Indonesia's Love Affair With Antibiotics and Drug Treatments...

There is little doubt that Indonesian doctors on the whole over-prescribe antibiotics. It is unfair to generalise because quite simply there are always exceptions to the rule. However, even if a doctor does not prescribe a course of antibiotics, then most people will self-prescribe and go to any one of the myriad of road-side drug vending stalls.

The overuse of antibiotics, and other drugs, is not without risks as the nasty things that make us sick also have an ability to build up immunity to the drugs designed to kill them. This means that Indonesia is without a doubt on the road towards creating a whole swathe of drug-resistant bacteria and viruses. Simply, the trend seems to be towards over-prescribing and poly-pharmacy no matter what the illness is. Generally, doctors or patients prescribe antibiotic and drug cocktails in an attempt to get well.

Interestingly, some Indonesian doctors have recognised the trend and are intent on arresting the malaise that is poor diagnosis and subsequent poor treatment options being prescribed. But, it would appear that changing the culture is an uphill battle if the data collected by the Foundation for Concerned Parents is anything to go by.

For example, in 2008 the Foundation found that antibiotics were prescribed in more than 78% of cases of respiratory or stomach illness. This is an increase on the slightly more than 54% in 2006. Perhaps more interestingly is the trend of prescribing certain brands of drugs in preference to cheaper locally produced generic medicines. The suggestion, albeit implied, seems to be that doctors might be being encouraged to prescribe certain drug regimes at every opportunity they get to do so. One would hope that doctors were getting a little more for their efforts than just the odd free pen or mouse pad.

The issue is one that the government is aware of and it is one that the government is keen to address. The World Health Organization (WHO) has also recognised that the over-prescribing of certain drug treatments in Indonesia is leaving the Republic susceptible to future outbreaks of super bugs and viruses that are resistant to all standard treatment options. Therefore, the WHO and the government have commenced a study to look at what can be done to turn back the tide.

Hmmm.

Michael Jackson RIP

This is a story of talent, triumph, tragedy, and potential.

The death of Michael Jackson at 50 is tragic. It brings to end an unbelievable music career. The man was not without his detractors and not without controversy. However, he has created a legacy that will endure long after his untimely death.

May you find a peace in death that you never seemed to truly find in life.

Michael Jackson (1958 - 2009) Rest in Peace.

Heath Ledger and Mary-Kate Olsen -- An Update

It is being reported that federal prosecutors have decided not to pursue the case of whether or not the prescriptions used by Heath Ledger to obtain the drugs that formed the lethal cocktail that killed him at this point in time.

What this means is that the federal prosecutors do not have sufficient evidence to pursue any one particular person. Therefore, the subpoena that might have been used on Mary-Kate Olsen to compel her to testify is no longer valid. Apparently, the subpoena was reliant on the federal prosecutors pursing the case. If they do not pursue the case then the subpoena cannot be enforced.

However, deciding not to pursue the case at this point in time does not mean that it could not be pursued at some later time should evidence become available that a crime has been committed.

Heath Ledger and Mary-Kate Olsen

The Heath Ledger story seems unlikely to fade away in the near future, particularly as The Dark Knight does a roaring trade at the box office. It is also likely to continue as the buzz for the first posthumous Oscar since 1976 (Peter Finch for Network, if I am not mistaken) builds. The story will also continue as long as Mary-Kate Olsen maintains her silence, refuses to talk to investigators, and asks for immunity from prosecution if she does talk.

The facts that we do know is that the masseuse that found the unconscious or dead heath Ledger made calls to Mary-Kate before she called 911, we also know that the masseuse called again after paramedics arrived, and we know that Mary-Kate sent around her personal bodyguards. Mary-Kate's lawyer is maintaining that the starlet has told investigators all that she knows and therefore any further questioning is unwarranted and unnecessary.

