The next mountain is always higher than the one I’m climbing

I always thought that my pharmacy in Mukah is a very nice place. Relaxing but challenging enough to keep me on my toes and my brains working. Not too modern but young enough to be comfortable. A pharmacy that have the potential to be first-class with a little bit of hard work.

Then I visited Hospital Sarikei.

It is also a district hospital, but at first sight, it was already Hosp Sarikei 1; Hosp Mukah 0.

Then as I went into the outpatient’s pharmacy waiting area. immediately, the score became 2:0.

Dispensing counter, 3:0

Arrangement of medications, orderliness, neatness, completeness, 4:0

Beauti-ness of the notice board and displays, 5:0

Well, I think I should stop here before it became a thrashing. In shortness, Hosp Sarikei is a dream hospital. It is big, new, have a relaxing feel, new computers and furniture. Pharmacy wise, it is well-run, systematic and beautiful.

At least after the trip, I had now a benchmark – a clear vision of what I want the pharmacy to be. And hence I should work harder =)

Lest I fail, there’s also the step as per saying “if you can’t beat them, join them”. I am now keeping Hosp Sarikei firmly in my sight as my next working destination if I got tired of Mukah one day.

But now, its to improve my pharmacy with renewed vigor!

Happy Mother’s Day

Mum, this is for you.

Happy Mother’s Day!

Kaul in pictures (2)

 

Welcome to Pesta Kaul!

One of the elaborate booths on display. Each kampong around Mukah build their own booth, where they had cooking demonstrations, exhibitions and sell their unique food and wares.

I had actually been to the site four times. This is a pretty pic taken at night.

Stalls selling things from perfume to clothes to handicrafts.

Food stalls with lots and lots of unhealthy glorious food.

Fishes swimming in the sky.

Kite aero-show. Those six people at the bottom left of the picture skilfully made their kites fly in beautiful synchronised formation.

The parade of the ‘Serahang’. It had some cultural significant to please certain gods. But whatever it is, it was intricately handcrafted.

Close-up pic of the serahang.

The beach during sunset still looks very nice…

But Malaysians do need to learn one day not to litter.

Hmm….that’s all for this post. Its getting too long…^^

Watching paint dry

Gone as a footnote in history:

For the past couple of years, this was the facade that greeted every patient who required some meds from the Mukah Pharmacy.

Towards the left hand side of the first photo was the door into the pharmacy, and next to it, the notice board which I was helping the hospital admin to decorate. Actually I hijacked it without permission for pharmacy’s gain =).

This was the interior of the pharmacy dispensing counter. Normal.

I had nothing against light colours, besides the fact that it is so without character. It just blended into the background as part of the ‘hospital furniture’. Lifeless. Mundane. Lack of vibrancy. So not cheerful. Not distinct. No way to go for a ‘top class’ pharmacy. No standard.

That’s why it had to be transformed. After waiting for a whole month, at last I had the novelty to watch paint dry for the whole day and continue to gaze and wonder at the brand new pharmacy for another. Tadaa! Presenting the final result:

 

The new look of the pharmacy counter. Bright youthful orange encrusted by a outer wall of contrasting dark brick-red.

 

The door into the pharmacy beckoned, surrounded by a welcoming brick-red warmth.

 

The cheerful interior of the new-look dispensing counter.

The view from afar which I took just before we close for the day. Now we look different and will be different.  Hope the positive ‘qi’ can increase staff morale and work rate. I am already happier. ^^

Kaul Festival in pictures (1)

Kaul Festival is the most happening thing in Mukah. It is sort of a Melanau new year which was celebrated annually around April.

The festival was held at the Kala Dana beach, which was the halfway point of my 6km jogging route. It was fascinating watching day-by-day as they slowly transform what was a barren field into a festive ground:

From this (above) to that (below) and that (below the below :)

They had also constructed a huge stage,

which was filled to the brim with local dignitaries and normal people at the day of the festival.

And who else to officiate and grace the opening ceremony if not the current most famous Melanau son. The one with white hair and beautiful wife.

I was there early and the usually serene and quiet roads of Mukah was already starting to choke with the unusual barrage of vehicles. And fellow human beings.

And since this is the most happening thing in Mukah, I guess I had to write about it in a few posts to do justice to it. And to finish this post, my take on youths playing the tibau – the famous Melanau flying swing that I think most Chinese parents will scream when their kids wander near it. Another version of this picture by an official photographer made it to the front page of the Borneo Post.

Watch out for the next photo-laden post! =)

2nd anniversary

        

      2008               2009             2010            2011

Today marked the second anniversary of me being a pharmacist in Malaysia.

