A killer – in the blink of an eye
PETALING JAYA: Dr Julius Goh Liang Chye of Universiti Malaya remembers his childhood journeys back to Kedah from Kuala Lumpur very well.
'As children, we always depended on our father to do the heavy lifting, including driving long hours during festive seasons.
'One particular journey took a frightening turn when he briefly dozed off at the wheel, jolting awake just in time to avoid a crash,' he said.
ALSO READ: Apnoea – something to lose sleep over
'At that time, we were unfamiliar with the term microsleep,' said Dr Goh, who is now a consultant otorhinolaryngologist at Universiti Malaya's Faculty of Medicine.
Otorhinolaryngology deals with conditions affecting the ear, nose and throat (ENT), some of which have the potential to affect sleep quality.
Experts agree: (From left) Siti Zaharah, Louis and Dr Goh say microsleep poses a menace that threatens road safety everywhere.
Road safety experts as well as the medical fraternity now want sleep management, in particular addressing microsleep, to be part of the lexicon, given the immense potential of sleep-deprived persons causing accidents whether at the workplace or on the road.
Dr Goh, who specialises in sleep surgery and medicine, said fatigue-related crashes are often under reported, yet they pose a significant risk, particularly among drivers who embark on long-haul journeys with inadequate rest.
While microsleep is frequently associated with obstructive sleep apnoea, other sleep disorders can also contribute to its occurrence.
'These conditions include insomnia, restless legs syndrome, epilepsy and narcolepsy may all lead to episodes of microsleep, making accurate diagnosis by a medical professional essential,' said Dr Goh.
Dr Louis Adaikalam, president of the Malaysia Sleep Apnea Association, said there are enough hints that microsleep is behind a significant number of road crashes in Malaysia.
'In fact, microsleep has been linked to several major industrial accidents, along with lots of road accidents,' he said.
He believes that the emergence of the gig economy is also a contributing factor to sleep deprivation, where some people attempt to be e-hailing drivers or couriers after their official day job.
'Some people are sacrificing sleep to earn more, and of course, there is obstructive sleep apnoea and other sleep-related issues that need medical diagnosis.
'For example, fatigue can also be caused by diabetes or heart problems, which in turn, can lead to more dangerous driving such as greater risk-taking on the road,' said Louis.
Malaysian Institute of Road Safety Research director-general Assoc Prof Dr Siti Zaharah Ishak said a collaboration is on the cards with a company to offer courses on managing microsleep at the workplace.
'This is being done through capacity-building and innovative training,' she said.
Get enough rest: Based on statistics provided by the police, drivers falling asleep due to fatigue caused over 1,300 fatalities on the road.— AZMAN GHANI/The Star
'Miros will also conduct more studies on sleep deprivation and its relation to road safety.'
In 2023, Malaysia recorded 598,635 incidents that resulted in 6,443 fatalities, with nearly two-thirds of deaths coming from motorcyclists and pillion riders.
Based on the last statistics provided by the police, 1,305 fatalities were attributed to drivers falling asleep due to fatigue between 2011 and 2021.
Datuk Ng Koong Sinn, president of the Malaysia Trucking Federation, said drivers under his company must take a 30-minute break after every four hours of driving.
'They are only allowed to drive up to eight hours a day, while the daily work hours (inclusive of driving) cannot exceed 12 hours.'
Another major logistics grouping, the Association of Malaysian Hauliers, acknowledged the risks posed by fatigue and microsleep among commercial drivers.
'Many of our members have implemented internal policies such as ensuring drivers are sufficiently rested before long hauls, providing safety bonuses for accident-free records, and encouraging break intervals where possible,' said association secretary Mohamad Azuan Masud.
'However, the reality on the road now poses several operational challenges. Long waiting times at port terminals, container depots and customer premises often stretch a driver's working hours unpredictably.
'The common practice of customers only allowing deliveries during office hours further restricts flexibility, while the ongoing driver shortage worsens the situation.
'Additionally, peak-hour road ban on heavy vehicles and a lack of proper rest facilities or parking bays at many R&R stops along highways make it harder for drivers to rest safely and on schedule,' said Azuan.
'Our members remain committed to upholding safety and continue to find ways to support their drivers through better scheduling, incentives, and the adoption of technology like Advanced Driver Assistance Systems where feasible.'
