￼Good health is indeed the foundation of a good life and in line with Brunei’s Vision 2035, the MoH is focused on the overall betterment of health for the nation in order to achieve a better country. Although health and well-being in Brunei has improved over the years, there is still room to do better. Life expectancy has increased, however, the MoH highlights that good health is not just about how long people live, it is about the quality of life and preventing people from spending a significant part of their lives in pain or discomfort and depending on others for support.
The Global Nutrition Report 2016 shows that Brunei is hit harder than its Asean neighbours by the big killers of obesity and diabetes. A total of 61 per cent of adults in Brunei are overweight and obese. Already the devastating effects of this can be observed. More than 30 per cent of the adult population suffer from high blood pressure, 70 per cent from abnormal lipid (cholesterol) and 12 per cent of adults from diabetes.
The cause of this ‘obesity epidemic’ is clear – an inactive lifestyle combined with excessive intake of foods high in sugars and saturated fats. With appropriate levels of nutrition and physical activity, obesity is indeed preventable. In light of the Global Nutrition Report 2016, the MoH has reiterated its commitment to tackling non- communicable diseases (NCDs), including obesity. It has made a call for action for the whole of society to do the same. The ministry is committed to support the national effort to prevent obesity and reduce excess weight.
The ministry stressed that this is something they cannot do alone. A whole-of-nation approach to tackling the problem is imperative. Government agencies and non- government entities must consider the consequences of their policies on health.
The ministry will work with partners in both government and private sectors including schools, institutes of higher education, and community grassroot leaders and civil society groups to encourage and support individuals to eat a healthy diet and become more physically active to achieve and maintain a healthy weight.
The MoH announced its new organisational structure in February 2016, stating that against the backdrop of rising number of NCDs in the country, demographic shifts, rising expectations of citizens and coupled with the global economic pressure, a new approach is needed.
The reorganisation was aimed to minimise duplication of services and reduce wastage of resources, with a focus on clear high-impact outcomes. The MoH aspires to position the national healthcare system to deliver a more cost-effective, integrated and holistic healthcare services. With the vision ‘Together towards a Healthy Nation’, the ministry has set three strategic priorities for the next five years:
1. To inculcate “health is everyone’s business”.
2. To prevent and control of non-communicable diseases (NCDs).
3. To deliver excellence through consolidation and realignment of healthcare services.
Measures taken by the ministry included a ‘Go back to basics’ approach through re-visiting its mission and goals; understanding its customers and their expectations; the progress and achievements so far; and its plans of going forward. It also placed emphasis on exercising continuous improvement at every level of the organization, focusing on reducing wastages and turning it into value for the public. The third step is an open and participatory approach – making everyone accountable for their health and well being. This requires collaborative and a whole-of- nation approach, involving every key stakeholder in the country. The ministry also aims to empower its more than 6,000 staff to be innovators and problem solvers, in order to promote a culture of accountability and pride in their work, as well as to minimise bureaucracy. Lastly is to inculcate a ‘Growth Mindset’ and support development of staff.
At the heart of the new organisation structure are the four core values of the MoH:
1. Client first – our clients define us.
2. Together – we are one and we embrace diversity and we are united through one common purpose.
3. Excellence – we uphold the highest level of professionalism, where everyone matters and everyone delivers the highest quality service every time.
4. Dynamic – we embrace change and develop our people through having a ‘growth mindset’ and we thrive on the opportunity to continuously improve.
The overall restructuring of the Ministry of Health has produced three broad clusters. The first is a strategic cluster. Second, comprised of two clusters, that is, service delivery overseen by the Deputy Permanent Secretary (Professional and Technical) and policy and foresight by the Deputy Permanent Secretary (Policy). The third and final is a services cluster run by frontline providers (such as hospitals, health centres, public health services and clinics).
The MoH oversees the Health Promotion, Legal Affairs, and a new unit called ‘Innovation Delivery Academy’ (IDeA).
Health Promotion was given a bigger profile with the necessary high-level commitment to ensure that the ministry works closely with relevant stakeholders from various government agencies, private sectors and the community – in taking the responsibility of maintaining health and ensuring health in all policies.
IDeA will be responsible for incubating new ideas, monitoring and managing the key strategic initiatives of the ministry and ensuring these projects are aligned with both the ministry and national’s agenda through a delivery framework.
The second cluster that comprises service delivery, policy and foresight highlights the importance of focusing on core businesses and the need for the ministry to be proactive by utilising health information and data for better informed policy and decision making. The ministry will track its performance through appropriate data management and ensure that delivery of services is safe, timely, efficient, effective, equitable, and personalised (patient-centric).
