USM Hajj Research Cluster

Introduction

The USM Hajj Research Cluster was created in 2006. It involves 11 researchers (principal investigators) at 4 locations – the Advanced Medical and Dental Institute (IPPT) in Bertam, School of Biology (PPSB) and School of Pharmacy (PPSF) at the main campus in Penang and the School of Medical Sciences (PPSP) in Kelantan.

RESEARCH AIM AND FOCUS

There are 6 major research focus areas in the Hajj Research Cluster. They aim to touch on various aspects of the health of the mass of the annual Malaysian Hajj pilgrims. These include knowledge, attitude and practice (KAP) of respiratory tract infections (RTI), nutritional status, medication status, air quality and microbial contamination of selected living quarters, incidence of acute respiratory syndrome (ARS), and economic analysis involving health policy and healthcare intervention and implications. The 6 research projects are:

(1)    Knowledge, attitude and practice (KAP) on the prevention of respiratory tract infections (RTI) among Malaysian Hajj pilgrims,

(2)    Assessment of nutritional status of Malaysian Hajj pilgrims,

(3)    Assessment of medication status among Malaysian Hajj pilgrims,

(4)    Monitoring of microbial contaminants and (suggestions for) improvement of indoor air quality in buildings in Makkah, Arafah, Muzdalifah, Mina, hostels and other strategic places used by Malaysian Hajj pilgrims,  

(5)    Incidence of acute respiratory syndrome (ARS) among Malaysian Hajj pilgrims, and

(6)    Economic analysis and policy implications of health care interventions carried out on Malaysian Hajj pilgrims.

MEDICAL RESEARCH

The School of Medical Sciences is involved with Project (5) above: Incidence of acute respiratory syndrome (ARS) among Malaysian Hajj pilgrims. This is further divided into 5 research projects (studies), each under a Principal Investigator (PI). The specific medical research projects (studies) are:

(1)    A study to determine the prevalence of acute respiratory infection among Hajj pilgrims.

(2)    A study to evaluate the effectiveness of influenza Fluvax®; 3 specific flu virus strains in reducing symptoms of Acute Respiratory Syndrome among Hajj pilgrims.

(3)    A study to evaluate the effect of two types of face mask in reducing symptoms of Acute Respiratory Syndrome among Hajj pilgrims.

(4)    A study to evaluate the effectiveness of “Natural Tualang Honey” in reducing symptoms of Acute Respiratory Syndrome among Hajj pilgrims.

(5)    A nonrandomized open label trial to compare the effectiveness of preventive measures against respiratory symptoms among Hajj pilgrims.

Research Projects

Project	Research Title	Principal Investigator
1	Knowledge, Attitude and Practice [KAP] on the Prevention of Respiratory Tract Infections among Malaysian Hajj Pilgrims	Prof. Noorizan Abdul Aziz [PPSF] Moved to UiTM
2	Assessment of the Nutritional Status of Malaysian Pilgrims	Assoc. Prof. Dr Narazah bt Mohd Yusoff [IPPT] HAEMATOLOGY / TRANSFUSION MEDICINE / CLINICAL GENETICS Email : narazah [at] amdi.usm.edu.my
3	Assessment of the Medication Status among Malaysian Pilgrims	Assoc. Prof. Dr Mohamed Izham Mohamed Ibrahim [PPSF]
4	Monitoring of Microbial Contaminants and Improvement of Indoor Air Quality in Buildings in Makkah, Arafat, Muzdalifah, Mina, Hostels and Other Strategic Places	Prof. Baharuddin bin Salleh [PPSB] BIOLOGICAL SCIENCES => MICROBIOLOGY => MYCOLOGY BIOLOGICAL SCIENCES => BOTANY => PLANT PATHOLOGY AGRICULTURAL SCIENCES => FOOD SCIENCE AND NUTRITION => FOOD TOXICOLOGY BIOLOGICAL SCIENCES => BIODIVERSITY AND CONVERSION => FUNGAL BIODIVERSITY AND CONSERVATION ENVIRONMENTAL SCIENCES => ENVIRONMENT MANAGEMENT AND BIOREMEDIATION => OTHER ENVIRONMENTAL MANAGEMENT AND BIOREMEDIATION Email : sallehb [at] usm.my
5	Acute Respiratory Syndrome among Malaysian Hajj Pilgrims	Prof. Nor Hayati bt Othman [PPSP] CYTOPATHOLOGY, HISTOPATHOLOGY, MEDICAL EDUCATION (PBL & STANDARDIZED PATIENTS) Email: hayati [at] kb.usm.my Scopus ID: 7003582354 Google Scholar ID : 14R3Q8oAAAAJ
6	Economic Analysis and Policy Implications of Health Care Interventions Carried Out on the Malaysian Hajj Pilgrim	Assoc. Prof. Dr Mohamed Izham Mohamed Ibrahim [PPSF]

PPSB = Pusat Pengajian Sains Biologi (School of Biology);

PPSF = Pusat Pengajian Sains Farmasi (School of Pharmacy);

PPSP = Pusat Pengajian Sains Perubatan (School of Medical Sciences);

IPPT = Institut Perubatan dan Pergigian Termaju (Advanced Medical and Dental Institute).

