We need local councillors who can do the job

I REFER to the article “Local govt polls may cause racial polarisation” ( Sunday Star, Jan 25) and would like to share my views on matters.

The core functions of local government is to look at matters that are closest to the people.

Both the state and federal governments are too far from the people for them to have good understanding of the needs of the people at the micro level. Today the local authority has become a government agency and the councillors have been a rubber stamp of the decisions made by the local authority. Many who were appointed to the post lacks quality and knowledge in functions and power of a councillor.

Appointed councillors are political party nominees. The council seats are shared according to an agreed ratio among the component parties. They are not independent. Appointments are given as part of political rewards to grassroot party leaders.

At times decisions made by the council are not in the best interest of the people as for the councillors, party interest comes first. There are clear professional conflicts of interest between political parties nominees and between those meeting the needs the people.

In my area, the appointed councillors do not understand their role as councillors. They have been turned into “complaint centre” for people to bring their issues to the local authority.

These councillors have been assigned certain zones and have been tasked to look after drainage, rubbish collection and grass cutting.

They have very poor knowledge of the local authority by-laws. They fail to function as a “Board of Directors” of the local authority and provide the much needed check and balance between addressing the needs of the people and the local authorities.

While we can accept the point of maintaining the current system but we cannot accept the fact that the powers-that-be failed to nominate “independent people with strong knowledge on the governance of local authority” as specified under Section 10(2) in Act 171.

The law says that the state authority must appoint councillors who have wide experience in local government affairs or have achieved distinction in any profession, commerce or industry, or are otherwise capable of representing the interests of their communities in the local authority area.

Unfortunately the state government appoints party members who are grassroot leaders who in most cases do not meet the requirement of the law.

In Petaling Jaya, the capable ones were removed as councillors and replaced with mediocre group of people. In Ampang, we have unemployed party members and people with poor education background serving as councillors. They do not meet the requirement of the Local Council Act.

The question remains which political parties in power will be the first to push forward the agenda that focuses on the people and not their respective parties.

By Dr Mohamed Fafick Khan Ampang The Star/Asia News Network

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Living life to the fullest

Chan, an avid mountaineer and myelofibrosis patient, with a photo of himself (in red jacket) and fellow climbers at the summit of Mount Kinabalu. Photo: UU BAN/The Star >>

Despite having a rare blood disorder, Tan Sri Chan Choong Tak not only continued his active lifestyle , but also took up mountain-climbing.

FORMER Dewan Negara president Tan Sri Chan Choong Tak’s motto in life is to live it to the fullest.

Not surprising then that among his many accomplishments are two Malaysian Book of Records titles as the oldest Malaysian to reach the top of Mount Kilimanjaro’s Uhuru Peak (on Aug 31, 2003, at the age of 70) and the oldest Malaysian to reach the top of Mount Kinabalu’s King George Peak (on Aug 29, 2004, at the age of 71).

Uhuru Peak is the highest point on Mount Kilimanjaro, which is the tallest freestanding mountain in the world (from sea level) and the tallest mountain in Africa, while King George Peak is located on the more challenging and lessclimbed Eastern Plateau of Mount Kinabalu, Sabah.

What makes these two records more significant – aside from the impressive fact that Chan only took up mountain-climbing in his sixties – is that he was suffering from a rare bone marrow disorder at the same time.

His condition, primary myelofibrosis, is one of a group of diseases called myeloproliferative neoplasms, which are caused by abnormal production of blood cells in the bone marrow.

In the case of myelofibrosis, the problem lies in the abnormally-increased production of megakaryocytes, which are the cells that directly give rise to platelets. This results in an initial increased number of platelets in the body.

Cytokines – protein growth factors that are produced by megakaryocytes – are also correspondingly increased.

And as these cytokines are what stimulate the bone marrow’s fibroblasts to produce collagen, this results in an excessive amount of collagen being made.

The collagen deposits in the bone marrow as webs of fibre – similar to scar tissue on the skin – resulting in the disease’s characteristic fibrosis of the bone marrow.

With the collagen taking up so much space in the bone marrow, regular blood cell production is disrupted.

Red blood cells (RBCs) are usually decreased in number and abnormally formed, resulting in anaemia, while white blood cells (WBCs) are abnormal and immature, resulting in increased infection rates.

With production of blood cells in the bone marrow disrupted, the spleen, which is the body’s secondary supplier of blood cells, steps up to meet the body’s needs.

This extra work usually causes the spleen to enlarge (splenomegaly), resulting in pain or a feeling of fullness below the left rib.

Occurring commonly in those above 50 years of age, myelofibrosis is caused by a spontaneous genetic mutation (i.e. not inherited) in the affected person’s blood stem cells. This is what causes the uncontrolled production of megakaryocytes.

