Antimicrobials are medicines that inhibit the growth of microorganisms such as bacteria, fungi, viruses and parasites, and cause their death.
Over the years, due to overuse/misuse of antimicrobials, these microorganisms have mutated into “superbugs” that have the ability to resist antimicrobial treatment.
As a result, infections continue to persist, resulting in prolonged illness and the increased risk of death, as well as increasing the risk of spreading the bugs to other people.
Small organisms, big problems
Antimicrobials have revolutionised and transformed medicine, saving millions of lives.
But over the last two decades, antibiotics usage has increased for both medical and non-medical applications, leading to the development of antibiotic resistance.
The World Health Organization’s (WHO) Global Antimicrobial Surveillance System (GLASS) reveals that nearly 700,000 people around the world die each year because of drug resistance.
It also predicts that the figure could rise to one million deaths annually with an exponential increase in medical costs of over RM400 trillion.
Although this is global data, Malaysia is no different from the rest of the world.
Causes of the crisis
• Overuse/misuse of antimicrobials
Way back in 1945, Sir Alexander Fleming, in his Nobel Prize acceptance speech, had remarked that when the public demands these drugs, there will begin an era of abuse.
As predicted, due to the lack of regulations in many countries, these medicines are sold over the counter without prescription.
Antibiotics are also frequently prescribed improperly in terms of indication, choice, dose and duration of treatment.
Even when correctly prescribed, patients often do not finish the full course of their medicine, which contributes to antibiotic resistance.
On the flip side of the coin, unnecessary usage can also lead to harmful side effects.
• Widespread agricultural use
The majority of antibiotics are actually used as growth supplements in healthy animals, or as a preventative measure for animals living in crowded or unsanitary conditions.
When humans ingest such animals, resistant microorganisms can get transmitted to them and cause severe infections.
• New antibiotics
Due to financial and regulatory constraints, the development of new antibiotic drugs has almost come to a standstill.
Pharmaceutical companies do not find these investments to be profitable as these drugs are meant to be taken only for a short time, and are generally curative.
The problem is that the pace of new drug discovery simply cannot match the pace of growing resistance.
If existing antibiotics are not used judiciously, even the commonest infections may become difficult to treat.
Antibiotics are often given to animals living in crowded conditions to prevent them from getting sick. However, this contributes to the rise of antibiotic-resistant microorganisms, which will affect humans.
Diffusing the time bomb
Antibiotic resistance is rising to precariously high levels, and without urgent action, the world is heading towards a post-antibiotic era.
Most of the causes responsible for this crisis can be tackled wisely.
One of the key strategies to prevent antibiotic resistance is by preventing infections of these antibiotic-resistant microorganisms.
This can be achieved by making drastic changes to the prescribing practices of antibiotics by doctors and their usage by patients.
How can you as a patient contribute?
• Never demand antibiotics. Only use antibiotics when prescribed by a health professional and always follow their advice.
Be sure to ask questions if anything is unclear.
• Always finish the full course of your prescribed antibiotics; never stop taking them halfway through the course, even when you feel better.
• Never share or use leftover antibiotics.
• Take good care of your personal health and hygiene.
Wash hands regularly, practice hygienic food preparation, avoid close contact with sick people and ensure your vaccinations are up to date.
• Go for meats and fishes that have been produced without the use of antibiotics.
Fighting the resistance
Antibiotic awareness week has been held every November since 2015.
This global initiative focuses on spreading awareness about antibiotic resistance, recommending guidelines for optimising antibiotic usage, and strengthening surveillance and research in countering antimicrobial resistance.
During the 68th World Health Assembly in May 2015, all member states were guided to set up national antimicrobial resistance surveillance systems that can yield reliable data.
In accordance to this, the Health Ministry and the Agriculture and Agro-Based Industry Ministry initiated the Malaysian Action Plan to combat antimicrobial resistance (MyAP-AMR).
This plan includes comprehensive educational and awareness programmes to educate both the public and professionals.
However, surveillance is still in its infancy, hence commitment and complementary efforts from all related sectors including veterinarians, farmers, fishery officers, health professionals and all related stakeholders, are required to tackle one of the biggest threats to global public health.
As responsible individuals, it is our duty to safeguard the world with our coordinated efforts against antibiotic resistance.
Otherwise, we will find our so-called “high-tech world” reverting back to the pre-antibiotic era in the not-too-distant future.
Dr Deepthi Shridhar P. is a lecturer in pharmacology at the Perdana University Graduate School of Medicine. This article is courtesy of Perdana University. For more information, email email@example.com. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star disclaims all responsibility for any [...]