Under Project 5, sub-projects are:

Project	Research Title	Principal Investigator
5.1	A study to determine the prevalence of acute respiratory infection among Hajj Pilgrims.	Assoc. Prof. Dr Zakuan Zainy Deris CLINICAL MICROBIOLOGY Email : zakuan [at] kb.usm.my
5.2	A study to evaluate the effectiveness of influenza Fluvax®; 3 specific flu virus strains in reducing symptoms of Acute Respiratory Syndrome among Hajj Pilgrims.	Assoc. Prof. Dr Habsah Hasan MEDICAL AND HEALTH SCIENCES => MEDICAL MICROBIOLOGY => MYCOLOGY; BACTERIOLOGY; OTHER MEDICAL MICROBIOLOGY N.E.C HEALTH => CLINICAL (ORGANS, DISEASES AND CONDITIONS) => INFECTIOUS DISEASES;  RESPIRATORY DISEASES MEDICAL AND HEALTH SCIENCES => CLINICAL MEDICINE => INFECTIOUS/COMMUNICABLE DISEASES E-mail : habsah [at] kb.usm.my Researcher ID: E-4561-2012 Scopus ID : 24469994500
5.3	A study to evaluate the effect of two types of face mask in reducing symptoms of Acute Respiratory Syndrome among Hajj Pilgrims.	Dr. Mohd Suhaimi Ab Wahab CLINICAL PHARMACOLOGY, GENERAL PAEDIATRICS Email : msuhaimi [at] kb.usm.my
5.4	A Study to evaluate the effectiveness of “Natural Tualang Honey” in reducing symptoms of Acute Respiratory Syndrome among Hajj Pilgrims.	Prof. Siti Amrah Sulaiman PHARMACOLOGY, TRADITIONAL & COMPLEMENTARY MEDICINE Email : sbsamrah [at] kb.usm.my
5.5	A nonrandomized open label trial to compare the effectiveness of preventive measures against respiratory symptoms among Hajj Pilgrims.	Prof. Syed Hatim Noor MEDICAL STATISTICS E-mail : nyi [at] kb.usm.my

Publications:
http://onlinelibrary.wiley.com/doi/10.1111/j.1708-8305.2009.00384.x/pdf

http://www.academia.edu/1380599/The_Prevalence_of_Acute_Respiratory_Symptoms_and_Role_of_Protective_Measures_among_Malaysian_Hajj_Pilgrims

Apitherapy:
http://apitherapy.blogspot.com/2010/02/honey-potential-treatment-for-lupus.html


Contact Us:

Dean (Clinical Science Research)

Prof. Dr Nor Hayati Othman

email: hayati [at] kb.usm.my

direct line: 609-767 2353

fax: 609 - 767 2351

Science Officer (Clinical Sciences)

Mazlita Zainal Abidin

email: mazlita [at] kck.usm.my

direct line: 609-767 2355 or ext:2355

fax: 609 - 767 2351

Science Officer (Biomedical & Health Sciences)

Tengku Ahmad Damitri Al-Astani Tengku Din

email: damitri [at] kck.usm.my

direct line: 609-767 2364 or ext:2364

fax: 609 - 764 8064

Sources:

http://www.research.kk.usm.my/

http://www.research.kk.usm.my/pages/intro.htm

http://www.research.kk.usm.my/pages/link.htm

http://www.research.kk.usm.my/pages/hajj.htm

http://experts.usm.my/

http://www.researcherid.com/

http://www.scopus.com/

Prepared by Prof. Faridah Abdul Rashid

Friday, 12 April 2013 at 10:24:29 PM
Updated: Wednesday, 29 May 2013 at 4:59 PM & 9:22 PM

References from USM 2007 Hajj Research paper:

1.      Moore PS, Reeves MW, Schwartz B, et al. Intercontinental spread of an epidemic group A Neisseria meningitides strain. Lancet 1989; 334:260–263.

2.      CDC Serogroup. W-135 meningococcal disease among travellers returning from Saudi Arabia—United States. 2000. MMWR 2000; 49:345–346.

3.      Alzeer A, Mashlah A, Fakim N, et al. Tuberculosis is the commonest cause of pneumonia requiring hospitalization during Hajj (Pilgrimage to Makkah). J Infect 1998;36:303–306.

4.      Rafiq SM, Rashid H, Haworth E, Booy R. Hazards of hepatitis at the Hajj. Travel Med Infect Dis 2009;7:239–246.

5.      Ahmed QA, Arabi YM, Memish ZA. Health risks at the Hajj. Lancet 2006; 367:1008–1015.

6.      Alzeer AH. Respiratory tract infection during Hajj. Ann Thorac Med 2009; 4:50–53.

7.      Al-Ghamdi SM, Akbar HO, Qari YA, et al. Pattern of admission to hospitals during Muslim pilgrimage (Hajj). Saudi Med J 2003; 24:1073–1076.