That means I  had already fulfilled one third of my contract with the government of Malaysia. At this rate, six years will be way faster than I imagined.

Two years down the road from the day I first stepped into the unknown landscape called pharmacy in Malaysia, I am now writing this in my wooden abode 500km from home, with the police sirens blaring outside as the luxurious convoy carrying the Chief Minister of the most current government sped through just 20 metres away.

You may ask, did it ever crossed my wildest imagination, that I will one day find myself in the current situation? Had I ever imagined when I first stepped into the hustle and bustle of Sarawak General Hospital two years ago as a greenhorn that I will now be in the middle of the Melanau heartland, holding the dubious post of Chief Pharmacist in a district hospital? The answer is “No”, partly because, as Mother told Sarah in the kindie song “whatever will be, will be, the future’s not ours to see..”

Nonetheless, the short span of two years had been an amazing experience, where I find myself evolving from a pharmacist carrying out the exalted duty of hands on patient care to a pharmacist whose main responsibility is to carve out programmes and policies to better serve a rural community.

My aspirations can be as fickle as the wind. After the end of my first year, I aspired to be a clinical pharmacist with a well-stocked ammunition of complicated drug know-hows . After the end of my second year, it becomes being a managing pharmacist with a well conceptualised plan to transform a backwater pharmacy to be world class. 

It is scary how situations and experience can easily change you.

Robert Frost’s “The Road Not Taken” had been an oft quoted poem. Two years ago, I held to my blind faith that there exists greater hope in Malaysia then Australia by returning home. No kompangs or heroes welcome was evident as I forged through this less taken road. But I have no regrets. I love what I had been doing so far.

Back to the Chief Minister. He is here today because coincidently, today also marked the first time I am eligible to vote as a Malaysian citizen; and he is the candidate here. But this privilege I had decided to forfeit, for after deep consideration and deliberation, I found myself unable to choose. As I foray closer to the next diverging junction of my career, I fervently hoped that when the time comes,  I will know which way to go.

Balingian

Roughly 60km from Mukah lies a small town that is full of juxtapositions and contradictions that it truly epitomises the spirit of 1Malaysia: no matter rich or poor, we both can live together.

On one hand, there are old wooden kampong houses like this dotting the riverside; this one looks as if it’s on the verge of jumping into the cool inviting river for a swim.

 

On the other hand, there’s these big factories so modern that it looks like a foreign body being wrongly transplanted here due to someone mistakenly interpreting the Sarawak map wrongly.

 

Balingian looks and feels like a sleepy hollow, with its row of 1960s wooden cowboy style shop-houses right by the river- an exact carbon copy of other little towns in Sarawak right to the ubiquitous Chinese temple. Occupants were seen lounging on wooden chairs, reading newspapers and bantering with their neighbours.

There’s also a new bazaar, but it bore semblance to a dead town – concrete buildings that had more swallows around it that humans. Most of the shoplots were unoccupied or closed – the one ones open this Sunday morning were a couple of coffee shops.

However be warned, despite its another-village-next-door unassuming facade, Balingian is literally an underdog powerhouse - home to a Metal factory, Aluminium factory and Coal factory. The polluting impacts of these factories on the pristine village are stuffs of urban legend – stories of dying yellowing trees and shrouding smokes that lives up to Balingian’s Chinese translation - 万里烟 (Ten thousand miles of smoke) filled coffeehouses chats in Mukah. Yet to my disappointment, throughout the whole road to Balingian, the only scenery greeting me were green trees and clear air.

Besides these factories, there are also some high class condominiums puncturing the continuous roadside greeneries. But instead of serving as dwellings for humans, these are condos for swallows.  Bird nest is a huge business around Mukah. But i did wonder how does the caretakers and builders and villages living in dilapidated wooden houses with attap roofs nearby felt about their high class neighbours living in brick and concrete condos… Such was the difference between the haves and have nots…

This is Balingian’s Health Clinic.

Some patients having hypertension and diabetes follow-ups here had to go all the way to Mukah (to see me) for their medications because they do not have any pharmacy dispensers here. From today onwards I guess I won’t give them any more IOUs after seeing the distance they had to cover and the obvious lack of public transport. I guess this is called going down the field to step into the shoes of patients. =)

Working in a pharmacy: a day’s journal

7.40am Reached the pharmacy with half cup coffee in hand. Switched on the lights, air conditioner  and computer. Glanced through the to-do list today. 10 items. Put a star on the urgent ones. Started to pore through the financial reports from pharmacy store. Found discrepancies. Again. Sigh.

7.55am A staff came in to give an idea on how to reduce the amount of waiting time at Out-patient pharmacy. Quite interesting. Happy that they are really thinking innovatively to solve the persistent problem.