HONG KONG: Divorced, in his 40s and fearing a solitary future, Zhou Xinsen went online like thousands of other Chinese men to find an affordable and fast solution to bachelordom — a Vietnamese bride.He was among millions of his gender struggling on the sidelines of China’s ultra competitive marriage market, where a decades-long one-child policy and sex-selective abortions of daughters has resulted in a massive gender gap.“It’s very hard for people my age to find a Chinese wife,“ 41-year-old Zhou says.Single men, many in remote rural villages, are known as “bare branches”, a pejorative term in a country where pressure to marry and extend the family tree is sharp.Running out of time, Zhou forked out nearly US$20,000 to find his second wife — a 26-year-old from Vietnam who he relocated to Jiangsu province.“For people my age, time is bought with money.”Having fixed his romantic quandary, Zhou then opened his own match-making business, taking a small slice from China’s multi-million-dollar annual trade in overseas brides.He charges around 120,000 yuan (RM72,817) to connect Chinese men with Vietnamese brides via his website, which shows photos of women aged 20-35 “waiting to be married”.It’s “profitable”, he says, remaining coy on the amount of money he has made.A portion of the money from matches is meant to be funnelled back to families in poor Mekong area countries.While many unions flourish, others quickly lurch into crisis with women disappointed at swapping village poverty in Cambodia, Laos, Vietnam and Myanmar for life in rural China.China’s single men are often older, divorced, disabled or too poor to pay the traditional “bride price” — a dowry in gifts or cash — for a Chinese wife.Those costs rose to between US$22,000-US29,000 in parts of the country last year, according to state media.Problems start when the brides feel duped about what they are getting into, says Zhou, who sends a monthly remittance to his wife’s family of $175 as a show of goodwill.“This is nothing to us, but for them it’s lifesaving,“ he adds.Family business Chinese men face a barrage of economic, psychological and cultural pressures to find a wife, says Jiang Quanbao, a Professor at Xi’an Jiaotong University’s Institute for Population and Development Studies.“Marriage is not only a personal matter, it concerns an entire family... especially the parents,“ Jiang told AFP.As women — especially in the cities — push back marriage while they work, study and enjoy single life, China’s villages are fast losing their female population. Sons left unmarried become an issue of family “face” in tight village communities, says Jiang.That crushing social expectation has driven a grim trade in brides.Increasing numbers of woman — and teenage girls — from neighbouring countries are kidnapped, tricked or forced into marriage, according to several rescue groups across the Mekong who spoke to AFP.“Buying a woman who has been kidnapped becomes a kind of hopeless choice,“ Jiang adds.Last year Chinese police rescued women sold into forced marriages in Henan, Anhui, Shandong and Jiangsu provinces, as the buy-a-bride trade billows out to the eastern provinces. Crime and deceptionUnder Chinese law, the abduction and trafficking of women or children is punishable by five to ten years jail. But critics say the law needs updating as the trade surges.“It’s extremely profitable and there’s no incentive at all for traffickers to stop,“ Mimi Vu of the Vietnam-based Pacific Links Foundation, which works to prevent human trafficking.“The demand is there and the money, the profit is there to be made.”Beijing switched from a one-child to a two-child policy in 2016, but experts say it may take decades to see a rise in the number of women of marriage age.That means the bride trade is unlikely to dissipate anytime soon.Zhou describes his work as “a public service” in a country where there are 33 million fewer women than men.But the outcomes for Chinese men are often far from perfect, with money warping motives throughout the system. Cautionary tales — of dodgy brokers, trafficked women and brides pocketing money then fleeing — abound on Chinese social media as the market widens.“It is an industry, and many of them (marriages) are fraudulent,“ one Weibo user wrote recently. “It’s time the government takes care of this business.” Another man in Hubei told state media he paid a broker US$8,700 to meet a young Vietnamese woman who left him after three months, later aborting their baby as she went on the lookout for another husband.“Now I have neither a wife nor the money,“ he told the Chutian Metropolis Daily. “I’m a laughing stock in the village.” — AFP [...]
Pak Daud took over the silversmith business from his uncle back in 1964. — Pictures by Ham Abu Bakar
KUALA LUMPUR, Dec 4 — Pak Daud, 70, is one of the very few artisans left keeping the tradition of silversmithing alive in Kelantan.His exquisite works include silverware for royalty and even a keris which was presented to former US President Barack Obama!Craftsmen of his calibre are fast dying out but with the Kelantan silver jewellery shoe project supported by Yayasan Hasanah, a foundation of Khazanah Nasional, his work will soon receive world recognition.
Yayasan Hasanah senior vice president arts heritage & culture, Zainariah Johari, explains how they are using Italian handmade shoes to promote the dwindling Kelantan silver industry.