8.      Madani TA, Ghabrah TM, Al-Hedaithy MA, et al. Causes of hospitalization of pilgrims in the Hajj season of the Islamic year 1423 (2003). Ann Saudi Med 2006;26:346–351.

9.      Madani TA, Ghabrah TM, Albarrak AM, et al. Causes of admission to intensive care units in the Hajj period of the Islamic year 1424 (2004). Ann Saudi Med 2007;27:101–105.

10.  Mustafa AN, Gessner BD, Ismail R, et al. A case-control study of influenza vaccine effectiveness among Malaysian pilgrims attending the Haj in Saudi Arabia. Int J Infect Dis 2003; 7:210–214.

11.  Rashid H, Shafi S, Bashir HE, et al. Influenza and the Hajj: defining influenza-like illness clinically. Int J Infect Dis 2008; 12:102–103.

12.  Shafi S, Booy R, Haworth E, et al. Hajj: health lessons for mass gatherings. J Infect Public Health 2008; 1:27–32.

13.  Al-Asmary S, Al-Shehri A-S, Abou-Zeid A, et al. Acute respiratory tract infections among Hajj medical mission personnel, Saudi Arabia. Int J Infect Dis 2007;11:268–272.

14.  Choudhry AJ, Al-Mudaimegh KS, Turkistani AM, AlHamdan NA. Hajj-associated acute respiratory infection among hajjis from Riyadh. East Mediterr Health J 2006;12:300–309.

15.  AlMudmeigh K, AlNaji A, AlEnezi M, et al. Incidence of Hajj related acute respiratory infection among pilgrims from Riyadh, 1423 H (2003 G). Saudi Epidemiol Bull 2003; 10:25–26.

16.  El-Sheikh SM, El-Assouli SM, Mohammed KA, Albar M. Bacteria and viruses that cause respiratory tract infections during the pilgrimage (Haj) season in Makkah, Saudi Arabia. Trop Med Int Health 1998; 3:205–209.

17.  Rashid H, Shafi S, Haworth E, et al. Viral respiratory infections at the Hajj: comparison between UK and Saudi pilgrims. Clin Microbiol Infect 2008; 14:569–574.

18.  El Bashir H, Haworth E, Zambon M, et al. Influenza among U.K. pilgrims to hajj, 2003. Emerg Infect Dis 2004; 10:1882–1883.

19.  Abdin EZ, Choudhry AJ, Al-Naji A. Effect of the use of face mask on hajj related acute respiratory infection among Hajjis from Riyadh, a health promotion intervention study. Saudi Epidemiol Bull 2005; 12:27–28.

20.  Babcock H, Merz L, Fraser V. Is influenza an influenzalike illness? Clinical presentation of influenza in hospitalized patients. Infect Control Hosp Epidemiol 2006; 27:266–270.

21.  Qureshi H, Gessner BD, Leboulleux D, et al. The incidence of vaccine preventable influenza-like illness and medication use among Pakistani pilgrims to the Haj in Saudi Arabia. Vaccine 2000; 18:2956–2962.

22.  Thursky K, Cordova SP, Smith D, Kelly H. Working towards a simple case definition for influenza surveillance. J Clin Virol 2003; 27:170–179.

23.  Rashid H, Rafiq S. Defining influenza like illness. Infect Control Hosp Epidemiol 2006; 27:1285–1286.

24.  Meysamie A, Ardakani HZ, Razavi SM, Doroodi T. Comparison of mortality and morbidity rates among Iranian pilgrims in Hajj 2004 and 2005. Saudi Med J 2006; 27:1049–1053.

25.  Gautret P, Yong W, Soula G, et al. Incidence of Hajjassociated febrile cough episodes among French pilgrims: a prospective cohort study on the influence of statin use and risk factors. Clin Microbiol Infect 2009; 15:335–340.

26.  Khamis NK. Epidemiological pattern of diseases and risk behaviors of pilgrims attending mina hospitals, hajj 1427 h (2007 g). J Egypt Public Health Assoc 2008; 83:15–33.

27.  CDC What you should know about using facemasks and respirators during a flu pandemic. 2009. Available at: http://www.cdc.gov/features/masksrespirators/. (Accessed 2009 Jan 15).

28.  Gautret P, Gaillard C, Soula G, et al. Pilgrims from Marseille, France, to Mecca: demographics and vaccination status. J Travel Med 2007; 14:132–133.

29.  Rashid H, Shafi S, Booy R, et al. Influenza and respiratory syncytial virus infections in British Hajj pilgrims. Emerg Health Threats J 2008; 1:e2.

30.  Deris ZZ, Hasan H, Sulaiman SA, et al. Preference of treatment facilities among Malaysian Hajj pilgrims for acute respiratory symptoms. Saudi Med J 2009;30:1103–1104.

31.  Balkhy HH, Memish ZA, Bafaqeer S, Almuneef MA. Influenza a common viral infection among Hajj pilgrims: time for routine surveillance and vaccination. J Travel Med 2004; 11:82–86.