8.15am Reached male ward for ward round prep. Scanned though patient’s medication chart and profiles. Two  interesting admissions last night. One was nephrotic syndrome. I adored kidneys. Made a note to clerk it later.

8.45am Met up with a few sectional heads to explain the non-drug expenditure report that HQ requires then to fill. My style: preferred to go through with them thoroughly with real time examples – way better than just throw the instruction paper to them.  Reward: they sent it in in the afternoon even though deadline is 3 days away.

9.15am Back to out-patient pharmacy. Started dispensing to patients from out-patients clinic. Today was diabetes day. Quite busy.  One patient had high blood glucose level despite on high dose insulin. Suspected non-compliance. Roped in to counsel. Re-teach technique and stressed on the importance of taking the shots on time.

10.30am Out-patient crowd thinned. Back to the ward to catch tail-end of ward round. Queried doctor on plan for some patients. One patient was going home with a newly prescribed MDI Salbutamol. Sat down with patient to do bedside counseling. Went through asthma in layman’s term with him – used the blocked pipe analogy. Demonstrated three times before patient fairly competent.

11.00am Another bad news. The weighing scale is broken! Called HQ. Can’t buy another one at the moment because its too expensive. Oh no….

11.15am Back to office intending to do some paperwork. Doctor rang for drug info – answered the query. Staff came in saying a patient is reluctant to inject IM Provera, due to fact that prior injection resulted in prolonged fever. Went through case notes, found out the previous injection was IM Lucrin. Confirmed correct medication was ordered with doctor, then assured patient while personally escorting her to see the nurse administering the injection.

11.40am Patient newly started on Humapen requiring counselling. No prior experience but very willing to learn. Went through the whole gamut with her: what is diabetes, why need to treat, the goals of treatment, what is insulin, how to prep pen, how to inject, where to inject, what to do on sick days and detection and treatment of hypoglycaemia. Took a full half an hour.

12.15am Returned to office desperately wanting to finish the items on “to-do” list. Called some wards to tell them their Diazepam had expired, better come and exchange. Indented the drug to them. Packed some dangerous drug (DD) tablets that is low on stock. Prepared the specifications output report for admin. Did counselling statistics – 37 patients counselled thus far these 2 months, on the right path to hit the 200 target I set for this year. 

1.00pm It’s Lunch time! Went home to have a healthy meal of chicken breast fillet salad with French dressing.

1.50pm Back to office to read up some articles on nephrotic syndrome to make sure patient is managed correctly.Dalat Hospital (a small Hosp nearby) called to borrow Potassium Chloride mixture. Gave them three litres in exchange of loaning their weighing scale. Agreed. Problems solved with mutual benefits.

2.30pm When to pharmacy store to go through the report with the staff there in detail, to find out the source of the discrepancies. All the figures made my head spin.

3.00pm A visit to the inpatient pharmacy. Taught the staff there how to use a min-max thermometer – newly acquired to ensure better management of cold chain item.  Collected all February scripts to scan through for prescribing patterns.

3.30pm Afternoon ward round. Went to 3 wards: Male, Female and Paed. Go through new cases in male and all cases in female and paed. Only found a small problem, doctor indenting methyldopa as metformin. But nurses were alert to it anyway.

4.15pm  Paperwork, paperwork and never-ending paperwork. Rearranged the mountains of paper on my table. Filed noted items. Printed out notice for the next Continuous Professional Development (CPD) presentation. Aimed to do twice per month so that every staff can collect more than 30 points per year. Its next Monday and I will be presenting. Sigh… need to go home and prepare. 

5.00pm Yes! Time to go home. Managed to finish 5 items on the to-do list. 50 percent…not bad. Did a new one for the next day. 5+3 = 8 items =(

My days had been action-packed like this for the last month. Anyone interested to be the only pharmacist in a district hospital? ^^

沐胶点滴2

沐胶没买珍珠奶茶，只好自创：

看起来不错吧！味道也跟商店卖的平分秋色。

不必鼓掌。

因为珍珠是古晋买的，稍微热水烫10分钟就行；奶茶是3合1。

但这 apple crumble 的确是我做的。 =）

最近工作有点忙。好多零碎的事要解决，新方案要实行。老板娘走后，一人做二人分量的工的确有些措手不及。但真的学到很多新的东西。

一个月前拍的药剂部全家福：

老板娘的感恩晚宴之美味佳肴：

我的最爱- 生鱼片：

药剂部新创意：回收药物箱。

我为他取名 “bujang ubat”. 不知为何砂劳越的鳄鱼都喜欢名为 “bujang xx”.

就这样，2011 年过了六分之一。