Chua Jui Meng, the
most irresponsible Health Minister in Malaysian history, had manipulated
statistics to deliberately mislead Parliament and Malaysians about the worst
dengue epidemic in nation's history instead of spearheading a nation-wide
alert and awareness campaign which could have saved at least 80 lives who
perished during the epidemic
in a briefing to MPs in Parliament House on how Health
Minister, Datuk Chua Jui Meng had mishandled the worst dengue epidemic in
the nation's history in Parliament House
by Lim Kit Siang
I thank the DAP MP for Batu Gajah, Fong Po Kuan on behalf of DAP MPs for
inviting me to Parliament to give a briefing on how the Health Minister,
Datuk Chua Jui Meng had mishandled the worst dengue epidemic in the nation's
history and all MPs who have come to share our deep concerns of this
continuing disaster and tragedy which is so unnecessary and avoidable if
Malaysia has not only "First World Infrastructure" but also "First World
We read in today's press the Health Minister's announcement of the
establishment of the operations room by the Health Ministry to monitor the
"atypical pneumonia" illness, also known as severe acute respiratory
syndrome (SARS), which has been reported in several Asian nations.
Chua said the operations room, under the ministry's Disease Control
Department, is open from 7.30am to 6.00pm daily and could be contacted at
"All measures taken by the ministry would be pro-active," he said. He said
the operations room would monitor the disease's situation in the country and
provide Malaysians with information on it.
I commend Chua for such swift pro-active response to the SARS crisis, which
only highlights the Health Ministry's grave negligence in failing to set up
a similar operations room to monitor the nation's worst dengue epidemic,
although it had killed at least 100 people last year and is still raging
unchecked, and I will not be surprised if it had claimed the lives of at
least 20 people this year alone!
Is Chua's prompt response to set up an operations room for SARS because
there is so far no reported cases of atypical pneumonia in the country,
although there are 170 reported cases of SARS worldwide, but once there are
reported cases and God forbid, fatalities, the Health Ministry would
immediately close down the SARS operations room and retreat behind the
Official Secrets Act by imposing one of Chua's famous "gag orders", refusing
to provide Malaysians with timely, accurate and full information as is the
tragic case with with the raging dengue epidemic?
dengue epidemic in the nation's history had been raging in the country for
about a year, claiming over a hundred lives, but last Tuesday was the first
time the Health Minister had addressed this issue in Parliament. How
irresponsible can a Health Minister be?
Chua's 11-page parliamentary reply on the dengue epidemic, answering nine
parliamentary questions in one-go which was a most irresponsible manoeuvre
to evade detailed questioning and scrutiny by MPs, was an indictment and
proof that he is the most irresponsible Health Minister in the history of
Malaysia - who could trifle with the lives of Malaysians by trying to
manipulate facts and figures to downplay the gravity of the worst dengue
epidemic in the nation's history and which is still causing unnecessary and
In his answer, Chua revealed for the first time that there had been 11
dengue deaths this year till February 22, which I believe err seriously on
the low side - but the country had become so numbed and insensitised by a
prolonged campaign of disinformation by the Health Ministry that such a
shocking revelation was virtually ignored by the mainstream media like the
New Straits Times and Utusan Malaysia, disregarding the killer dengue
epidemic which had been officially certified to have claimed 11 lives this
year till February 22 and yet could blazon screaming headlines about the
SARS when there is not a single reported case let alone death in the
country! Chua said in his parliamentary answer:
"Pada tahun 1998
boleh dikatakan seluruh dunia mencatatkan peningkatan kes termasuk juga
egara kita yang meningkat sebanyak 73.1%. Di Malaysia, sejak tahun 1997
sehingga 2002 purata kes dengi (demam denggi dan deman denggi berdarah)
setahun adalah 8,364 kes dan kematian sebanyak 54 kes. Jumlah kes tertinggi
dilaporkan dalam tahun 1998 (13,742 kes). Dalam tempoh masa yang sama
beberapa negeri telah melaporkan purata yang tinggi. Negeri-negeri tersebut
ialah Selangor (1,661 kes), Wilayah Persekutuah (1,326), Johor (1,268 kes)
dan Perak (926 kes). Lain-lain negeri melaporkan purata kes kurang dari 700
"Pada tahun 2002 kejadian kes denggi telah meningkat di seluruh Malaysia
sejak pertengahan tahun. Jumlah kes demam denggi dan demam denggi berdarah
yang sah serologi yang dilaporkan pada tahun 2002 ialah sebanyak 11,394 kes
dengan 57 kematian. Negeri-negeri yang sama mengalami jumlah kes yang tinggi.
