Story About a Disabled Person Essay Example for Free

Story About a Disabled Person Essay What is a disabled person? A disabled person is classified as any person who is unable to obtain for himself or herself, fully or partially, the normal requirements of an individual and /or is unable to participate fully in the community due to shortcomings either physically or mentally which may have occurred since birth or later in life. There are people who have overcome these shortcomings and achieved great success through self-reliance and diligence. One such person that comes to mind is none other than my Uncle John. Uncle John is my mother’s youngest brother. He was born on June 12, 1970, in Kuala Lumpur, Malaysia. Uncle John was not born deaf and blind. According to my grandmother, when Uncle John was 16 months old he came down with meningitis, which robbed him of both his sight and hearing. The sad thing about this was that my grandparents were not aware about this and only realized my uncle’s disability when he was only two years old. By then the damage to the nerves in his eyes were too severe to be rectified and there was nothing that could be done for his ears. With great determination my grandmother tutored my uncle at home in Mathematics, Language, Music and Art. My uncle was a fast learner and picked up well in all the subjects. But he showed tremendous improvement and excellence in Music. My grandmother decided to get him a music tutor although it took a toll on their livelihood as my grandfather was the only wage earner in the house and he had a family of five young kids to feed and educate. My grandmother decided to sell cakes to make extra money. My uncle progressed so well that he had completed all the 8 levels of music in just 5 years. When he was 15 years old my uncle decided to lift the burden of my grandparents by teaching music to earn a living. He was such a patient and caring music teacher that parents were waiting at the doorstep to enrol their children in his music classes. He had been teaching for about five years when he decided to further his studies in music. At the age of 21 he asked for his parents blessings to allow him to pursue his ambition of being a concert pianist in America. My grandmother was reluctant to let him go as she was worried that he would not be able to cope on his own. By then all his older siblings including my mother had graduated and were doing well in their respective fields. They talked their parents into allowing my uncle to follow his dream. With a heavy heart my grandmother gave in and my uncle left for America. While there, my uncle enrolled in the prestigious Julliard School of Music in New York City. Although he had saved enough money to see him through only the first year of college, that did not deter him. He gave his most and his disability was not an obstacle. He excelled in all his classes and was well liked by both his peers and lecturers. He was voted into all the committees as he was someone that could be depended on. At the end of the first year my uncle scored distinctions in all his subjects and was placed on the Dean’s list. He was given a full scholarship to continue his studies for the next year. He excelled for the next three years and was given a full scholarship for the rest of his college studies. At the end of his four year study he was invited to take part in a concert for budding concert pianists. At the tender age of 24 he played in front of an audience of 7,000. The audience was awed by his skills. He appeared in the newspapers and everyone was talking about this young talent. After this he was invited on many premier shows such as The David Letterman Show, The Ellen DeGeneres Show and even The Oprah Winfrey Show. He travelled all over the world giving concerts. He became a world renowned concert pianist earning a lot of money. After being away for 10 whole years my Uncle decided to return to Malaysia. Throughout the ten years away he never forgot the sacrifices his parents made for him. He set them up in a beautiful house with a maid to look after them. He made sure his parents and siblings were well taken care off. He also made sure that his parents travelled to all his concerts all over the world. Today he is happily married with two healthy children – my cousins Deidre and Antoine. He will always be my inspiration because he did not let his disability bring him down. He has taught me that one can excel in anything if one is determined.

