Prof Datuk Dr Daniel Mahendran Thuraiappah

Walking down Memory Lane. . .

. . .with Professor Datuk Dr Daniel Mahendran Thuraiappah.

On a Friday morning of the 21st October 2022 at 7.55 am, I was sad and shocked to receive a whatsapp message from Datuk Dr Daniel Mahendran Thuraippah’s mobile phone to me that stated “ Datuk Dr Mahendran Thuraiappah passed away this morning”…….the message came from his wife, Datin Dr Gnanam Duraisamy. I could not believe what I had read because just the day before, on the late afternoon of the 20th October at 5.05 pm, I received a text from him stating “ hope you can attend “ in relation to a particular healthcare event that he forwarded. That probably may had been the last message he had sent to anyone.

In the last few weeks prior to his passing, both of us had been in regular communication on whatsapp. We chat in relation to my recent WONCA meeting in Oslo, Norway, and my proposal on the MOH’s White Paper as well as his nomination for the Wes Fab Oration. I had also shared past fotos of our past travels in WONCA and ARPaC. And he also shared the letter from MMA on the award of the Meritorious Service Award 2022 that was accorded to him.

On Sunday 23rd October, Dr Norsiah Ali, Dr Aishah Mohammad Zain, Dr Kaviayarasan , my wife and I paid our respects at his funeral at his home in Taman Titiwangsa. I was invited by his family to read a eulogy , which I did spontaneously . It was an honour and privilege for me, but I also said that those few minutes did no justice to someone whom I had spent almost 20 years in AFPM as a colleague, a mentor and a travelling companion.

Being one of the remaining few in AFPM who had the privilege of working with the Founding Fathers, namely the late Dato’ Seri Diraja Dr Syed Mahmood Jamallullail, Datuk Paduka Dr Ruby Abdul Majeed , Dr MK Rajakumar and other Past Presidents, I strongly felt that I needed to share my thoughts and memories in words. This was to honour a colleague who had spent a great deal of his professional life giving his utmost commitment and sacrifices to AFPM, ARPaC and WONCA as well as to other institutions and communities. I needed to share and made it known to all our friends and colleagues, both in and out of AFPM, of this truly great Malaysian family physician.

AFPM

My first working association with the late Datuk Thurai, as most of us fondly called him, began in 2001, when I was admitted into Council after passing the Conjoint MAFP-FRACGP examinations. I was given a “gentle nudge” then from Past President Dr Chua Wan Tiong (who was then a Council member) who proposed my name at the AGM in Vistana Hotel nearby. The late Datuk Paduka Dr Ruby Abdul Majeed was then the President, and Datuk Dr Thuraiappah, the Honorary Secretary.

Apart from the usual Council meetings at the old AFPM office in the MMA building, regular meetings were also held at the Datuk Paduka Dr Ruby Abdul Majeed’s home in Petaling Jaya.

The late Datuk Dr Ruby Majeed, Dr MK Rajakumar, Datuk Dr Thurai and I, often had meetings with the respective Ministers and senior officers of the Health Ministry then. In particular we met regularly with Datuk Dr Narimah Awin and To’ Puan Dr Safurah Jaafar of the Family Health Development division in charting the course of primary care and the role of AFPM.

As various Presidents continued in succession and gave their important share of contributions,
Datuk Thurai in his capacities as Honorary Secretary and subsequently as Chairman of Council, was responsible in ensuring that AFPM maintained a firm focus and road map in organisational and family medicine development planning. In assisting him as Honorary Treasurer, we both spent many extra hours out of EXCO and Council meetings engaging in such discourses.

During the Presidency of the late Dr MK Rajakumar (2003-2005), the three of us had more focused but informal meetings at the nearby Royal Selangor Golf Club . Dr Rajakumar wanted the formation of s structured family medicine specialty curriculum and an entity by AFPM to promote this programme, as well as to ensure that this program would be officially recognised by the government. This later led to the formation of a subsidiary known as Medibase in which Datuk Thurai and I were its first directors. Additionally, Dr Rajakumar also suggested the formation of a Quality Improvement Program (QIP) and Quality Primary Care (QPC) entities that were to oversee the GPs in the country, in the same function as MSQH which catered to hospitals.

In 2009, during the time of the then DG of Health, Tan Sri Dr Ismail Merican and the Presidency of the late Dr HK Doshi, the Diploma in Family Medicine (DFM) curriculum was launched, which included a special video presentation. Its implementation was under the directive of Tan Sri Dr Ismail Merican, who wanted AFPM to ensure that that we were to prepare the GPs to be trained to reach a minimum level of competency in anticipation of a national health finance system in the country.