Silver embellishments, made by Pak Daud and four other silversmiths, will be adorning handmade Italian shoes.The project was first mooted back in 2016 by Yayasan Hasanah, following a study by Kraftangan Malaysia and Tradisi Busana PR Sdn Bhd that showed the number of silversmith artisans are now less than 40.It's a drastic decline from around 200 silversmiths back in 1995. The study highlighted that this was due to a lack of demand for silverware since most people aren't aware of the fine craft.
Designs for the silver pieces were inspired by the surroundings in Kelantan like this floral matt silver piece.
Pak Daud, whose full name is Mohd Daud bin Yusoff, said another difficulty artisans faced was the fluctuating price of silver. He lamented that at one time, it went up to RM5,000 per kilogramme! Sometimes it can drop down to, say, RM1,000 per kilogramme.This causes uncertainty for their pricing. In terms of crafting the silverware, it needs a pair of hands versus machines. For instance, Muhammaad Khairi bin Suhaimi, 20, explained that the craftsmen need to ketuk (knock) by hand, as the silver is too soft to do otherwise.
The elegant black Italian handmade shoe is enhanced with the handcrafted silver piece made by the Kelantan silversmith artisans.
Yayasan Hasnah, senior vice President, arts heritage & culture, Zainariah Johari, explained that initially they were approached by Dodi Mohammad from Tradisi Busana PR to do preservation work.As Dodi was a protege for 20 years of celebrity shoe designer Jimmy Choo, they decided to combine the silverware industry revival with shoes.She added, “Our silver craftsmen are always producing household items or decorative items like brooches. We feel the industry needs a lot of boost and with a big name behind it, this will take it a couple of steps beyond.”
Carry a piece of Malaysian 'wau' crafted from silver on this patent men's shoe.
The eight-month project identified five silversmiths scattered around Kelantan that included Pak Daud from Pengkalan Chepa. The rest are KB Permai, Zaini Arif, Suhaimi Mat Jusoh and Razak Ismail.All of these artisans specialise in various items that range from jewellery and trophies to royal ceremonial items. Usually, these items are commissioned by various parties.Pak Daud explained that for his designs, he'll see what raw materials are easily available around him. Hence, he uses bull horns, since it's found in his village.
Kelantan silverware needs a lot of patience as you need to carve and 'ketuk' by hand to achieve its beautiful texture.
As part of expanding the pool of silversmiths, these artisans selected six proteges from their own village. Some of the artisans also have the new generation helping out like Suhaimi Mat Jusoh's two sons and Pak Daud's son and daughter.To further facilitate the project, a fashion consultant was also brought in to advise. The project also included teaching the artisans how to be sustainable, which was done via an academician from a higher learning institute.“You cannot just create something beautiful but it sits on the shelf. You need to be sustainable. But that remains a challenge, as an artisan is an artisan,” said Zainariah.With the crafting of Italian shoes, they worked closely with the Italian Trade Commissioner Dr Samuele Porsia. It's via the know-how shared by the Italian shoe makers that the Kelantanese artisans learnt how to create special hooks for the silver pieces to attach onto the shoes.
Suhaimi Mat Jusoh is famous for his carving techniques on metal substances like this elegant silver handbag.
The collection features a total of seven shoe designs: Five for women and two for men. The designs of the silver adornments are all inspired by the Kelantan environment and feature wayang kulit characters, wau and flowers.Tradisi Busana PR has also secured a retail space at Amato Couture Gallery in Dubai to market these shoes.Yayasan Hasanah is hopeful that this project will be the stepping stone to bigger things to come for the whole industry. As Zainariah explained, “The shoe is not the hero. The hero is the craftsman. We want to save the craft and the product is the silver. The shoe is just a tool. It could be bags.”
Syahrul Syazwan explains to customers about their silver jewellery pieces.
Seeing the exquisite silver craftwork, two companies have also signed a memorandum of understanding with the artisans to promote their craft.The first is Nusantara Collection, a local company with an established customer base in the US for their website designs. Another is LORD's Tailor who is well known for their handmade suits. They have plans to introduce silver lapel pins, buttons and cufflinks, which highlight the Malaysian tradition and the Kelantan silver craftsman.With the awareness created, there's hope for the artisans to make more ties with other companies to promote their work. Yayasan Hasanah has also invited other charity foundations to consider funding further initiatives.
Various brooches made by Razak Ismail who started learn [...]
KUALA LUMPUR (Nov 17): Aside from the 1Malaysia Development Bhd scandal, the problems at the Federal Land Development Authority (FELDA) were part of the reason... [...]
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