The Israeli-Palestinian Peace Process Essay Example for Free

The Israeli-Palestinian Peace Process Essay The Israeli-Palestinian conflict is not descriptive of a catalytic event but a chronic conflict that has persisted for more than half a century. The military and political ramifications of the conflict in Palestine and the Arab world are nothing but huge (Barsalou 2003; Bregman El-Tahiri 1998). For years the Israeli-Palestinian conflict has trudged on dotted with what has currently been accepted as twists and turns of small successes and persistent failure of the peace process at large. The underlying issues are as broad as the range of interventions that can be used to solve them but the political will to enforce recommendations has been lacking ever since Israel self declared its independence and Palestine in collaboration with the Arab world declared war on the Israeli state. However, the complexity of the eventualities that led to the collapse of the peace process can not forever prevent the success of any future interventions so long as key issues are straightened out. As the peace process remains stalled, any future intervention will have to desist from pushing partial agreements and instead advocate for a comprehensive and sustainable7 final status agreement. There is need to avoid sequenced confidence building strategies that had been prevalent with the past peace process negotiations. This is crucial to prevent the peace process from becoming a hostage to security. Instead both parties in the negotiation table should be encouraged to adopt a strategy that promotes a mutual and comprehensive ceasefire by both the Israelis and the Palestinians (Brown2009). The Israeli government should freeze all construction developments in occupied territories because these settlements are in contravention of international law. Abidance to such preliminary conditions is critical in driving the negotiations to sustainable resolution of underlying issues and subsequently the charting out of a final status document that is agreeable for all the negotiating parties. As the international community; the United States included, continues to provide support towards the democratization and the creation of the Palestinian state, it should be understood that such sovereignty cannot be achieved under conditions akin to military occupation, thus the ceasefires. It is a fact that with America spearheading the peace process, Palestinians and the Arab world will never believe in the impartiality of the mediator. Thus, if America is to continue being the mediator in the Israeli-Palestinian peace process, the United States must restore its credibility as an impartial and honest broker by adopting an even handed role. The nature of America’s Middle East foreign policies is a slap in the face of their supposed stance of impartiality. The military and economic cooperation with the Israelis will only serve to advance the understanding that America can only drive the negotiation to endpoints that are in congruence with its own interests and values such as the advancement of democracy and equal rights. Such positions even if unbiased in America’s perspective may not be in congruence with the desires of the Palestinian populace (Avineri 2001; Baddar 2007; Carpenter 2008). The failure of the United States to exert considerable pressure on Israel on important concessions of the peace process negotiations remain a great stumbling block to the realization of sustainable peace. As opposed to earlier formulations of the peace process, a sustainable peace process should allow the resolution of the Israeli-Palestinian peace process to be driven by principles of international law. This would mark a paradigm shift from the current status quo. Basing the peace negotiations on international law ensures the neutrality of mediation. Moreover, under international law, Israel will have to stop settlements in territories that are not recognized under international law as well as improving on the definition and clarity of negotiations based on neutrality. Additionally, such a shift would make the negotiations and the final resolution of the conflict acceptable to the international community. Only international law can level the playing field in the peace process negotiations. If such a strategy is used the final resolution will not only be reflection of justice but also ensure that the fundamental rights of the Palestinians are respected. If negotiations proceed as per the current status quo, the final resolutions that are not in congruence to international law may not be easy to implement. The international community and especially the United Nations should be involved in the pursuit of novel approaches of solving the Israeli-Palestinian conflict (Daalder et al 2006). This call is not only urgent but late in coming. The failure of the Israeli-Palestinian peace processes has been partly attributable to the insistence of keeping out the United Nation in the peace negotiations. The specially scripted negotiations such as the Oslo Process and even the RoadMap to peace by various mediatory parties have only led to persistent stagnation and hopelessness among the Palestinians (Greenstein 2003; Rubenberg 2003). It is only in the best