In the run up to the creation of the DFM programme, Datuk Thurai focused on the curriculum development, whilst I focused on the administrative matters, which included a couple of meetings with the then Dean of Faculty of Medicine of University Malaya, Tan Sri Prof Dr Amin Jalaluddin, who subsequently became the Vice- Chancellor of University Malaya.

In order to ensure the GP-friendliness, wide accessibility and coverage of the program, we both felt that an online distance learning concept was the way to go.

Datuk Thurai, Dr Frank Tan (the then President of AFPM), Dr Suthananthan and I, initiated a working collaboration with Open University of Malaysia, who was then led by its President, Professor Emeritus Tan Sri Dr Anuwar Ali, and who is now the Chancellor of University of Cyberjaya where I am attached to. Subsequently of course, AFPM developed its own online learning systems.

Having ensured that the DFM programme was running smoothly, Datuk Thurai went further to get recognition for our MAFP-FRACGP programme.
The intention to recognise our Conjoint MAFP- FRACGP examinations as a Specialist Family Medicine qualification was proposed by the National Specialist Register in a letter to Datuk Thurai as Chairman of Council in December 2009, subject to the fulfilment of certain requirements. Having fulfilled all the requirements, the full and official recognition was granted by the Public Service department and the Ministry of Health on the 13th February 2012.

In 2015, Datuk Thurai as President of AFPM, led the MOU signing ceremony with the then Minister of Health, Tan Sri Dr Subramaniam, for AFPM to train doctors from MOH for the Conjoint MAFP-FRACGP. This was witnessed by the Director General of Health, Tan Sri Dr Nor Hisham Abdullah.
As we know now, this programme is very well taken up as a parallel pathway to family medicine specialisation.

WONCA (World Organisation of Family Doctors)

In the preparations for the WONCA Asia Pacific Regional Conference Kuala Lumpur 2002, I was brought in to assist him into the Host Organising committee by the late Datuk Dr Ruby Majeed. That was my first experience in hosting a WONCA event in which Datuk Thurai was Chair of the Host Organising Committee, although my first attendance at a WONCA event was at World WONCA London in 1986, when the late Dr MK Rajakumar was the President of World WONCA.

It was also the first time that we had a royal audience with the then Royal Patron of AFPM, HRH Tuanku Syed Sirajuddin Jamalullail, the Raja of Perlis and HRH the Raja Perempuan Perlis Tengku Fauziah binti Almarhum Tengku Abdul Rashid, at the Istana Perlis in Kuala Lumpur. Our Royal Patron was the nephew of Dato’ Seri Diraja Dr Syed Mahmood Jamallullail, Past President of AFPM (then College of GPs, from 1978 to 1980).

It was also both the late Datuk Dr Ruby Majeed and Dr MK Rajakumar who suggested that I accompanied Datuk Thurai for my first overseas mentoring at a WONCA conference in Kyoto in 2005.

Ever since then, both of us regularly represented AFPM in the annual conferences except for the WONCA World in Cancun, Mexico 2010 that I was unable to attend. And it was through the late Datuk Thurai’s experiences as Honorary Secretary and Vice-President of WONCA Asia Pacific Region that gave me the confidence to assume the Chairmanship of the Host Organising committee of WONCA APR Kuching conference 2014, which turned to be a successful and profitable event. Incidentally, when I again attended WONCA Kyoto in 2019, I was elected to the post of President Elect of WONCA APR.

In 2006, I had the pleasure of accompanying Datuk Thurai to the 49th RACGP Annual Scientific Convention in Brisbane, Queensland at which Datuk Thurai was awarded the Honorary Fellowship of the RACGP by the President, Prof Michael Kidd. I was also given the privilege of being seated with the RACGP Council on stage and the honour of addressing the guests in the hall, together with representatives from the Hong Kong College of Family Physicians and the Royal New Zealand College of General Practitioners. It was also at that function that the new RACGP President, Dr Vasantha Preetham, was installed.

In 2009, after the WONCA APR Hong Kong Conference, Datuk Dr Thurai, AFPM staff Mr Chin Yew Meng and I, extended our trip to Guangzhou, China. We visited and discussed with several universities, including Jinan and Southern Medical Universities to explore any possibilities of collaboration. I believe in subsequent trips, Datuk Dr Thurai and Mr Chin Yew Meng were successful in getting some candidates from Shenzhen who registered with our DFM course, although no further progress was able to be carried out after that due to certain regulations that posed some problems.