32.  Rashid H, Shafi S, Haworth E, et al. Value of rapid testing for influenza among Hajj pilgrims. Travel Med Infect Dis 2007; 5:310–313.

33.  Razavy S, Dabiran S, Ardekani HZ. The incidence of influenza like illness and determination of the efficacy of flu vaccine in Iranian pilgrims during hajj pilgrimage. Act Med Iran 2004; 42:397–401.

34.  Rashid H, Shafi S, Haworth E, et al. Influenza vaccine in Hajj pilgrims: policy issues from field studies. Vaccine 2008; 26:4809–4812.

35.  CDC. Surveillance for the 2009 pandemic influenza A (H1N1) virus and seasonal influenza viruses—New Zealand, 2009. MMWR 2009; 58:918–921.

36.  Kelly H, Grant K. Interim analysis of pandemic influenza (H1N1) 2009 in Australia: surveillance trends, age of infection and effectiveness of seasonal vaccination. Euro Surveill 2009; 14:19288.

37.  Gallaher W. Towards a sane and rational approach to management of Influenza H1N1 2009. Virol J 2009;6:51.

38.  H1N1 prompts hajj restrictions Aljazeera English News 2009. Available at: http://english.aljazeera.net/news/middleeast/2009/07/200972311236123448.html. (Accessed 2009 Aug 31).

Why was Malacca chosen for announcement of Merdeka?

Some students asked me in class, why the Malayan independence was announced first in Malacca before Tunku cried Merdeka, Merdeka, Merdeka at Stadium Merdeka in Kuala Lumpur on 31 August 1957. I could not find a good answer until tonight. I will share some stuff here which you can gather from Baharam's blog and other places.

http://baharam.blogspot.com/2009/01/kesatuan-melayu-muda-melaka-1937.html

1. Malacca was one of 3 Straits Settlements, and without a sultan
2. The Kesatuan Melayu Muda Melaka (KMMM, established in 1937 in Malacca) was active in pushing and promoting reform for the Malays
3. KMM led to the formation of KMS (Kesatuan Melayu Singapura); people from KMM moved to Singapore to help establish KMS; KMM learned from KMS's experience as KMS fared better - KMS obtained a Malay settlement (Kampung Melayu) under Eunos
4. KMM was highly influential and had better educated men; Prof W.R. Roff referred to them as the Malay intelligensia. They were a better lot and were proactive
5. The Malacca Malays were united and stuck together for their own good; their battlecry was "Bersatu kita teguh, bercerai kita roboh"
6. Malacca was the seat of the famed Malacca Sultanate, the biggest and most widespread Malay kingdom that had the biggest influence on Malay civilisation
7. Malacca was famous as Serambi Makkah as it was the centre of religious learning
8. Malacca was the centre of Malay and world trade, and will always be (insyaAllah)
9. Malacca was an international city

Malacca's Currency Prior to 1511

Malacca used its own currency before it fell to the Portuguese on 11 July 1511. There is evidence that Malacca used coins with Jawi scripts. The reigning sultan was Sultan Ahmad bin Sultan Mahmud. Sultan Ahmad's name was inscribed in Jawi on the coins used in Malacca. On one side of the coins was inscribed his name, Ahmad bin Mahmud, and the reverse side was inscribed his honour, with the words, Al Sultan Al Adil. These words therefore show that the reigning sultan was a just ruler. So the Portuguese had come to attack a just ruler whose kingdom was trading fine and freely. Why then did the Portuguese launched an attack on Malacca, and captured it altogether? Why did the Portuguese destroy the very trade that kept Malacca going as the biggest and most well-known and safe trading haven? Why destroy Malacca's peaceful trade?

http://baharam.blogspot.com/2009/01/sultan-melaka-terakhir.html

Beneath The Bedpan

I wrote the story 'Beneath the bedpan' long ago. It was the first post I wrote that attracted many readers who were USM lecturers at our medical school. Then I wrote short stories for kids, which were translated into other languages (including Russian) by mothers for their children. Some were good stories, others were just plain story-telling. The one that many readers enjoyed was entitled '12 Golden pins'.

Many don't know that I don't have lights in my office when I type posts in my blogs. I type with just the light coming from the computer monitor. So you will see many typo errors because I can't see the keyboard myself. If I have time or remember, I will do the corrections. Otherwise they remain in my posts. I can type in dimmed light from my experience playing the piano and the piano keys have to be memorised. So my typing is just like when I was playing my piano, only that I played my piano with my eyes closed!

The repair boys have arrived, and I told them my room was flooded from upstairs. Sure enough, it short-circuit my ceiling lights and that's why I don't have lights.

Just like the other days, today too, I don't have lights in my office and I'm typing with just the lights from the computer monitor. I should have lights by noon, or next week, hopefully. I will come back and type later as it is quite straining on the eyes working in the dark.