interest of the international community that the United Nations steps in to give the Palestinians hope and steer the peace process to sustainability. Finally, it should not be lot on all negotiating parties that any strategy should conclusively address and resolve the root causes of the Israeli-Palestinian conflict. In essence, the sidestepping of the real causative issues in the conflict has been at the core of the failures of the peace process. Infact, the conflict only arose when the native Palestinians were dispossessed of their land during the establishment of the State of Israel. Moreover, when it comes to the question of the Palestinian refugees, Israel has consistently refused to make an alteration on its position preferring instead to disregard the existence of legitimate rights of these populations. The important of the centrality of the refugee question based on international law is thus critical in future negotiations. In conclusion, the Palestinians must, as a matter of criticality in the peace process, accept the existence of Israel as a state because failure to accept that single historical eventuality will automatically stagnate the peace process. So long as the ideals of liberating Palestine from Israeli occupation coupled to the complex desires of the Muslim fundamentalists are supremely put to the fore in the negotiation process, Israel will undoubtedly maintain its hard-line stance on the need to protect its citizens from external extremist attacks and consequently continue to create a buffer zone between Israel and Palestine. The political instability of Palestine is also a detriment to the pursuit of lasting peace. Palestine must strive to create a stable government that is not only representative of the entire Palestinian populace but also possess the full political and military authority to upkeep the recommendations of the peace process. In this stride, the international community should help Palestinians through interventions that are acceptable to the world at large because the ongoing extremism, fundamentalism and resultant political instability is not beneficial to pursuit of global peace and security. References Avineri, S. (2001). A Realistic U. S Role in the Arab-Israeli Conflict. Carnegie Endowment for International Peace. http://www. carnegieendowment. org/publications/index. cfm? fa=viewid=866 Baddar, Omar. (2007). US Policy and the Israeli-Palestinian Conflict. Paper presented at the annual meeting of the Southern Political Science Association, Hotel InterContinental, New Orleans, LA, Jan 03, 2007 Not Available. 2009-02-04 http://www. allacademic. com/meta/p154225_index. html Barsalou, J. (2003). The Long Road to Palestinian Reform. Middle East Policy; 10:1, 154-164 Bregman, A. , El-Tahiri,J. (1998). The Fifty Years War: Israel and the Arabs. London: Penguin,1998; 1-15 Brown, N.. Palestine and Israel: Time for Plan B. Policy Brief, February 2009; No 78 http://carnegieendowment. org/publications/index. cfm? fa=viewid=22792prog=zgpproj=zme Carpenter,T. G. (2008). Smart Power: Toward a Prudent Foreign Policy for America. Cato Institute; 122 Daalder, I. H. , Gnesotto, N. , Gordon, P. H. (2006). Crescent of crisis: U. S. -European strategy f for the greater Middle East. Brookings Institution Press; 48 Greenstein, F. I. (2003). The George W. Bush presidency: an early assessment. JHU Press; 110-115 Rubenberg, C. (2003). The Palestinians: in search of a just peace. Lynne Rienner Publishers; 286-290

Principles of Sterilisation in Microbiology

Principles of Sterilisation in Microbiology Moist and dry heat How are microorganisms destroyed by moist heat? By dry heat? Moist: Destroys the structure and organisms by destroying with heat. The combination of steam and pressure, the temperature is usually 121 °C and 15 lbs. per inch for thirty minutes. Dry: Kills organisms using oxidation methods. Most resistant of the spores requires a temperature of 121 °C for around two hours Are some microorganisms more resistant to heat than others? Why? Endospores are extremely resistant to heat because they have a tougher coat and a low moisture content. Additionally, they have a large amount of calcium and dipicolinic acid that helps to protect them from heat. Is moist heat more effective than dry heat? Why? The National Library of Medicine states, â€Å"Moist heat penetrates faster than dry heat† (Medicine, 2015). Moist heat penetrates the molecules, additionally, the water molecules conduct heat much better than air. Why does dry heat require higher temperatures for longer time periods to sterilize than does moist heat? Because water is a better conductor than air, therefore the dry heat does not penetrate as well. What is the relationship of time to temperature in heat sterilization? Explain. Basically the higher the temperature the less time needed. The autoclave Define the principles of sterilization with an autoclave and with a dry heat oven. An autoclave sterilizes using high pressurized steam heat that is made by high temperature boiling water and pressure. The steam vibrations destroy the microorganisms. Judelson states, â€Å"Autoclaving generally involves heating in saturated steam under a pressure of approximately 15 psi, to achieve a chamber temperature of a least 