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Sinar Daily
3 days ago
- Sinar Daily
Urban lifestyle and modest dressing linked to higher vitamin D deficiency rates, especially among women
Vitamin D deficiency, a condition often associated with countries with limited sunlight, is surprisingly prevalent in Malaysia. Health experts share the impacts on the population's health, particularly among urban dwellers, women and specific ethnic groups. Speaking to Sinar Daily, Consultant Public Health Specialist, Professor Dr Hematram Yadav explained the widespread nature of the issue, emphasising that even in a sunlit tropical nation like Malaysia, vitamin D deficiency affects children, adolescents and adults. One of the main culprits behind this unexpected health concern is Malaysia's urban lifestyle. Dr Hematram said many Malaysians spend the majority of their day indoors—working, studying or simply avoiding the heat. "This significantly reduces their exposure to sunlight, which is crucial for the body's natural synthesis of vitamin D," he said. The cultural and clothing practices of certain groups further exacerbate this issue. For example, modest dressing, common among many Malaysians, including hijabs and long garments, limits direct skin exposure to sunlight, impacting vitamin D synthesis. Additionally, ethnicity plays a key role. Studies indicate that Malays and Indians, who typically have darker skin tones, require longer sun exposure to produce the same amount of vitamin D as those with lighter skin tones, such as Malaysian Chinese. This biological reality, combined with lifestyle and dietary habits, puts these groups at higher risk. Vitamin D deficiency appears to disproportionately affect Malaysian women. 'Females tend to have lower Vitamin D levels than males,' noted Dr Hematram. He said this disparity is linked to cultural practices, limited outdoor activities and physiological differences, with the elderly and pregnant women particularly vulnerable. Meanwhile, Professor in Epidemiology and Public Health at Universiti Malaya, Dr Moy Foong Ming, pointed to findings from a systematic review on vitamin D status in Malaysia. 'The pooled proportion of vitamin D insufficiency (<50 nmol/L) was a staggering 64 per cent. Urban populations, women and Malays and Indians showed significantly higher rates of deficiency,' she revealed. According to her, the implications of vitamin D deficiency are severe and far-reaching. Modest dressing, common among many Malaysians, including hijabs and long garments, limits direct skin exposure to sunlight, impacting vitamin D synthesis. Photo: Canva Dr Moy said the long-term deficiency can lead to weakened bones, increased risk of fractures and osteoporosis, particularly among the elderly. "Women, especially postmenopausal, are at risk of osteomalacia and osteoporosis due to a loss of bone density. "Pregnant women face heightened risks, with deficiency linked to gestational diabetes mellitus (GDM), preeclampsia, preterm births and impaired fetal bone development. "Adolescents, too, bear the brunt of this deficiency, which can hinder peak bone mass development, impact cognitive performance, and contribute to mood disorders such as depression and anxiety," she said. Beyond bone health, Dr Moy said vitamin D deficiency is associated with an increased risk of chronic diseases like hypertension and Type 2 diabetes, autoimmune disorders and even mental health conditions like seasonal affective disorder. Recognising the symptoms Symptoms of vitamin D deficiency often go unnoticed until severe. Common signs include fatigue, muscle and bone pain, slow wound healing, increased susceptibility to illnesses, hair loss and even depression. Therefore, the expert said combatting vitamin D deficiency in Malaysia requires a multi-faceted approach Education and awareness: Many Malaysians remain unaware of their risk or how to safely obtain vitamin D. Dispelling myths about sun exposure, such as fears of skin cancer, is essential. Dietary improvements: Encouraging the consumption of vitamin D-rich foods, including fatty fish like salmon and sardines, fortified products, and supplements, can bridge the gap. Promoting safe sun exposure: Malaysians should aim for short periods of sun exposure, particularly in the morning or late afternoon, when UV rays are less harmful. The tropical sunlight that bathes Malaysia year-round should ideally protect its population from vitamin D deficiency. However, as urbanisation and lifestyle changes continue to shift Malaysians indoors, it becomes increasingly important to ensure the public is informed and equipped to address this hidden health issue.