My office was leaking for 2 weeks and I had 2 big rubbish dump of gunk from upstairs, the surgical ward. It seems, the 'new nurses' didn't know where to dump plaster of Paris (POP) after use and they simply dumped the leftover into the sink and over time, the POP built up in the plastic drainage pipes over my head. Of course, back pressure built up and the pipes burst at the joints, and I had the gunk and slurry from ages, down in my office, on  my research materials, on my teaching materials, on my carpets and sofa, on my fridge and magnets, etc. Everything in my room was drenched with gunk from upstairs. I can't say much because we already have ISO in place, so to speak. But what is ISO good for when I come to office and get a flooded office with gunk from upstairs? I can still work and produce books and papers even though I have one of the worst offices in a medical school. I think we have to simply survive this challenge in this age and keep writing our lousy workplace stories.

I'm going out to get some fresh air. The gunk and everything else stink in my office. It's nauseating but that's life here. Well, I will have survived and worked here for 30 years come 28 June 2013.

To The Doctor Or To The Bomoh?

For almost 2 days, Affandi couldn't decide on how to help his mother. The nature of the problem was grave, at least it seemed to me. His mother had recently re-married and 2 days ago had fallen in the toilet at her rental unit which she now shares with her new but former husband. Her place is not far from our home, maybe 5 minutes drive or so. Why couldn't Affandi decide and just take his mother to hospital? I found out that the big problem was his parents and siblings believe in bomoh, more than they have faith in western trained doctors at hospitals. Why? I will explain the reasons why ...

The Malay community is looked after well by its many bomoh. Bomoh is the first that comes to mind, not doctors. Never doctors! Not under any circumstance will the Malays think of doctors first! In Affandi's mother's case, the bomoh was found after contacting 2 people, his elder sister and a male cousin. The elder sister does not take any hospital medications and has no trust in such western medicines. The male cousin suffered from some chronic sprain and often goes to this particular bomoh.

Who is this bomoh? The word bomoh is arguably very sensitive and almost controversial. It is never mentioned when I am around! The word bomoh is hushed and silenced when I am around. So I am actually oblivious to anything that has to deal with bomoh. But this time, I have had enough of the bomoh tricks and I asked Affandi to seriously tell me why he took his mother to see a bomoh.

It was hard on him to explain to me. But Affandi narrated his account with much reluctance and holding back a lot of what he didn't want me to know about bomoh. According to Affandi, this male bomoh is not a bomoh! I was stunned! Try to understand that! If he is not a bomoh, then what is he? I had to probe Affandi and asked him the nature of this supposedly 'bomoh' man he took his mother to.

From Affandi's account, I see that this 'not bomoh man' is actually just a Quran reader. He reads Quran, that's all. I was happy with that. But he is such a good Quran reader than he has been bestowed special healing powers, that of healing bones. I was so intriuged by this new story and find. So I begged Affandi to tell me a bit more of this Quran reader's practice. It seems he only needs to press on the supposedly broken bone or painful spot and read a special verse and the pain disappears like magic! There is little residual pain and the patient walks away fine. I was even more thrilled so I went on to ask, "What verse did he read from the Quran?" Affandi said he read a verse about the bones that were gathered and thrown far beyond the hills and the birds came back flying! At that instant I remembered reading a verse in the Quran but I couldn't recall which particular verse. So, I still need to find that verse and write it here for you later, insyaAllah. That's all about the art of healing bone pain using a verse from the Quran. So he wasn't actually a bomoh, just a Quran reader and healer.

Affandi went on to mention that this healer also sells honey, of the good kind. Good genuine honey costs RM240 a bottle but Affandi managed to get 2 bottles for RM40 each. They look just like the other honey bottles we have at home.

I have seen and been to see a female bomoh once after a lot of coaxing. I don't know why, but Affandi trusts traditional healers more than I do. I have my reservation.

Here is the verse from the Quran on  page 44, second surah: Surah Baqarah, Ayat 260:

Dan (ingatlah) ketika Ibrahim berkata, "Ya Tuhanku, perlihatkanlah kepadaku bagaimana Engkau menghidupkan orang mati." Allah berfirman, "Belum percayakah engkau?" Dia (Ibrahim) menjawab, "Aku percaya tetapi agar hatiku tenang (mantap)." Dia (Allah) berfirman, "Kalau begitu ambillah empat ekor burung, lalu cincanglah olehmu kemudian letakkan  di atas masing-masing bukit satu bahagian, kemudian panggillah mereka, nescaya mereka datang kepadamu dengan segera." Ketahuilah bahawa Allah Maha Perkasa, Maha Bijaksana.

From: http://www.usc.edu/org/cmje/religious-texts/quran/verses/002-qmt.php

002.260
YUSUF ALI: When Abraham said: "Show me, Lord, how You will raise the dead, " He replied: "Have you no faith?" He said "Yes, but just to reassure my heart." Allah said, "Take four birds, draw them to you, and cut their bodies to pieces. Scatter them over the mountain-tops, then call them back. They will come swiftly to you. Know that Allah is Mighty, Wise."

PICKTHAL: And when Abraham said (unto his Lord): My Lord! Show me how Thou givest life to the dead, He said: Dost thou not believe? Abraham said: Yea, but (I ask) in order that my heart may be at ease. (His Lord) said: Take four of the birds and cause them to incline unto thee, then place a part of them on each hill, then call them, they will come to thee in haste, and know that Allah is Mighty, Wise.