It would seem that the investigators do not believe this and have gone so far as to obtain a subpoena. The subpoena by its very nature will compel Mary-Kate to testify before a grand jury if one is convened. The fact that investigators have gone to the trouble of getting subpoenas would suggest that a grand jury will be called. But law is a game in that sense and the threat of a grand jury is like shaking a tree and seeing what falls out.

It would seem that the investigators into the unnatural death of Ledger suspect that at least some of the drugs in the lethal cocktail of drugs that killed him were illegally obtained. The suggestion is that the prescriptions used were forged. The interest in Mary-Kate and the desire for investigators to follow-up with her could infer certain things but the allegations where these inferences are likely to lead have not been made public. Yet, most people should be able to join the dots on this one.

The claim for immunity immediately suggests that there is some degree of illegality involved that requires the maker of the statements, in this case Mary-Kate, needs protection from. I would have thought pleading the Fifth might have been an option in terms of not incriminating yourself at all. It is also interesting because Mary-Kate is the only person who investigators have wanted to speak to who has been reluctant to talk or who has claimed a need for immunity to be granted before speaking. Nevertheless, the other possibility is that all publicity is good publicity and drawing this thing out maximizes exposure.

There are drawbacks to maximum exposure like that the more coverage this gets the more it draws people out of the woodwork and then allows the investigators to put together a chronology of events even without Mary-Kate's testimony.

I enjoy watching the legal machinations unfold. After all it is my thing! My expertise is in this area.

Maybe there will be updates on this as things unfold or unravel, depending on which side of the fence you stand!

Honouring Heath Ledger

The question of what is a fitting tribute to Heath Ledger has split the art's community of Perth. The Western Australian Premier, Alan Carpenter, has indicated that the State intends to re-name the Northbridge Center after the recently deceased actor and current star of the latest installment in the Batman franchise, The Dark Knight.

Heath Ledger was a young actor and he was making his name on the big screen and not in the theatre. This seems to be the gist of the arguments against naming a theatre after Ledger. Nevertheless, Ledger was an actor and he was an actor that was gaining increasingly good reviews of his work. He will be forever remembered for his role in Brokeback Mountain. However, there is increasing talk that his performance in The Dark Knight is superb and worthy of awards.

Some of the arguments against naming the theatre after Ledger take aim at his personal life and question whether or not he was a good enough role model. It would be interesting to see where those arguments might lead. Ledger died of a drug overdose. This was subsequently ruled to be an accident. If anything this tragedy should highlight the dangers of self-medicating with prescription medications. Ledger, if anything, was guilty of being naive and failing to understand the inherent dangers in mixing medications. But a bad role model? I guess that is a matter of opinion.

For me, I hope they stick to naming the theatre after Ledger. It might just be what the theatre community needs. The memory of a young man who was dedicated to his craft, one who was getting better each time he came to ply his trade, and one who may have one day done more stage work, might just be the incentive to attract more young West Australians to the theatre.

But then again what do I know about theatre or film other than watching it? Not a lot! Yet, I do think it is a fitting tribute to a fine Australian export to the world.

Herbal Medicines -- Jamu

Although this particular story originates from Malang in East Java it might just be representative of any region in Indonesia. Indonesians are big believers in traditional herbal medicines and cosmetics both of which are big business and provide turnovers to the owners of these businesses in the many millions and hundreds of millions of dollars annually. These companies include Martha Tilaar and Jamu Jago to mention but two.

However, a recent survey by the Indonesian Department of Health through the Health Service of Malang found that 77 types of jamu in Malang contravened current safety regulations with respect to the ingredients contained in the jamu. Of these 38 were registered and 39 were unregistered brands. The registered brands were immediately cancelled.

Most contained substances that are banned because they require a doctors prescription to be bought. The banned substances include diuretics, beta-2 stimulants, non-steroidal anti-inflammatories, powerful pain relievers, asthma medicines, and a range of other prescription drugs.

I guess you drink jamu at your own risk!