The Star
10-06-2025
- The Star
‘DRG grouper that can be used by all hospitals needed'
PETALING JAYA: The Health Ministry should develop a national grouper on diagnosis-related groups (DRG) that will work for all hospitals. DRG groupers are used to categorise patients into DRGs, which are groups of cases with similar diagnoses, procedures and other characteristics. Prof Dr Maznah Dahlui, a health economist at Universiti Malaya and chairperson of the technical advisory committee for the DRG under the Health Ministry, said currently, there are different groupers based on hospital type. 'The ministry needs to come up with a DRG grouper that can be used by all types of hospitals. Currently, public hospitals use the grouper that they developed and teaching hospitals use the grouper developed by Universiti Kebangsaan Malaysia, while some private hospitals adopt (the model) from Australia,' she said when contacted. The main purpose of the DRG grouper is to assign DRGs, which are then used to determine payment for the hospital stay under the inpatient prospective payment system (IPPS). Prof Maznah said DRGs work as a costing model to improve hospital efficiency and as a payment model, but may not necessarily be applied for health insurance reimbursement. 'At the end of June, representatives from hospitals will have a workshop to discuss the development of the national grouper. 'Most likely, we will adopt the available grouper in public hospitals but modify it to consider patient characteristics (diagnosis and procedure) in private hospitals. So it's still under discussion,' she said. 'There is another group under the Health Ministry that looks at developing the health benefits package and the healthcare payment model for Malaysia, in preparation towards National Health Insurance (NHI). So, DRG is only part of and not necessarily only for NHI,' she said. The DRG, she added, is the bundling of treatment costs, which is equivalent to treating a certain DRG. 'We want to standardise how we group the patients for diagnosis plus procedure. It gives transparency of treatment cost,' she said. Dr Khor Swee Kheng, health systems specialist and CEO of Angsana Health, said implementation of DRG could take up to a decade if done in phases. 'Any DRG implementation should take five to 10 years, and it happens in phases. This has been the experience in other countries that have launched their DRGs, which started in 1983 in the United States,' he said. Dr Ginsky Chan, co-founder and access director at Angsana Health, said the phased introduction of DRGs, starting with minor illnesses, is a positive move towards value-based healthcare. 'Implementing it by the end of 2025 is ambitious but feasible with strong coordination. 'While it does not require a national insurance system immediately, it does highlight the need for integrated financing across the public and private sectors. A phased, collaborative approach will be key to its success,' he said. The DRG-based model has been implemented in a number of countries, including Indonesia and South Korea. However, there appears to be some resistance in the private sector towards its implementation. IHH Healthcare Bhd said last month that the payment model is not suitable to be implemented in local private hospitals, and feels that further studies are needed before considering its adoption. Its group chief executive officer, Dr Prem Kumar Nair, said DRGs are very difficult to implement in private hospitals, adding that it was originally designed to fund public healthcare through a single-payer model. Under the framework, inpatient cases are grouped into categories based on clinical similarity and expected resource use, allowing payers to reimburse hospitals with a fixed rate per case rather than through itemised billing.
Borneo Post
08-06-2025
- Borneo Post
‘From Sibu to Singapore'
Sarawak-born doctor proud to have become pioneer in colorectal surgery in Lion City, hails late wife as 'greatest supporter' Dr Goh regards the relocation to Singapore in 1981 as 'the defining step of his career'. THE move from Sarawak to Singapore in 1981 was indeed the defining step for Mukah-born Prof Dr Goh Hak Su. It later earned him the recognition of being one of the most respected figures in the field of colorectal surgery. 'Well, I grew up in a poor household in Mukah. 'I went to school and studied up to O-Level at Three Rivers School. 'That's the highest you could go in Mukah. Usually, after Form 5, the next step would be to go to Miri to do the A-Level,' he shared with thesundaypost during an exclusive interview recently. Dr Goh, now 77, could never forget how fortunate he was to be awarded an English scholarship after his O-Level, which enabled him to pursue A-Levels at the prestigious Sevenoaks School in the UK. He then went on to pursue two degrees – one in Biochemistry, and the other in Medicine – at the King's College London and the University of London. He then underwent training as a surgeon and obtained a Fellowship of the Royal College of Surgeons (FRCS) in England, before coming back to Sarawak in early 1980. 