SHAKIR: And when Ibrahim said: My Lord! show me how Thou givest life to the dead, He said: What! and do you not believe? He said: Yes, but that my heart may be at ease. He said: Then take four of the birds, then train them to follow you, then place on every mountain a part of them, then call them, they will come to you flying; and know that Allah is Mighty, Wise.

If It Is War ... What Will Our Food Be ...?

During the Japanese war in Malaya, Malayan families had little food to live on. Fresh food items had to come from nearby villages. Many war survivors tell me stories which I still find hard to believe, even today. I will share some of the stories with you ...

Chicken and eggs
In Penang, Dr Kamil Ariff's family obtained fresh livestock and vegetables came from farms in Balik Pulau.

On the mainland, the late Tan Sri Dr Abdul Majid bin Ismail (Coco Majid) narrated his war stories about where he got fresh chickens. He had to take the train from Kuala Lumpur and go up north to Alor Star, to get chickens for selling at Pasar Chow Kit. But the trip was too taxing, both on him and the chickens he tried to bring back. Most of his chickens died in the hot train and on the long trip (without food and water for the chickens). He survived but many of his chickens died, leaving him very little to earn cash. He then made money from selling dried salted fish (ikan sepat masin) and kerosene (minyak gas), which sold very well during the war.

Tea
My mother narrated the war story in Malacca, about my grandmother and her last son, her 14th child - Pak Salleh. My grandmother had her last child and last a son, Pak Salleh, in 1944. There was no milk during the war and my grandmother didn't have breastmilk for her new baby. Pak Salleh was brought up on tea! Imagine giving tea to a baby! Pak Salleh grew up to become a strong man indeed and worked very hard as an audit at the Malayan Railway in Kuala Lumpur; I was still a college student when Pak Salleh was working. Somehow, I noticed he aged too fast, faster than my father who was the 7th child. I kept on observing Pak Salleh as I grew up. Every time I saw him he had more white hair and a more stressful face. I also went up to ask him if he was ok. Of course, the jovial Pak Salleh always smilingly replied, "Alhamdulillah, I'm fine, I'm fine! ..." Somehow, there seems to be this worry tone in his voice even though he was seemingly happy. I worry. I often wondered whether tea would actually ruin a baby's life and result in an old man's face. I judged them to be linked - babies given tea will result in a stressful life as an adult, giving a stressful and older face, like my Pak Salleh. But sometimes I ask myself, "Is it just the tea given to babies that cause men to get old face fast?" I don't know and it is hard to tell or define or do a good study. I can only record the effect of that war even though I was born after the war and never experienced living during a war. I don't want to have to live through any war. Pak Salleh's face is enough to instill fear in me.

Malay Dress (2)

What do Malay females wear? LOL. Baju! What is baju? Baju was a word that I learned when I was a small girl. Pakai baju is instructing to put on one's clothes. Mana baju? is asking where are your clothes? Tu baju is pointing to a set of clothes for one to wear. Ni baju is saying these are the clothes I want to wear. Alright then, let's find out what Malay females like to wear ...

Malay females are the most clothed persons on Earth! They wear some of the most colourful and very fancy dresses that the world has yet to see and admire. They don't wear drab garments but they wear beautiful well-sewn clothes. Malaysian females always wear beautiful clothes, most are tailor made or custom made, not franchised pieces at retail stores. You don't find them at Coles, Woolworth or Calvin Klein stores. Their clothes are unique pieces and some are masterpieces. Let's see ...

How many clothes do Malay females own? Plenty! At least 3 cupboards-full! LOL. They love to shop for clothes. Malay females spend a lot of money on clothes! I have no clue how much Malay females actually spend on clothes, maybe RM500 over 3 months? Not done a good study on female spending patterns.

FEMALE APPAREL

Kain baju means clothes, both top and bottom pieces.

Baju

The Malay female wears a top called baju. Baju can be of any style and shape, without or without buttons, colourful or monotone. There is baju Kedah, baju kurung, baju kebaya, baju kebaya pendik, baju kebaya panjang or baju kebaya labuh, baju kaftan (caftan), baju shirt, baju T-shirt, baju tangan panjang (long sleeves), baju tangan pendek (short sleeves), baju jersey, baju ko-ku (top for co-curricular activities at school), baju sekolah (school uniform), baju tidur (pyjamas or sleeping dress), baju mandi (bathing suit or swimsuit), baju kerja (work shirt or dress), baju sukan (sport shirt), ... (the list is endless). Most ladies prefer baju Kedah made with printed floral cotton materials, and the neckline is machine-embroided.