121 °C (250 °F)—but industry, other combinations of time and temperature are sometimes used† (Judelson, 2015). Dry heat ovens subject the microorganisms to high temperatures and destroy the bacteria’s by drying them out and basically sterilizing them from the outside to the inside by heat and no water. Unlike an autoclave which is one piece of equipment, dry heat can include a hot air oven, incineration, radiation, microwave, Bunsen burner and flaming. What pressure, temperature, and time are used in routine autoclaving? With the combination of steam and pressure, the temperature is usually at 121 °C and 15 lbs. per inch for thirty minutes (Kenneth Todar, 2015). What factors determine the time period necessary for steam-pressure sterilization? Dry-heat oven sterilization? The combination of temperature and time are what decides the actual time. Accordint to Mazhar Hussain, â€Å"The thermal death time is the time required to kill all the bacteria in a particular culture at a specified temperature. Both TDP and TDT are useful guidelines that indicate the severity of treatment required to kill a given population of bacteria† (Hussian, 2015). With dry heat the materials play an important factor. Why is it necessary to use bacteriologic controls to monitor heat- sterilization techniques? They are necessary to ensure that the autoclave is working properly and efficiently. They are place throughout the autoclave to ensure a complete testing of the autoclave. When running an endospore control of autoclaving technique, why is one endospore preparation incubated without heating? The control is used to ensure that the spores are destroyed effectively and that there are no problems with the machine. Primary media for isolation of microorganisms Define a differential medium and discuss its purpose. Morello taught us that a differential media has one or more components that are used by some types of microorganisms and yet not others. (Morello, Granato, Morton, 2013) This a will allow an individual to tell the differences of a colony based on the colonies characteristics (i.e. shape, color or pattern). Define a selective medium and describe its uses. Selective media choses one type of microorganisms and then suppresses the others while not inhibiting their ability to actually grow. MacConkey’s agar would be a selective media as it selects gram negative bacteria and yet inhibits gram positive bacteria. Why is MacConkey agar selective as well as differential? According to Austin Community College, â€Å"MacConkey Agar (MAC) is a selective and differential medium designed to isolate and differentiate enterics based on their ability to ferment lactose, by using bile salts and crystal violet inhibit the growth of Gram positive organisms and lactose provides a source of fermentable carbohydrate, allowing for differentiation† (ACC, 2015). Why is blood agar useful as a primary isolation medium? Blood agar would be a differential media because of its ability to destroy hemoglobin and red blood cells. What is the major difference between Modified Thayer-Martin (MTM) and chocolate agar? When would you use MTM rather than chocolate agar? Modified Thayer-Martin is a selective medium that is for gram negative microorganisms that has both a medium and antibiotics, whereas chocolate agar is a non-selective medium. Modified Thayer-Martin is only used when the culture ordered is from the genital area or for sexually transmitted diseases, whereas chocolate is used for many different types of cultures. Metabolic activities of bacteria What is the color of phenol red at an acid pH? Yellow is the color below 7.0 pH. What is the function of a Durham tube? A Durham tube contains a small inverted tube that is used for trapping the gasses that are formed when the broth inside is incubated. (Morello, Granato, Morton, 2013) Why is iodine used to detect starch hydrolysis? When the iodine dissolves with a solution of potassium, it will to turn a purple or blackish color due to the interaction with starch. How is indole produced in SIM medium? How is it detected? Hardy Diagnostics states, â€Å"The ingredients in SIM Medium enable the determination of three activities by which enteric bacteria can be differentiated; sodium thiosulfate and ferrous ammonium sulfate are indicators of hydrogen sulfide production and the ferrous ammonium sulfate reacts with H2S gas to produce ferrous sulfide, a black precipitate, additionally the casein peptone is rich in tryptophan, which is attacked by certain microorganisms resulting in the production of indole† (Diagnostics, 2015). Following the incubation period, the indole is detected with the addition of the reagents. Therefore the detection of the motility is due to the semisolid nature of the medium. How is hydrogen sulfide demonstrated in this medium? The hydrogen sulfide is detected after the production of ferrous sulfide when ferrous ammonium sulfate has reacted with H2S gas. What is the advantage of viewing mold structures in a transparent tape preparation? Southern University of Illinois states, â€Å"The advantage of transparent tape preparation is it allows the fungal structures to be viewed without disrupting the characteristics of their morphology† (Illinois, 2015) What fungus can be