Pada tahun 2002, kadar kematian yang disebabkan oleh demam denggi berdarah
di Malaysia ialah 10.0% iaitu 57 kematian daripada 568 kes demam denggi
berdarah. Peratus ini menunjukkan kadar kematian disebabkan demam denggi
berdarah di Malaysia adalah lebih rendah jika dibandingkan dengan negara
lain. Kejadian demam denggi berdarah di negara ini adalah hanya 0.1%
daripada jumlah kes demam denggi berdarah yang dianggarkan berlaku di dunia
the next day also reported what Chua told reporters at the Parliament lobby
after question time. When asked that about "the DAP's statistics" that there
were 32,289 cases of dengue fever with 57 deaths until Dec 28 last year,
Chua said he did not know where DAP had obtained the statistics but it could
be the number of suspected cases instead of confirmed ones.
number of suspected cases will definitely be higher than confirmed cases,"
that I was stumped by Chua's statement, implying that I had been rather
irresponsible, anti-social, and indulging in the despicable conduct of
rumour-mongering to create panic in talking about "suspected cases" instead
of relying on "confirmed cases" of dengue.
of unease that I had done something wrong and been guilty of being
anti-social was not relieved when in response to my rebuttal that the
Selangor Mentri Besar, Datuk Seri Dr. Mohamad Khir Toyo had in his email to
me dated February 24 as good as confirmed the figure of 32,289 dengue cases
till Dec. 28 last year when he confirmed that there were 9,385 cases in
Selangor state for the period, Selangor State exco member for health, Datuk
Tang See Hang said Khir Toyo was referring to "reported cases" and not
Was I responsible for irresponsible rumour-mongering in referring to 32,289
dengue cases till Dec. 28 last year, and was Chua being responsible in
blithely claiming that there were really only 11,394 "confirmed" cases and
dismissing the 32,289 "reported cases" ?
This question nagged and mortified me, as I had no intention of being
irresponsible, anti-social or to rumour-monger and create baseless public
It vexed me for in its literature on dengue in Malaysia, the World Health
Organisation (WHO) used the figure of 27,379 reported dengue cases for 1998,
the worst recorded year for dengue until last year, and not the 13,742
confirmed cases used by Chua in Parliament on last Tuesday. In fact, Chua
himself used the "reported dengue cases" for 1998 in a speech in April 1999
talking about the 20-fold increase in dengue cases from 1986 to 1998, when
"there were only 1,408 cases with eight deaths in 1986 but 12 years down the
line, the number had spiraled to 27,373 cases with 58 deaths". Was Chua
being irresponsible, anti-social and even guilty of rumour-mongering when he
referred to "reported cases" instead of "confirmed cases" for dengue?
I have received an education in the past few days to understand the
difference and the importance of the distinction between "reported" and
"confirmed" cases when referring to dengue in particular in the current
dengue epidemic raging in the country.
I feel a great sense of outrage from what I have learnt at the utterly
irresponsible attempt by Chua to try to pull the wool over the people's eyes
in a matter affecting the life and death of Malaysians, as well as the
colossal failure of the Health Ministry to educate and alert the people
about the killer dengue disease - although the Health Ministry has
indirectly admitted that we are facing not an epidemic but a pandemic! It
has also given incontrovertible proof that we have in Chua Jui Meng the most
irresponsible Health Minister in the history of Malaysia.
Without going into all the technical and scientific details of laboratory
diagnosis of dengue infection, let me draw the following conclusion from my
recent education on "reported cases" and "confirmed cases" of dengue.
Firstly, it is the height of irresponsibility of the Health Minister to
dismiss "reported cases" of dengue as if they are baseless suspicion no
different from rumour-mongering with no scientific basis whatsoever. Is Chua
seriously suggesting that apart from the "confirmed cases" of dengue, the
"reported cases" could he dismissed as nothing more than Old Wives' Tales?