Kain

The Malay female wears a bottom piece called kain sarong. The usual kain sarong is a floral printed batik cotton cloth. This material is good for Malaysian weather which is rather hot and very humid, and the profuse sweat sticks to the thighs and body folds. The cotton absorbs excess sweat before it becomes moist and then soggy and turns smelly after a day's use. So the kain sarong needs to be washed daily and often is not worn for 2 straight days - it can't because it will be smelly from so much sweat! How many kain sarong does a Malay lady need? I would say many own a stack of kain sarong, maybe about 7 to 10 pieces. A good kain sarong may cost approximately RM18.00 each, and less if bought in stacks of 12; a dozen (satu kodi) or 2 dozens (dua kodi). When 4 metres of material is provided, a pair of baju kurung sews for RM20 in Kelantan. It takes approximately 2 weeks to get a pair of baju kurung made. For festivities, tailors take baju kurung orders 3-6 months ahead of its intended use. For special functions, festivities or a wedding, it takes a lot of planning to make matched sets of baju kurung for a family of 10. A few retails shops carry matched sets of baju kurung for family use. Some bridal shops rent out matched sets of baju kurung.

Seluar

Some Malay ladies don't wear kain sarong and they prefer seluar (pants). Modern Malay ladies like to wear pants even though elderly Malay males may jeer at such preference. The stout torso of the average middle-age Malay ladies make it unsuitable for them to wear pants. Many Malay ladies have a problem with weight - are overweight or obese. It is impossible to slip into a pair of pants unless they are tailor made. Malay ladies prefer to wear dark coloured pants - black, brown, dark purple, maroon, dark green, etc. Some women like to wear cream or white pants, being careful that these do attract a lot of roving male eyes. Malay females are often shy and they tend to wear their tops over their pants, covering the entire buttock with their top, rather than tuck in their tops. It is rare that they will tuck in their tops and expose their bulges, front and back. Lately, Malay ladies have been seen wearing tights and leggings along with a loose top. Though this may well be suited for dance routines and workouts in air-conditioned rooms, it is not so good for outside use and they do seem out of place (tak kena tempat).

Handbags

Malay ladies own some of the most fancy handbags and some of the branded and expensive ones. They mostly match their handbags with the clothes that they wear. Some official functions require them to carry a matching B/W handbag, or specify a colour for the handbags. A black suit will require a shiny black handbag. Many prefer big handbags but often there is nothing inside - just a handphone, some tissues, a lipstick, some cash and a credit card. It is not worth stealing a Malay woman's handbag.

Footwear

Malay ladies have fancy footwear to match the clothes and occasion. They wear Japanese slippers and some young ones colour their toe nails. The younger ladies prefer high heels or high platform shoes and they don't mind showing them off when they try to painsfully do the casual catwalk. The older ladies prefer low heel open shoes or sandals and they walk well. Malay ladies have short legs, with short femur and tibia, so they tend to wear long dress to cover their legs and you can't see their shoes. But when they sit, and the dress pulls up a bit, you can see their shoes. You can also see their shoes when they climb stairs or when they take the elevator. You can see their shoes at the surau (prayer place) or mosque.

Headgear

Many Malay females wear something for head cover. This can be a kain tudung or selendang (scarf). These come in many shapes, sizes and brands. In the 1960s, scarves were translucent but colourful light artificial pieces. They were small and meant for children to wear when they go to learn the Quran at the kampung, often a little hut by the paddy fields. In the 1970s, scarves were thick dull black pieces that hung down to below the breasts. They were worn by some college and university students. Some ladies from religious groups also wore them. In the 1980s, there was a trend towards more colourful long scarves, some plain, some with beads and gemstones, and some with embrodery. The old scarf was the rectangular embroided muslin called tudung bawal. Tudung bawal was RM15 each and became RM10. There are less of them today. In the 1990s. ladies wore more colourful scarves, more fancy and sophisticated. In 2000s, ladies were still experimenting with fabrics, styles and colours for their scarves. Today, in 2013, ladies have come up with even stranger and some prettier headgears. Many of the scarf styles have names. The more recent branded scarves are tudung Fareeda and some other. The genuine tudung Fareeda are RM200+ each, and customers have to queue up and only one customer is allowed into the shop at a time, and for 15 minutes only. The fake tudung Fareeda sells for RM65-RM70 and has 2-3 layers of colourful printed or plain silk material. These pieces sit on the breasts and are quite revealing, especially for busty women.

Brooches

There are so many types of brooches and you can buy them anywhere in Malaysia. Some are cheap and some are very expensive. Most Korean brooches sell for RM30-RM60 each. The cheap fake ones sell for RM10 for 3 small pieces at pasar malam (night market). They are usually worn on the scarf, baju kebaya or baju kurung. The fake ones do not last long and are often broken and thrown out, and need frequent replacement. In the long run, it is more expensive to keep having fake brooches. Most Malay ladies will have at least 10 fake brooches and 1-2 genuine good brooches. The fake ones are the ones we often see on dressing tables in Malay homes. When male thieves steal from Malay homes, they tend to take the fake ones because the genuine ones are very carefully hidden.