identified reliably by using the germ tube test? Morello taught us that â€Å"Candida albicans is the most common yeast found using the germ test and is an important cause of human infection† (Morello, Granato, Morton, 2013) Name three stains or reagents that may be used to facilitate the microscopic detection of fungi in clinical samples. Potassium hydroxide Calcofluor white India Ink Wright, Giemsa, or Diff-Quikstains Gram stain What is the main advantage of using the slide culture technique for identifying molds? It is a fast way to prepare, identify and examine fungal colonies. It makes it easier to study with little disturbances. According to Amrita, â€Å"Fungi are identified mostly by close examination of its morphology and the characteristics it possess† (Amrita, 2015). What is an opportunistic pathogen? Name three fungal specimens. It is a pathogen that takes advantage of an individual that has a compromised immunity system. Candidiasis, Apergillosis and Cryptococcosis Protozoa and animal parasites Describe the basic structures of protozoa. Can these same structures be seen in bacteria using a light microscope? The structure of protozoa is a single celled organisms with a true nucleus with chromosomes and surrounded by a membranous envelope. Additionally, Professor Anderson of Columbia University states, â€Å"They also have other internal cellular structures known as organelles that perform the many physiological functions needed to maintain the life of the organism and these organelles include mitochondria that break down nutrient molecules during respiration to produce energy for the cell† (Anderson, 2015). Are any parasitic diseases directly communicable from person to person? If so, how are they transmitted? What kinds of precautions should be taken in caring for persons with directly transmissible parasitic infections? Yes, but most have to have a host to be transferred. Lice for and an example is a parasite that can jump from one individual to another. Additionally, if someone is infected and does not use proper cleaning/washing of hands they can introduce a parasite through the preparation of food. Washing of hands and using precautionary techniques is the best way to prevent the contamination or spreading of parasites. What parasitic forms can be seen in the feces of a patient with hookworm? Eggs can be seen in hookworm, Eggs and body parts can be seen in tapeworm, in cryptosporidiosis the parasite can be seen, in trichinosis, the doctor will look for the antibodies of the roundworm. (Merck, 2015) What parasitic forms can be seen in the blood of a patient with African sleeping sickness? Filariasis? Amebiasis? In the blood of an individual with African sleeping sickness, the T. b. rhodesiense parasites can be found. In Filariasis, According to The Center for Disease Control (CDC), â€Å"The adult worms only live in the human lymph system† (CDC, 2015). For Amebiasis The Center for Disease Control also states that, â€Å"Diagnosis can be difficult because other parasites can look very similar toE. histolyticawhen seen under a microscope† (CDC, 2015), but the cysts can be seen in the stools/feces of an infected person. What is meant by the â€Å"life cycle† of a parasite? What importance does it have to those who take care of patients with parasitic diseases? The life cycle depends on the parasite, there are stages, the parasite infects a host, feeds off of the host and lays eggs. Sometimes the eggs hatch and sometimes the y turn into cysts. The eggs, cysts and sometimes parts of the body are then transferred out of the body through fecal matter, or sometimes infected blood. When this happens they then go onto the next host and the cycle repeats. The main importance is protection and cleanliness. Proper use of protective wear and then washing of the hands and any surfaces that may have been contaminated are the primary rules for the containment of spreading parasites. References ACC, A. C. (2015, January 13). Retrieved from http://www.austincc.edu/microbugz/macconkey_agar.php Amrita, U. o. (2015, January 13). Amrita. Retrieved from http://amrita.vlab.co.in/?sub=3brch=76sim=693cnt=2 Anderson, P. (2015, January 13). Retrieved from protozoa.uga.edu/education/students/for_students_sop_web_ora CDC. (2015, January 13). Retrieved from http://www.cdc.gov/parasites/lymphaticfilariasis/ Diagnostics, H. (2015, January 13). Retrieved from https://catalog.hardydiagnostics.com/cp_prod/Content/hugo/SIMMedium.htm Hussian, M. (2015, January 12). Retrieved from http://microbiologyon-line.blogspot.com/2009_08_02_archive.html Illinois, S. U. (2015, January 13). Retrieved from http://www.siue.edu/~cbwilso/250myco1_032.htm Judelson, H. (2015, January 8). Retrieved from http://oomyceteworld.net/protocols/autoclave operation.pdf Kenneth Todar, P. (2015, January 8). Retrieved from http://textbookofbacteriology.net/control.html Medicine, N. L. (2015, January 12). Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3808259/ Merck. (2015, January 13). Retrieved from http://www.merckmanuals.com/home/infections/parasitic_infections/hookworm_infection.html Morello, J., Granato, P., Morton, V. (2013). , Paul Granato, and Verna Morton. In Microbiology: Applications to Patient Care, 11th Editio (p. 111). McGraw-Hill.