Overall, the new structure is lean, seamless and based on the functional need for the ministry to provide quality service to its clients and stakeholders. The ministry will also benefit from greater management and operational flexibility as well as enhance its ability to respond to changing circumstances. Together, with the cooperation of all stakeholders, the ministry aspires to improve the health and well-being of the people of Brunei through a high-quality and comprehensive healthcare system which is effective, efficient, responsive, affordable, equitable and accessible to all in the country.
Brunei cancer patients will soon have better access to cancer care following the completion of the construction of The Brunei Cancer Centre (TBCC) with state-of-the-art facilities in the near future.
Located in Jerudong, this upcoming B$100 million centre will house both TBCC and the Brunei Neuroscience, Stroke and Rehabilitation Centre.
The TBCC will provide diagnostic and therapeutic services for cancer patients which will include chemotherapy and radiotherapy with its new and modern linear accelerators, brachytherapy equipment, 3D planning system and CT-simulator.
A cyclotron, PET-CT scan and SPECT scan will help it provide nuclear medicine facility. It will also be equipped with six radio-iodine isolation rooms for radio-iodine treatment for thyroid diseases.
TBCC aims towards becoming a Cancer Centre of Excellence in the country and within the region
through its competency in providing comprehensive cancer treatment, reducing morbidity and mortality and developing an effective cancer palliative care service.
TBCC is a government entity whose overall operation is overseen by a board of directors. The centre is led by an executive director and the daily function is managed by a medical director. This stand-alone Centre of Excellence is regulated by the Ministry of Health. The doctors and nurses are registered with the Brunei Medical Board and the Brunei Nursing Board respectively.
Once patients are diagnosed with cancer at one of the government hospitals, they are referred to TBCC for subsequent management. These patients are discussed at multidisciplinary team meetings of different cancer specialists with specialised skills and expertise such as surgeons, pathologists, radiologists, medical oncologists and radiation oncologists. The team members make consensus treatment recommendations to provide the best care for the patients.
TBCC will also strive to continue further collaboration with other relevant agencies across Brunei in an effort to promote and educate the people of early detection of cancer and cancer prevention. For this, public awareness talks at government departments, schools and non-government organisations will be organised.
TBCC is providing consultations and chemotherapy treatment for patients diagnosed with cancer. The centre provides both outpatient and inpatient services. There were 8,282 outpatient clinic attendances in TBCC in 2015. This represented an increase from 7,967 attendances in 2014 and 7,825 attendances in 2013.
The Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital has been in existence since 1984 as the nation’s main landmark to healthcare. It provides secondary and tertiary healthcare for citizens and residents of Brunei.
It also aims to become a hub for expertise in medical and allied health services, as well as a training institution in collaboration with higher national and international education institutions and also to support the national health promotion programmes.
Situated in Kampong Kiulap, the hospital consists of seven main blocks which include the Ward blocks, the Specialist Clinics block, the Plant and Engineering block, the Outpatients and State Lab block, the Sports Complex, the Transport Complex equipped with jetty and helipad facilities and the
recent addition, the Women and Children’s Block.
The Women and Children’s Block was launched in April last year by Her Majesty Duli Raja Isteri Pengiran Anak Hajah Saleha binti Al-Marhum Pengiran Pemancha Pengiran Anak Haji Mohamed Alam.
The 11-floor Women and Children’s Block features the Paediatrics Ward, Obstetrics and Gynaecology Ward, Children’s Specialist Ward, General Paediatric Ward, Neonatal Intensive Care Unit, Special Care Baby Unit, Paediatric Intensive Care Unit, Oncology Ward (children), 13 suites (labour room), two operation rooms, Gynaecology Ward (private rooms), Doctor’s Office, Seminar Rooms, Prayer Rooms, Pharmacy, car park for staff and public as well as a cafeteria.
Another recent addition was the relocation and integration of the Developmental Paediatric Services, formerly known as the Children Development Centre (CDC), to provide more convenience and better access for those with special needs in one centralized healthcare environment.
The integration serves to provide excellent facilities and services, including the community paediatric clinic, occupational therapy, physiotherapy, dietetic, medical social work, clinical psychology, podiatry and prosthesis as well as orthotist and optometrist.
RIPAS Hospital has gone through numerous developments and expansions over the years, striving to provide excellent and efficient healthcare services and treatments to the local communities and
JPMC is a private hospital in Brunei situated in the Jerudong Park area that offers general, specialized and surgical healthcare services since its foundation in 1992.
Since its establishment, the hospital has undergone significant developments in expanding its services and improving facilities for meeting the healthcare needs of patients across the country.