Bangles

Malay ladies like bangles and adorn their arms with all sorts of bangles. Some are just glass beads, others are real gemstones or gold/golden items, and some are magnetic or metallic pieces. Most are fakes. The real gold ones are worn to special official functions at the palace. Kelantanese ladies wear the most number of ornate gold bangles on both arms. They often start their gold bangle collection soon after puberty, when they are old enough to understand that "gold means everything to a woman". Their mothers are often gold bangle collectors too and this indirectly instills interest in gold bangles in their daughters from very early on in a Malay girl's life. The knowledge about gold and gold ornaments is passed down from grandmothers to mothers, and in turn from mothers to their daughters. The Malay women know more about gold, better than others! You cannot cheat the Kelantanese Malay women when it comes to gold - they know better! Outside Kelantan, the ladies don't deal with gold ornaments so much.

Earings

Malay ladies wear earrings. They have their ears pieced at age 12. The grandmothers do the ear piercing for them. This is done using a heated metal needle, the same one that is used for sewing clothes. The ear piercing process is called bertindik or tindik telinga. Girls do get intimidated when they reach age 12 and when it is their turn to be pierced. The Malay females wear their earrings throughout their lives, changing earrings whenever they get new ones from their fathers (before marriage) or husbands (after marriage). The pierced ears do suffer from irritation and inflammation, some resulting in painful episodes, often with pus. Most pierced ear problems go away with antibiotics application. Some stop wearing earrings altogether for health reasons and when they don't want ear problems. The pierced ear hole heal and close up, sometimes obliterating the hole, making it difficult to fit an earring again after long disuse. Application of some cooking oil will help to re-open the ear hole, with little pain, and the earring fitted once again. Intricate golden earrings easily accummulate dirt (scum, daki) and will need to be removed for cleaning. The earrings are washed with soap and water, and then air dried. It is best for schoolgirls who already wear earrings to continue to wear simple earrings so the ear holes don't close up and give them problems later. They can then wear more elaborate earrings after they finish school and start working. There are many types of earrings to choose from, from simple ear studs to elaborate mobile earrings. The simple ear stud is the subang. It is meant for children (young girls) and schoolgirls can wear them too. They are safe enough for daily wear and do not get tugged during rough play as in sports or field games. The elaborate intricate ones are worn by more senior ladies who are already working. They are also worn to special functions. Elderly ladies prefer the big but light ear studs (subang besar) as their ears are already sagging.

I'm standing 3rd from right, in blue-white baju kebaya labuh, high heels and blue scarf.

The Campus Director's secretary is in brown baju kurung and light grey scarf

I'm in black baju kebaya labuh and brown scarf

I'm on the left in black kebaya labuh and my blue scarf

I'm in pink baju kebaya labuh and light cream-grey scarf

My daughter (far right) and her school friends in their secondary school uniform at an outside function - stadium in Kota Bharu, Kelantan. Here, female school children wear blue baju kurung with matching kain baju kurung (sarung).

Diplomatic Corp Service

I have not made any of my posts to be of any use to fill the void for the diplomatic corp service (DCS) and medical missions overseas. I have just noticed that last night when my son Ibrahim got an offer for the DCS exam (to be held on 13 April 2013 at Ahmad Maher School in Kota Bharu, Kelantan). Affandi went frantic trying to recall whom we can obtain help from, for Ibrahim's sake.

Many of you may have sibs, relatives and friends in the DCS and medical missions overseas. Please respond (under Comments) so I can tailor some of my posts to help others in the DCS and medical missions overseas.

I can only recall when my own father was to be Malaysia's Ambassador to Germany in the 1970s, I was instructed by my mother to privately study German in Penang. It was quite difficult to adapt to her wish and I refused to learn a new foreign language, and my mother was very disappointed. Our schools don't offer or teach foreign languages and these will need to be learned outside of school hours from private institutions. Most schools overseas offer languages - French, Spanish and German. Many Malaysian universities offer languages but I don't know how useful these programmes are. Reading, comprehending, writing and translating a foreign language is hard if not tackled at a young age.

Administrative skills is something picked up from handling problems at the workplace. A fresh graduate will need at least a few months to be settled and happily working. Overcoming the initial obstacles at the workplace is a big stumbling block and most first timers find it intimidating and will often want to back out. They don't realise that a lot of problems crop up at the workplace because we have an artificial workplace created by unthinking people before us. Newcomers may need to slightly modify the old workplace and realign the work procedure before they will get to enjoy working with others.

Learning the cultures of other nations and fitting in at a new place overseas can be comforting, discomforting or intimidating for some. But there is the Internet and so many travel books we can buy and read about other countries. I'm sure kids love reading about other countries and want to visit them. Our school system may have this bit built-in or not, I'm uncertain. But I have heard of student exchange programmes, so these are already in place for kids who are keen on international exposure.

We can always fall back on the idea of 'Hijrah' and take the challenges at any workplace, be it local or foreign. It is actually up to us, to make good of any workplace and under any work condition. The world is a large working place. I almost forgot 'Katak di bawah tempurung' is something of old and we can do away with it. Now, we can safely say, "I wanna be myself and working for the world, at my place, at my rate". That way, we will always be able to adapt and adopt and fit in well, just about anywhere, for any job, at any time. I think that is the best attitude to take when faced with a new and challenging job offer.