The Polemic about Tattoos :: essays research papers fc

The polemic about tattoos I was wondering why tattoos are a controversial point in our society! There are people against and people that really like tattoos, but who is right? Should I think it is a good or a bad thing? Maybe for the tattooists the art involves is worth the pain and sacrifice of being tattooed. For the religious, it is a sin to sacrifice one’s body with so meaningless purpose. Now I don’t think there are excuses to justify so drastic a way of art, but analyzing the points of view I will try to clarify some questions I still have about this body art such as the reason people have tattoos, â€Å"When did tattooing start?†, the dangers involved in this procedure, the removal of a tattoo and society’s reaction to tattooed persons. Thinking it is weird to have one’s body penetrated many times by a needle to make only a drawing I do not think is worth it. So, why do people have tattoos? Why it is a common place nowadays? Probably because people see that the tattoo is a way of expression, but the real motivation to acquire it varies among groups and cultures. It marks thoughts, opinions, memories†¦Some persons obtains tattoos as a means of asserting their personal identity or sexual orientation. Tattoos may be a testament to feelings of love, they have been associated with rites of passage and identification with groups. Nowadays tattoos is used for some cosmetic medical procedures and permanent make-up applications, according to the National Institute of Environmental Health Sciences’ web site. Some women seek facial tattooing as method of permanent adornment that reduces the need of cosmetics, what can be helpful when, for example, a compromised vision impairs the ability to apply make-up. Talking with a friend who likes a lot of body art, Manoela Cunha, she said: â€Å"I like tattoos because they make me feel â€Å"the one†! There is no one else in the world like me it is a way of identification†. She adds: â€Å"It is not a rebellion of thoughts, it’s just something I like and I really don’t care about other peoples judgment†. She said it is not a painful thing, none of her 3 tattoos and her piercing hurt, and she is planning to get others. Analyzing the past, I can see it is not a recent thing. I read once in a web site about frequently asked

Four Conditions for Knowledge Essay -- Essays Papers

Four Conditions for Knowledge I. In this paper, I offer a solution to the Gettier problem by adding a fourth condition to the justified true belief analysis of knowledge. First though, a brief review. Traditionally, knowledge had been accounted for with the justified true belief analysis. To know something, three conditions had to be met: first, you had to have a belief; second, the belief had to be justified; third, this justified belief had to be true. So a justified true belief counts as knowledge. Gettier however showed this analysis to be inadequate as one can have a justified true belief that no one would want to count as knowledge. In the first Gettier counterexample, Smith is justified in believing that Jones is the man who will get the job. Smith’s also justified in believing that Jones has ten coins in his pocket. From that he infers and has a justified belief that the man who will get the job has ten coins in his pocket. It turns out that the man who gets the job is not Jones but Smith, and Smith does in fact have ten coins in his pocket. Smith has a justified true belief that the man who will get the job has ten coins in his pocket. However, this shouldn’t count as knowledge. In the second Gettier counterexample, Smith is justified in believing Jones owns a Ford. Therefore, he’s justified in believing Jones owns a Ford or Brown is in Barcelona. Turns out, Jones doesn’t own a Ford but Brown is in fact in Barcelona. Once again, we have an example of a justified true belief that shouldn’t count as knowledge. ... ...eliefs: (a) I’m in a community of barn facades. (b) That looks like a barn (q), his belief that he sees a barn, isn’t justified, though. Therefore, Dom cannot know (q). The internalism of my account is obvious. What’s required for justification of (q) is different for Henry and Dom because of each’s belief about the kind of environment he is in. It is the belief about the environment and not the environment that matters. In other words, two people could be in the exact same circumstances but what required for justification would be different because of the beliefs they have. Causal accounts of knowledge can’t account for why Henry is justified for (q), but Dom is not. My account is not a causal account; as is shown in the Dom variation above, my account has no problem accounting for the different justifications required for Dom and for Henry.