The cause of the mutation itself in primary myelofibrosis is, as yet, unknown.

Accidental discovery

As the symptoms of myelofibrosis, like fatigue, shortness of breath, pallor, frequent infections and easy bruising, are quite vague, diagnosis can be quite difficult.

In Chan’s case, he did not notice any signs or symptoms of myelofibrosis prior to his diagnosis.

In fact, it was a combination of a road accident and his wife, Puan Sri Cecelia Chia’s sharp eyes that alerted them to the possibility of a problem.

He shares: “My son gave me a racing bike for my 60th birthday – that was 21 years ago. So, I used to cycle around. Then, I met with a road accident.”

Chan was cycling along the narrow, winding roads of his hillside residential area in Seremban, Negeri Sembilan, when he suddenly met an oncoming car.

With no space to avoid the car, he braked hard and was thrown to the ground in a head-first fall.

“My helmet broke and I thought I would be paralysed. My friend, who is a doctor, straightaway rang up the hospital and they sent the ambulance,” he says.

Fortunately, Chan suffered no major injuries from the accident.

However, his cardiologist son insisted that he be checked more thoroughly for brain injuries, which resulted in him seeing a neurologist.

While his brain turned out to be fine, his wife noticed that his platelet count from the blood test were quite high – between 600,000 to 700,000 platelets per cubic millimetre, when the upper limit for normal is 400,000.

His son then sent him to consultant haematologist Dr Ng Soo Chin, who prescribed hydroxyurea to bring down his platelet count.

That seemed to work quite well for Chan, and it was, in fact, shortly after this that he began mountain-climbing with a group of fellow MBA (Masters of Business Administration) alumni from Tenaga Nasional Bhd.

Chan was then a director of the company, and had gone to Ohio University, United States, to study his MBA along with other Tenaga Nasional executives.

“So, as I climbed, I continued to take hydroxyurea and everything was normal.

“But Soo Chin said, hydroxyurea will eventually bring down your red corpuscles (another term for RBCs), and recommended anagrelide,” he says. Anagrelide is a platelet-reducing agent.

Accelerating disease

Chan continued happily with the two medications, until the year 2011, 18 years after his initial diagnosis.

By then, he was seeing consultant haematologist Datuk Dr Chang Kian Meng at Hospital Ampang, Selangor, as Dr Ng had advised him to continue his follow-ups at a public hospital as his medications are quite expensive.

Chan shares that Dr Chang started him on epoetin alfa and pegylated interferon that year as his blood cell levels were fluctuating.

While interferon decreases the production of blood cells in general, epoetin alfa stimulates the production of RBCs to counteract the effects of anaemia.

However, his haemoglobin levels dropped even further, and he started requiring blood transfusions about once every two months.

The transfusions made a big difference as he reports feeling “very energetic” after receiving the first one. (Fatigue is a common symptom of anaemia.)

The following year, it was the WBCs turn to go “completely haywire”, when a blood test revealed that they had dramatically increased to about 56 from the regular range of about 4 to 10.

He also started experiencing profuse night sweats and cramps, along with the occasional itchiness that had started in his seventies – all of which are among the symptoms of myelofibrosis.

“Then, both Dr Chang and Soo Chin agreed that I had entered into myelofibrosis in acceleration,” he says.

The only cure for myelofibrosis is a bone marrow transplant, but aside from the difficulty of finding a suitable donor and the riskiness of the procedure, Chan’s age rendered him unsuitable for such a treatment.

Fortunately for him, a new drug had recently been approved by both the European Commission and the United States Food and Drug Administration for use in myelofibrosis at that time.

A new drug

The drug, ruxolitinib, inhibits certain enzymes in the JAK pathway, which regulates blood cell production. Half of primary myelofibrosis cases are caused by mutations in the JAK genes, which results in the dysfunctional production of blood cells in the bone marrow.

However, the drug was not available in Malaysia then. (It was only launched in the Malaysian market in 2013.)

This is where his political connections as a Gerakan life member and former secretary-general came in useful.

Then Minister in the Prime Minister’s Department and Gerakan president Tan Sri Dr Koh Tsu Koon offered to help pass on the letter Chan had written to the Health Ministry requesting approval to use the drug on compassionate grounds, to the Health secretary-general.

Four days later, Chan received the approval he needed, and received his first dose of ruxolitinib in October 2012.

Since then, after some adjustments in dosage, Chan’s blood cells are back in the normal range and his last transfusion was in December 2013.

He is currently doing well enough for his doctor to lower his dosage of ruxolitinib, while still taking epoetin alfa and interferon.

Life goes on as normal for this active 81-year-old, who still climbs hills, reads newspapers of various languages and blogs daily, works out in the gym and does regular morning calisthenics.