JPMC has a team of dedicated and passionate medical and administrative workers from different parts of the world offering their medical specialist knowledge. However, they all have one focus: to provide ‘Excellence in Healthcare’ and to serve the needs of the community in Brunei and beyond.
JPMC offers general outpatient services, such as a 24-hour Outpatient Clinic (OPD) with facilities for health screening, adult vaccination, treatment for acute and chronic medical conditions and provision of ambulance services. Other facilities include clinics for dental, dietetics, general outpatient, obstetrics and gynaecology, orthopaedics, paediatrics, pharmacy, specialist consultation and Brunei Neuroscience Stroke Rehabilitation.
The pharmacy provides a range of pharmaceutical services, including prescription and non-prescription drugs (over the counter). Laboratories are also avail- able at JPMC such as Biochemistry, Haematology, Serology, Immunology, Microbiology, Blood Banking and Donation Services, Reproductive Medicine Lab Services and Stemcell Services.
JPMC also has Diagnostic Imaging Service (Radiolo- gy), Dietetic, Rehabilitation centres, Anaesthesiolo- gy and Intensive Care as well as Nursing.
Other amenities at JPMC include an extensive range of fitness equipment, swimming pool, indoor badminton court, health and fitness testing, aerobics and circuit training, personal training and tailored fitness progammes as well as a jacuzzi, steam room and sauna suites. These services and facilities are provided with state-of-the-art equipment and tech- nologies by JPMC’s highly qualified and committed multi-disciplinary medical team.
Located along the shores of the South China Sea, JPMC is surrounded by the tranquility of nature, offering an ideal ambience for healing and wellness for the whole family.
The birth of Gleneagles JPMC (GJPMC) came about when the Brunei government saw a pressing need to establish a world class cardiac centre in the Sultanate, due to an increasing number of patients in the country who needed to be referred to Singapore or Kuala Lumpur for cardiac treatment.
This state-of-the-art private specialist hospital is a joint venture between the Brunei government and Parkway Pantai Limited, a 100 per cent subsidiary of IHH Healthcare Bhd, which is listed on the Malaysian and Singapore Stock Exchanges and is the world’s second largest listed healthcare operator by market capitalisation. GJPMC began operations in August 2002 and has provided Bruneians excellent healthcare and top-tier cardiac treatment for close to 15 years.
The hospital is situated in the Jerudong Park area, with patient rooms enjoying expansive views of the Jerudong Beach and the South China Sea and also offering extensive Outpatient and Inpatient care and services.
GJPMC has been at the forefront of medical innovation. From the first coronary stenting and open heart surgeries performed in Brunei in 2003, the hospital has introduced, successively, device closure of congential heart abnormalities in 2007, the use of bio-resorbable scaffolds for coronary stenting in 2012, the use of 3-D mapping of the heart for electrophysiology and ablation for heart rhythm abnormalities in 2013.
On November 11, 2014, GJPMC and the Ministry of Health made history by successfully implanting a Left Ventricular Assist Device (LVAD) – a mechanical device that helps pump blood from the left ventricle
to the rest of the body – into the heart of a local patient, the first-ever such procedure carried out in the country, and indeed, in Borneo.
Dato Paduka Haji Dr Isham bin Haji Jaafar, Senior Consultant Cardiac Surgeon in the patient’s surgery team, commented, “Before this option was made available, patients with severe heart failure could only be treated with lifestyle modifications and medication or pacemaker/defibrillator devices, which were sometimes only partially successful. This device allows the patient to lead an almost normal life.”
In another first-of-its-kind operation in Brunei Darussalam, MicraTM leadless pacemakers were implanted successfully in two patients suffering from bradycardia at GJPMC in June, 2015. The revolutionary pacemaker is the world’s smallest wireless pacemaker. Dr Sofian bin Dato Paduka Dr Haji Johar, Gleneagles JPMC Consultant Cardiologist, was one of the surgeons involved in this procedure.
Dr Sofian said that this treatment “could change the way we treat patients with heart rhythm problems. Although we have many patients who have been successfully treated with normal pacemakers, the MicraTM leadless pacemaker is a significant milestone in pacemaker technology and potentially eliminates a lot of the disadvantages of the normal pacemakers.”
Asked to comment on the future plans of GJPMC, CEO Dr Peter Tay said, “Going forward, GJPMC will continue to be at the forefront of medical advancements and will adopt cutting-edge technology where appropriate. We will build on our excellent working relationships and continue the close collaboration with the Ministry of Health in order to serve all cardiac patients of the Sultanate to the best of our abilities.”
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