
4. Encouraging close contacts
of persons diagnosed as having tuberculosis to
seek medical advice.
5. Giving financial assistance
to needy TB patients where necessary to ensure
that they come for their full course of treatment.
6. Assisting the Ministry
of Health in their campaign against TB when requested. |