Reincarnation :: essays research papers fc

Reincarnation Synopsis Reincarnation is the embodiment in flesh or human form of the soul of a person now dead. Reincarnation is the belief that the soul survives after death and is reborn in the body of another person of some other living thing. This concept is called Transmigration of the Soul. Different religions from different countries have different beliefs of reincarnation. According to the Law of Karma, after death the soul is capable of passing to another body. The new body in which the soul is said to be reincarnated may be human, animal, plant or inanimate. According to the Hindu’s a good man may be reborn into a higher caste or perhaps even a god, were a lesser man becomes an insect or a worm. Cases One of the best documented cases is that of a young Indian girl named Shanti Devi living in Delhi (born 1926) who at the age of three began to recall details of a former life in the town of Mutta eighty miles away. She said she had married a cloth merchant, given birth to a son and died ten years later. Her claims continued and when she was nine years old her family wrote to her claimed husband who visited her home unannounced and was immediately recognized by Shanti Devi. A committee was set up to witness her visit to Mutta and testified the fact that she did recognize other relatives, knew the way to her former house, which she recognized and in fact revealed that money had been hidden in the house. The hiding place was found and her former husband admitted he had removed the money. The Pollock family is another well recognized case is that of the two little girls of the Pollock family who were killed by a run- away car in the town of Hexham in Northumberland. Twin girls born two years later to the same parents claimed dolls of the former children as their own. One said â€Å"That’s my Mary.’† The other girl said, â€Å"That’s my dolly that we had a long time ago†! Investigations Dr Ian Stevenson of the University of Virginia has spent thirty years investigation of reincarnation. His strongest cases are based on children with pre-natural memories that can be verified often in considerable detail and in circumstances that made it highly unlikely that the children would have searched the information. Other evidence that match marks on previous suspected incarnations particularly where they might relate to the death of the former individual, for example where the reincarnation of a gunshot victim has birthmarks which match the entry holes of the bullets in the victim.

Medical Tourism: Study Case of Ijn

Medical Tourism Sustainability through the Export Market Orientation Behaviours: The Case Study of Institut Jantung Negara (IJN) Ili-Salsabila Abd-Razak1 and Asmat Nizam Abdul Talib Universiti Utara Malaysia, Kedah, MALAYSIA The inclusion of tourism sector as one of the 12 recognized national key economic areas (NKEA) for the 10th Malaysia Plan represent the sector’s prospect in not only driving the nation’s economy, but also transforming the country into a high-income economy by 2020. With approximately 10 years left, many concerned groups are keen to know how this will be achieved.This paper aims at exposing the prospects of medical tourism as an essential subsector of tourism which would offer a number of proven benefits, and hence contribute to accomplishing the government aspiration of transforming the nation’s economy via the said sector. In discussing the subject, the case study method is employed involving Institut Jantung Negara (IJN) as an emerging medi cal tourism provider in the country. Findings of the case study are presented herein. Key words: medical tourism, economy, Institut Jantung NegaraIntroduction The promising prospect of tourism as an economic stimulator has enabled it to be included in the list of 12 National Key Economic Areas (NKEA), which has been specifically drafted to transform the Malaysian economy into high-income economy by year 2020. While there are tremendous numbers of tourism categories, ranging from environment, cultural, sports, and entertainment, to name a few, this paper intend to highlight on the prospects of medical tourism as a significant tourism-related economic contributor in this country. Connell (2006) defined medical tourism as health-related tourism involving specific medical intervention. Among the most popular medical tourism products are orthopaedic and cardiac surgery, which are very popular among Asian medical tourism providers, as well as executive health evaluations, cosmetic surgery , joint replacement, and similar complex medical, surgical and dental procedures (Horowitz and Rosensweig, 2007).Therefore this is a distinguished industry than that of the wider health tourism industry which involves tourists travelling to search for spas, yoga and meditation, or any other forms of health tourism (Connell, 2006; Garcia Altes, 2005). 1 Email: ili. [email  protected] com 169 In a relatively detailed account of medical tourism development which began in 1800s, Schroth and Khawaja (2007) proposed that the current phenomenon is different due to the unique combination of global demand and supply within the international medical market.As observed in the region, this proposition is regarded as well-founded. The present development of medical tourism in the international market is very unique, manifested by the escalating statistics of players, patients and revenues generated around the globe of late. How Malaysia is positioned within this backdrop, and how it would affe ct the development of this fast emerging economy, are among the focus of discussion of this paper. The Statistical Development of Medical Tourism Medical tourism has been a very significant industry over the years.By judging from its health travel umbrella, the sector is expected to generate some handsome revenue of RM240 billion (roughly USD73 billion) in 2010, with ASEAN contributing RM9. 