Of his condition, Chan shares that he never felt the need to know about the disease, being only interested in his blood test results.

“I didn’t know what myelofibrosis was all about until I was asked to do this interview. That was the first time I went into Google to see what was myelofibrosis,” he says with a laugh.

“But I knew it was a dangerous disease, but I wasn’t bothered. I continued to carry on with my normal life.”

He adds: “I’m not bothered with what happens because I have full trust in my doctors.

By Tan shiow China The Star/ANN

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101 Ways To Live Your Life To The Fullest personalexcellence.co/blog/101-ways-to-live-your-life-to-the-fullest/  - If your answer to any of the above is a no, maybe or not sure, that means you're not living your life to the fullest.

US: an engine or a threat to the world economy? Unwise to write shortsighted rules!

Is the US an engine or a threat to the world economy?

According to the World Economic Outlook published by the World Bank, the international economy is forecast to grow by 3 percent in 2015 and 3.3 percent in 2016. The US and the UK will maintain their economy recovery while Japan and the eurozone will remain sluggish, with growth forecast at no more than 1.1 percent. The World Bank also predicted that the US economy will grow by 3.2 percent in 2015. Developing countries are facing lots of challenges in its economic development.

The US seems to be the only engine of the world economy. But the US Federal Reserve is likely to raise its interest rate from 0 to 0.25 percent. The World Bank worries that any such move will make it more difficult for emerging economies to raise money. The US has emerged from its financial crisis while other countries are still trapped in economic troubles. From this perspective it is hard to assess whether the US is an engine or a threat to the world economy.

There is still a worry that Greece will exit the eurozone. If this happens, the eurozone will be thrown into turmoil. In Japan, so-called "Abenomics" have failed to generate the anticipated results. Russia and Venezuela are each facing their own troubles and threats.

The US economy is closely linked to the whole. Only when other economies achieve sound development, can the US economy maintain sustainable development. The US can't just focus on its own development.

This article was edited and translated from 《美国是引擎还是威胁？》, source: People's Daily Overseas Edition, Author: Zhang Hong

It is unwise for the U.S. to write shortsighted rules

In the latest State of the Union Address, President Barack Obama mentioned China many times. He claimed that China wants to write the rules for the world's fastest-growing region (Asia-Pacific) but the U.S. should write those rules. He went on to urge Congress to give him the authority to promote trade with this region.

Obama is setting considerable store by the Trans-Pacific Strategic Economic Partnership (TPP) Agreement (TPP) and Transatlantic Trade and Investment Partnership (TTIP). These trans-regional trade and investment agreements are designed to increase America's competitiveness and encourage its exports. Although Obama's government has tried hard to promote these agreements and to make his mark on presidential history in the U.S., parts of the bills of the two agreements are opposed by some of the negotiation partners, and it is not clear whether Congress will support the agreements.

The U.S. is avoiding queries over its strategic rebalancing toward the Asia-Pacific. The American government cannot give a clear answer to whether TPP targets any specific country. However Obama has now made his position clear: "We should write those rules. We should level the playing field. That’s why I’m asking both parties to give me trade promotion authority to protect American workers, with strong new trade deals from Asia to Europe that aren’t just free, but fair."

It is readily apparent that America is not satisfied with international trade rules set by the World Trade Organization (WTO). Some countries are trying to break rules while China is attempting to set rules for the world's fastest-growing region. However, China's efforts could undermine American interests. Obama hold the view that China is taking advantages of existing free trade rules and it is not fair to the U.S.

It is not wrong for America to benefit from reform of international trade rules. But from a country good at promoting global rules in the past to one now busy promoting trans-regional rules between Asia and Europe, America's leadership in international system gradually fades out. The U.S. thinks that it has suffered losses from past world trade rules and therefore wants to establish new trans-regional institutions that exclude China and other counties.

America is no longer a country positively promoting global financial trade rules. It now seems to be focused on short-term rules to suit itself and a few allies. Although these agreements will co-exist with the WTO, world trade may become more fragmentized due to trans-regional agreements. A conflict of interests is slowly developing between a group of developed countries, including America, and the developing countries. Trade interests between developing countries might also be damaged. In view of this situation, it is hard to say that the world will be freer or fairer.

Are the trade rules established by WTO really unfair? The U.S. thinks that the standards involving environmental protection, intellectual property protection, and markets are too low. However, America should always bear in mind that it too encountered these problems during its industrialization. Progress was achieved only after a long period. If America remains reluctant to cooperate with other countries to define international rules, it might lose international respect and miss out on new opportunities for development.

The article is edited and translated from 《美国切莫制定短视规则（望海楼）》, source: People's Daily Overseas Edition, author: Shen Dingli, Vice Dean and professor of Institute of International Studies, Fudan University

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