'There were very few doctors in Sarawak in those days. I thought that before coming back, I would be more useful if I were a surgeon rather than just a GP (general physician). 'As a GP, you treat general medical conditions, which is also important. 'But if someone came in bleeding or with appendicitis, I wouldn't be able to deal with it as a GP. 'So I trained as a surgeon after completing my medical degree. 'The whole point of training and going back was to serve Sarawak,' he said. 'Return to homeland' Upon his return in early 1980, Dr Goh was posted at Sarawak General Hospital (SGH) in Kuching. His wife Associate Professor Dr Cynthia Goh, also a trained doctor, had taken some time off to raise their son and daughter. Photo shows the old Lau King Howe Hospital in Sibu, where Dr Goh had served as its only surgeon from 1980 to 1981. — Photo from Dr Goh said after several months at the SGH, he was persuaded by the former deputy chief minister, the late Datuk Patinggi Tan Sri Dr Wong Soon Kai, to relocate to Lau King Howe Hospital (LKHH) in Sibu, where there were no surgeon at the time. 'It was a request that I graciously accepted,' said Dr Goh. He said including himself, there were two surgeons in Kuching at the time. 'The other was a more senior colleague. In Sibu, however, there was no surgeon stationed there. 'Datuk Patinggi Dr Wong, a great and highly-respected surgeon, approached me and said: 'We have two surgeons here in Kuching, but none in Sibu – why not serve where you're needed most'. 'So, after four months in Kuching, I agreed to move to Sibu.' 'One surgeon, many roles' Dr Goh then served at the LKHH as the sole surgeon, providing surgical care and covering not just Sibu, but the entire division at that time. 'I enjoyed my work at the LKHH very much. People came from Kanowit, Kapit, even as far as Belaga. 'Sometimes, though, we had patients with appendicitis who had to travel for two to three days just to reach us for surgery. 'Sadly, some did not make it.' As the only general surgeon in Sibu, Dr Goh performed a wide range of operations, from on the abdomen and lungs to, at times, heart and kidneys. 'I didn't do eye surgeries, because there was an eye surgeon; and there's one for O&G (obstetrics and gynaecology). 'The rest, I had to do myself. Obviously, it was very challenging. 'Given the limitations at the time, my team and I had to make do with what was available. 'It was a demanding environment, but it's also one that gave us invaluable experience and taught us to adapt effectively.' 'Decision shaped by circumstances' However, nearing the end of 1981 after having served in Sarawak for 18 months, Dr Goh left Sibu for Singapore. It was not a decision that he made lightly. 'It was driven by necessity,' he said, pointing out that the circumstances surrounding foreign spouses at the time made it almost impossible for his family to settle in Sarawak. In explaining this, he said Dr Cynthia was born in Hong Kong, but after having studied in the UK for so long, she was granted British citizenship. 'My wife, having studied in the UK for years, and my children, who were born in England, all held British passports. 'At that time, the situation was very different – they couldn't become Sarawak residents. 'My wife had to renew her permit every three months, and although she was a trained doctor, she wasn't allowed to work in Sarawak. 'It was very difficult,' he shared. 'A new chapter' After his family left Sarawak, Dr Goh joined the Department of Surgery at the National University of Singapore (NUS). It was in his first eight years with the university that he developed a special interest in colorectal surgery. 'Even at that time, we already knew that colorectal cancer was going to be a very important focus, because from the cancer registry, we could see that the numbers and the incidence were increasing very dramatically compared with the other types of cancers.' In 1989, Dr Goh was asked by Singapore's Ministry of Health to establish the Department of Colorectal Surgery at Singapore General Hospital. 'That's where it began. I started the first colorectal surgery programme in Singapore, as well as in Southeast Asia. In 1989, I established the Department of Colorectal Surgery at Singapore General Hospital, marking the beginning of the specialty in the region.' The department trained most colorectal surgeons in Singapore and provided fellowships and training to surgeons from across Southeast Asia, China, India, Bangladesh, and even as far as Australia and UK. In 2021, Singapore Health Services (SingHealth) and Duke-NUS Medical School established the Goh Hak Su Professorship in Colorectal Surgery, with a perpetual endowment, in honouring Dr Goh for pioneering the surgical specialty in Singapore, and also in Southeast Asia. A view of the wall showing the awards and recognitions conferred on Dr Goh, at a corner of the Goh Hak-Su Colon and Rectal Centre in Singapore. — Photo from However, it was only one part of the Goh's legacy. Dr Cynthia also left an equally profound impact in the field of palliative care. 