It is shocking that the professionals in the Health Ministry could allow the
Health Minister to indulge in such unprofessional, unscientific and
irresponsible behaviour, when they know fully well the implications,
especially as WHO literature on dengue rely more on "reported cases" than
"confirmed cases" of dengue.
This is because the "reported cases" of dengue are not the suspicions of any
Tom, Dick and Harry, but the reports to the authorities by doctors and other
health practitioners of suspected dengue cases as required by law on
notifiable diseases - about patients who had undergone the Hess test with
confirmed small bleeding spots, blood tests with low platelet count,
hospitalization from high fever and haemorrhag and even cases of fatalities.
There are medical practitioners who hold that easily 80 to 90 per cent of
the "reported cases" of dengue are actual dengue cases. "Reported cases"
means clinically diagnosed as dengue by doctors, while "confirmed cases"
mean cases which have been "laboratory-confirmed" - and in the case of
dengue, it is the clinical diagnosis which is more important in
Although a high percentage of the clinically-diagnosed dengue cases,
including dengue deaths, cannot be lab-confirmed because of technical and
practical constraints, the number of "reported cases" are a more accurate
measure of the gravity of the dengue epidemic.
There are two basic methods for establishing a laboratory diagnosis of
dengue infection - detection of the virus (e.g. culture) or detection of the
anti-dengue antibodies (serology).
Detection of dengue virus by culture is the definitive diagnostic test, but
practical considerations in particular its cost limit its use. Can Chua
state what percentage of the confirmed cases of dengue are the result of
The serology tests also have practical limitations, whether IgM or IgG tests
for primary dengue infection (first infection) or secondary infection
The bottom line about the dengue epidemic however is that reported dengue
cases should be an even greater cause of concern than confirmed cases, in
view of the limitations of laboratory facilities in the country, and this is
why Chua was acting most irresponsibility in failing to address the question
of reported dengue cases last year, for which he should be severely censured
Chua dishonesty and manipulation with facts and figures to mislead
Parliament and the country can also be illustrated by the following
denial that WHO had issued a global dengue alert in July last year warning
governments to take effective counter measures against a dengue epidemic and
even pandemic worse than 1998. I had given three Internet reports on such a
warning, and Chua should explain how he could have missed the WHO global
dengue alert, resulting in his failure to take any follow-up pro-active
measure as was successfully done in Singapore, which brought the dengue
epidemic under control in November last year.
press secretary, Woon Yong Teal, in a letter to Malaysiakini (17th March
2003) recapitulated the Health Minister's parliamentary reply, described the
1998 year as a "dengue pandemic". Why is Chua continuing to insist that
dengue was "endemic" and not even an "epidemic" last year, although there
should now be no dispute that the number of reported dengue cases last year
exceeded that of 1998?
letter, Woon inadvertently revealed that there had been 82 dengue deaths in
1998, confirming widespread suspicions that the Health Ministry had been
manipulating dengue statistics even in the past few years. WHO literature on
dengue In Malaysia in 1998 had always referred to 58 deaths. Even the Health
Ministry's website on "Health Indicators" gave 58 dengue deaths in Malaysia
for 1998. For five long years, the nation and the world, especially WHO, had
been misled into believing that there were only 58 dengue deaths in 1998
when there were actually 82. How could anyone have belief and trust in facts
and figures furnished by the Health Ministry henceforth?
Meng said that there were 11 deaths this year till Feb. 22. Why didn't he
give the most update figures till the first week of March? Is this because
there had been more dengue deaths since then, including two in Perak after
Feb. 22, one on Feb. 27 and another one on March 1?
very proud that the DHF case-fatality rate for last year was 10%, totally
forgetting that under the Seventh Malaysia Plan, the target for
case-fatality rate for DHF alone is not more than 1% - which is now exceeded
by over 1,000 per cent with a DHF fatality rate of 10%.
Parliament must not allow Chua to get away with such irresponsible
Ministerial performance and in particular his manipulation of statistics to
deliberately mislead MPs and Malaysians about the worst dengue epidemic in
the nation's history when he should be spearheading a nation-wide alert and
awareness campaign which could have saved at least 80 lives who perished
during the epidemic.
Lim Kit Siang, DAP National