Low health literacy among B40 a growing concern

by Professor Dato Dr. Ahmad Ibrahim, 

THE pandemic has exposed serious flaws in health matters in the country. The fact that health literacy is low in the country is a cause for concern. 

Many are still in denial about the usefulness of the vaccine in managing Covid-19 infections. This is despite all the evidence available. 

Though low health literacy is not limited to any group, it is most rampant, unfortunately, among the Bottom 40 percent (B40).

Low in the recent three-country study on hypertension among the B40 group. The study, called "Respond", is a joint effort between the United Kingdom, Malaysia, and the Phillippines. 

In terms of access to information, diagnosis, and treatment, the study confirmed that we in Malaysia do enjoy a good health support infrastructure.

Led by the late Datuk Dr. Khalid Yusof of UCSI University, the study unveiled some disconcerting facts about hypertension management among the B40 group.

The findings provide feedback to policymakers on the implementation challenges of national hypertension policies. The UK partner, the London School of Hygiene and Tropical Medicine provided useful partnerships in the research.

The study's B40 participants included those in urban and rural areas. The states of Penang, Johor, Kelantan, and Selangor were selected.

Questions posed covered access to information, diagnosis, and treatment. The findings have been written as policy briefs for submission to health professionals and the government.

As part of efforts to share the study's findings with the public, especially the B40, a webinar was held. An overwhelming number of about 800 participants joined.

Three key members of the study presented the findings and answered questions from the audience. Judging by the questions, many among the B40 still have a poor understanding of how to best manage hypertension.

In terms of access to information, diagnosis, and treatment, the study confirmed that we in Malaysia do enjoy a good health support infrastructure.

Government health clinics are easily accessible in many parts of the country, especially in West Malaysia.

The situation in East Malaysia is still dire though. Clinics provide good support in terms of information and consultation for those who require advice on hypertension.

There is, therefore, no reason for the B40 not to know what to do when dealing with hypertension.

Regular screening of hypertension is part of the prescribed management regime. The government has introduced a scheme called PeKa B40 which provides all kinds of support, including paying for transport to health clinics for screenings.

But according to the Health Ministry, the campaign has received a lukewarm response. So much so that the government is thinking of using mobile clinics.

Based on findings from the Respond study, the major challenge has to do with the need to change lifestyle. Despite being diagnosed with hypertension, many still skip taking the prescribed medicine.

Many still treat the disease as not serious. Many were surprised when told that there is no cure for hypertension. The fact that hypertension can be effectively managed through diligent medication and suitable lifestyle change is also not well understood.

Few would dispute that hypertension costs the economy significantly. It is a silent killer which has no cure. But over the years, scientists have found ways to manage the disease through medication and lifestyle changes.

It is unfortunate that this message has not reached everyone. This was revealed in the Respond study. A major suggestion of the study is for health authorities to rethink the communication strategy on hypertension to achieve a wider reach in the population.

Unfortunately, the part that is most challenging concerns the practices of the B40 themselves. This is where no kind of infrastructure can help.

It is to do with the behavior of those with the disease. Many among the B40, as revealed during the webinar's question time, still believe hypertension is curable.

It's the same with Covid-19. Despite the fact that those vaccinated are shown to be less prone to serious infections, many still refuse to get the booster dose.

It all boils down to a low appreciation for evidence-based health management in the country. Many still listen to hearsay rather than take the advice of doctors.

Al, drone tech can help palm oil industry

by Professor Dato Dr. Ahmad Ibrahim, 

There is growing concern about the import ban on palm oil products into the United States.

A few companies were slapped with the withhold release order (WRO) by the US Customs and Border Protection (CBP) agency on claims of forced labor.

The affected companies have submitted evidence to clear their names to secure the entry of their goods into the US market.

The industry is also seeking more lasting solutions. About 100 people joined the recent online discussion on the issue hosted by the Law School of Universiti Malaya.

The webinar proved very informative. Constructive solutions were proposed.

Apparently, as explained by the Malaysian Palm Oil Board (MPOB) officer based in Washington, the US law on forced labor is not new. It has been around for many decades.

But, in the original act, only imported products that competed with locally produced US products were subjected to such a ban. Other products were spared from the ruling.

This changed in 2016, during the President Barack Obama administration when the law was made to apply to all imported products. Since then, many imported products were affected.

Palm oil is not the first. According to information shared during the webinar, we have been aware of this all along.

The government has in fact created laws to get businesses to conform to the International Labour Organisation standards on forced labor. But we have been weak on enforcement and implementation.

Some of the criteria relate to poor living conditions of workers, the withholding of workers' passports, and very low pay.

Under the requirements for the import of migrant labor, the amount that workers have to pay to secure jobs here can hold them in bondage for years, therefore forcing them to work to be relieved from such bondage.

All the panelists agreed that the issue of forced labor is here to stay. There is a good chance that the ruling may be adopted by other countries. This is in line with the new ESG demand on businesses globally.

Some say those businesses which fail to embrace ESG (good practices in environment, social, and governance), will face obstacles in their business dealings.

In Malaysia, sectors that mostly use migrant labor include construction, plantation, manufacturing, and food and beverage (F&B). The pressure is less on the construction and F&B sectors since they are not exporting.

Apart from the US import ban, the palm oil industry also faces labor shortages.

With the current historic palm oil price touching RM7,000 per tonne, the shortage of migrant labor causes the industry to lose billions of ringgit in unharvested oil palm fruits. It appears that this issue of labor shortage won't go away anytime soon.

Unless the problems of an import ban and labor shortage are addressed, the palm oil industry will face hard times in the coming years.

A planned phasing out of the industry's addiction to cheap migrant labor should receive serious consideration.

The industry must not discount a more concerted investment in technology to wean away from being over-reliant on cheap labor.

Over the years, the industry has implemented many mechanization approaches to ease its dependence on labor. But the mechanization of the harvesting operation remains unresolved.

The industry may need to relook at the bottlenecks in the adoption of technologies. There are now labor-saving technologies available as a result of years of investment in research and development.

They include robotics or drones, artificial intelligence (AI), and digitalization. We need to not only boost our investment in R&D but also tap into the best research brains locally and internationally to develop such technologies.

Using MPOB as the anchor R&D center, a new research alliance on mechanization and automation should be established to deliver this.

The research alliance should bring in R&D initiatives at universities and other research centers, such as MIMOS and SIRIM. The alliance should also explore links with international R&D centers which specialize in the relevant automation technologies.

Otherwise, such labor concerns will continue to haunt the industry in years to come.