'A wife's grace, a nation's care' Born on Nov 21, 1949, in Hong Kong into a family of doctors, Dr Cynthia pursued medicine in the UK. There, she met her future husband at St Bartholomew's Hospital in 1969, and married him in 1974. To Dr Goh, Dr Cynthia was 'simply remarkable – a woman of brilliance, with sheer drive and deep compassion'. 'She trained to become a physician, and completed a PhD in molecular biology, all while raising a family. 'She could do it all – housewife, doctor, scientist. 'She was a brilliant person,' he said. Dr Cynthia took a holistic approach to medicine, added Dr Goh. 'She believed that a person was never just a diagnosis. She treated people, not just illnesses.' That belief, said Dr Goh, shaped her life's work in palliative care, which was a nascent field in Asia back then. Archive photo shows Dr Cynthia (left) attending to a patient at St Joseph's Home during her earlier years in the field of palliative care. — Photo from Dr Cynthia began volunteering at St Joseph's Home and Hospice, Singapore in 1986, and went on to establish palliative care services at Singapore General Hospital and the National Cancer Centre Singapore (NCCS) in 1999. She also co-founded HCA Hospice Care in 1991, and served as its first president. 'Hospice Care Association (HCA) was a voluntary organisation. 'Doctors and nurses visited people in their homes so they didn't have to die in hospital,' said Dr Goh. Dr Goh says in recognition of her contributions, Dr Cynthia was hailed as the 'Mother of Palliative Care in Singapore'. Dr Cynthia's contributions helped bring palliative care into mainstream healthcare, and in 2008, she was appointed co-chair of the Worldwide Hospice Palliative Care Alliance (WHPCA). Even after being diagnosed with pancreatic cancer in 2020, Dr Cynthia remained focused on strengthening the field. She envisioned a lasting platform to support palliative care across Asia, and had laid the groundwork for what would become the Cynthia Goh Palliative Care Institute (CGPCI). 'Upon knowing that she was dying, she wanted the work to continue and grow. 'That's the legacy that she left behind,' said Dr Goh. Dr Cynthia passed away in February 2022, at the age of 72. In her honour, the CGPCI was launched on July 1, 2023, during the Eighth Singapore Palliative Care Conference, housed within the NCCS under Duke-NUS Medical School, where she had long championed the cause. Photo shows the Duke-NUS Medical School in Singapore, where together with SingHealth had established the Goh Hak Su Professorship in Colorectal Surgery in 2021, in honouring Dr Goh for pioneering the surgical specialty in Singapore, and also in Southeast Asia. — Photo from Funded initially by S$6 million (then, one Singapore dollar = RM3.19) in donations from family and friends, the institute's key objectives are to build regional palliative care capacity, train future leaders through the Cynthia Goh Fellowship, and serve as the permanent home of the Asia Pacific Hospice Palliative Care Network (APHN). In recognition of her contributions, Dr Cynthia was hailed as the 'Mother of Palliative Care in Singapore'. 'Measure success by purpose, not wealth' When asked what would be his advice for those from the younger generation aspiring to succeed, Dr Goh emphasised the importance of placing values above material gain. 'Never put money at the forefront of what you are doing. 'When we plan our life, we should not plan with the idea of wanting to be rich first. 'When you have money in front of you, and that's your goal, then to me, life would not be so fulfilling.' He added that one must always strive to do their best, making the most of whatever opportunities being given to them. He said: 'I was very lucky. I wanted to become a doctor, and I was given the opportunity to become one. 'So, I always wanted to be as good as I could, and that has enriched my life tremendously.' Dr Goh also expressed his gratitude for the unwavering support from Dr Cynthia, who shared his values and stood by him throughout their time together. 'I was trained in England and had no obligation to return to Sarawak – I wasn't bonded. 'But I wanted to come back to serve. 'Most people, at that time, had wondered why we chose to move to a place like Sibu, as it's not a big city. 'But Cynthia supported me fully. She believed that it was important for me. 'It was unfortunate that we could not stay longer in Sarawak, but we were given great opportunities in Singapore to develop, and that's where we went.'
