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JUNE 30-JULY 14, 1995


Malaysia’s Raj Karim speaks out

KUALA LUMPUR, Malaysia—As director general of the National Population and Family

Development Board, Dr. Raj Karim’s main focus is to work with the national plan of action that takes into consideration the priorities of the Malaysian people concerning development.

“Basically we want to see Malaysia industrialized by the year 2020, while at the same time in maintaining our culture, our value systems and a caring society,” said Karim, “Progress of the country will be based on a strong and resilient family system, which is able to withstand the pressures of development.”

With 18 million people and a booming economy, the Malaysian reproductive health programs are more concerned with how to improve the quality of life for its people. “We encourage couples to space pregnancies for healthier children and we give information so that couples can make a decision. We focus on high risk groups, very young mothers or those above 40 years and help those with medical problems,” Karim said in a recent interview here. The delivery of health services in Malaysia cover the population and even rural clinics are integrated with child health and family planning services. Rural health facilities are free and even in urban are as the fees are low. In urban areas people have a choice between private clinics, government family planning clinics and clinics run by the Family Planning Association.

“Each group of villages has a health center with paramedical workers and a trained midwife. We also offer child care and immunization and for difficult cases there are district hospitals,” Karim added. A Specialist reproductive Research Center was opened in 1979. Dr. Mohammed Ismail who is the acting director of the clinic, said “We felt that there should be a clinic specializing in fertility, counseling for psycho-sexual problems and marital problems.”

The clinic, which is equipped with state of the art equipment, is fully computerized and has a sophisticated “In Vitro Fertilization” program. It also handles pap smears, cervical problems and infections. Initially funded by Unfpa and the World Bank, it is the only one of its kind in Kuala Lumpur. Unfpa has funded doctors to go abroad for specialized studies. Pap smears from family planning clinics are sent to this laboratory for evaluation.

Malysia has already put into action a plan following last year’s successful International Conference on Population and Development in Cairo, says Karim, adding: “We would like to offer a reproductive health program at the primary health level.  We are doing a needs assessment.  Our role is to initiate and develop models that can be implemented by the Ministry of Health.  We already have a comprehensive safe motherhood and child care program but we need to add counselling services,” Karim acknowledged.

The two areas where there will be a major thrust is family development programs which includes parenting, family health and how to strengthen the family and up scaling existing facilities to include reproductive health problems like menopause, prevention of cancer and HIV infections, as well as educating adolescents.


Creating a successful life for oneself

MALACCA, Malaysia—“I think economic development has in own evils.  I am concerned about labor migration and how migrant workers are marginalized and have limited access to health care,” said Dr. Selva Ramachandran who heads the Australian International Development Bureau in Malaysia.  Ramachandran’s interest in migrant labor stems from his own life story.  As the son of a plantation worker, his grandparents were brought to Malaysia from India by plantation owners.  His father died when he was 2 years old  and his mother worked in a rubber processing factory to support her eight children.  Determined to move out of the plantation, Ramachandran got a scholarship to go to university and got a doctorate in labor and development from Griffith University in Brisbane, Australia.  His thesis was on the marginalization of plantation labor in Malaysia.

 “Due to an acute shortage of labor in plantation and the construction business, Malaysia import labor from Bangladesh, Indonesia and Pakistan. They are between the ages of 18 and 30 years and though the official figure is 1.5 million, there are about 3 million migrants working here,” said Ramachandran.

The workers have three year contracts and since they come without their families they visit brothel. “There is a growing problem of  reproductive health infections but unfortunately nobody has done much research on it,” he said, “This has to be monitored not only in Malaysia but in other countries like Singapore and Brunei.”

Ramachandran feels that the import and export of diseases like Tuberculosis and AIDS will be a major problem in the future if governments don’t act now.

Ramachandran funds NGO projects in Malaysia, “The Australians are very supportive of women and development projects,” he said, “and have funded a women’s NGO for Beijing.” He feels that NGOs have to help each other more and  promote the smaller grassroots organizations that are working in rural areas.


‘I see us as a catalyst…’

Professor Jayantilal K. Satia is executive director of the International Council on Management of Population Programmes (ICOMP).  Earlier, he taught at the prestigious Indian Institute of Management in Ahmedabad, and was also a consultant to the World Bank.  Professor Satia was interviewed at his office in Kuala Lumpur. Excerpt:

How is ICOMP funded and what is its annual budget?

There are several donors.  Some have contributed regularly and some fund projects.  Our annual budget is about one million dollars of which $300,000 is used for operating costs and $700,000 is for projects and programs.  Our donors include Unfpa, Swedish International Development Authority, Candian International Development Agency, Asian Development Bank, Danish International Development Agency, governments of Norway, Netherlands, India China and Indonesia.  We also get funding from foundation which include Ford, Rockefeller, Tinker and MacArthur.

What do you think are the achievements of ICOMP?

One of our achievements in the early years was that we sensitized managers on population management issues. At first people would ask what was the relevance of management to population programs.  But after a few years it was considered necessary.  ICOMP conducted 35 training workshops in Asia, Africa and Latin America and trained about a 1000 persons on the skills required to run successful population programs.  It also brought NGOs and program managers together at meetings, workshops, through publications to share experiences in the population field.

How qualified is ICOMP to help with the implementation of the Program of Action that came out of the International Conference on Population and Development?

With over two decades of experience in the field of population management, ICOMP is qualified to take on the new goals of the Program of Action. At one level, these are women’s

empowerment, linkages between population, consumption patterns and the environment. At another level, it means that today’s family planning and maternal and child health programs will have to become tomorrow’s comprehensive reproductive health programs. There will have to more government and NGO partnership.

What has ICOMP initiated to meet these new challenges?

For youth and reproductive health we began documenting innovative programs in five countries with funding from SIDA.  We then had a workshop where these models were discussed by program managers, NGOs and government officials from 10 countries.  Other aspects of reproductive health were also dealt with, such as how to deal with reproductive tract infections, STDs; family welfare programs; how to enhance women’s role in decision making and to enhance male responsibility.

How do see ICOMP’s role evolving in the next decade?

I see ICOMP’s role as a catalyst.  With countries drawing up National Plan Of Action after ICPD, there is a growing need for well-managed population programs that take into consideration the overall health needs of people.  ICOMP can help train managers and NGOs to meet the new challenges.  We will work with various institutions to develop population management programs that will take future needs into consideration.