6 billion (roughly USD3 billion) (PEMANDU, 2010). Specifically focusing on medical tourism industry, the anticipated revenue to be generated in Asia is RM14. 2 billion by 2012 (roughly USD4. 3 billion), with Malaysia is expected to bring in RM2. 1 billion (roughly USD64 million) from that amount (Ang, 2009).As a comparison, India, another top Asian medical tourism destination, expects to gain USD2 billion by the same year (Connell, 2006; Horowitz and Rosensweig, 2007). These statistics surely are translated by a growing number of medical tourists around the globe. The movement of medical tourists is another significant indicator of this trend. At the global stage, approximately 350 000 medical tourists moved from developed nations to less developed countries for treatment in 2003, while a year later 1. 18 million patients travelled to India alone and another 1. million to Thailand for the same reason (Horowitz and Rosensweig, 2007). Glancing at the local development, the Association of Private Hospitals of Malaysia (APHM) has been projecting for a stable 30% growth of takings from foreign patients until 2010. This is apparent from the steady increase of foreign patients to Malaysia which recorded a total of 39 114 patients in 1998 and 374 063 patients ten years later (APHM; Liow, 2009). In terms of revenue, RM14. 1 million was documented in 1998 before jumped to RM299. million in 2008 (APHM; Liow, 2009), and is expected to contribute to another RM540 million in 2010 (Leonard, 2009). The revenue per patient has almost tripled from RM360 in 1998 to RM800 in 2008 (Choy, 2010). In the latest development, medical tourism is expected to generate RM4294. 4 million of Gross National Income, together with 5295 jobs in 2020 (PEMANDU, 2010). This occurrence has readily attracted a number of giant MNCs with diversified structure such as General Electric (GE) to invest further in the industry (Panjanadan, 2010). The Revolution of Medical TourismThe presented statistics did not appear by chance. The numbers occurred out of plausible factors. The development of medical tourism industry is indeed different (Horowitz and Rosensweig, 2007). As mentioned earlier, Schroth and Khawaja attributed the uniqueness of the industry’s current development to the forces of market’s demand and supply, which is in resonance with Horowitz and Rosensweig (2007) who ascribed it to the movement of patients from industrialized nations to less developed countries. Connell (2006) argued that medical tourism is a niche which 170 xperienced rapid growth and has become an indust ry. The said paper also enlisted several factors promoting the development of medical tourism, such as the low costs factor, the long waiting list, the relatively affordable international air travel and favourable exchange rate, plus the aging of the baby boomers generation. These factors are also often cited in a number of studies regarding medical tourism such as Hansen (2008), Herrich (2007), Horowitz and Rosensweig (2007), Garcia Altes (2005), Marlowe and Sullivan (2007), and Schroth and Khawaja (2007), to name a few.Apart from these popular factors, other notable factors motivating the development of the industry spotted in the literature extent are the use of internet and mobility of technology, the unavailability of certain procedures in the local market, and the reduced trade barriers encouraging the mobility of workforce. Hansen (2008) argued that the revolution in medical tourism today is consumer-driven. This is in line with Horowitz and Rosensweig (2007) who argued that the industry is market driven with complex involvement of multitude medical, economic, social and political factors.While the progress of the industry seems to be very promising, the general overview of Malaysia’s involvement at the international level is not very charming. Even though medical tourism experienced an astounding per annum growth of 22% from 2004 to 2009, the global share is still considered as small with RM350 million in 2010 (PEMANDU, 2010). Furthermore, PEMANDU also reported that while the global healthcare travel is a multi-million dollar industry, Malaysia is yet to get a sizeable share.The said industry is expected to generate USD75 billion of revenue in 2010 at the global level, while Malaysia is expected to make about USD0. 1 billion. The statistics provide a brief sight on the development in the country weighted against the global development. Malaysia should therefore be proactive enough to catch up with the global progress to stay competitive in the i ndustry. To enable this, the players and responsible parties must quickly recognize potential constraints that can hamper the development and address the issues well.The Required Expertise and the Potential Economic Opportunities Based on previous arguments, medical tourism offers bountiful opportunities and chances. In order to remain competitive at the global stage, marketing strategies should be revised against the present circumstances. Marketing the medical expertise and offerings should be distinctively conducted. The primary concern of assessing an excellent marketing strategy is the effectiveness of the strategies implemented.StuartKregor (2005) argued that defining marketing excellence for medical-related industry is different with that of the commercial-based industry. As customer is the centre of marketing excellent in the industry, the paper suggested that the effectiveness of marketing strategies should then be done by measuring the customer’s satisfaction over t he service provided. Therefore, all other marketing excellence measured by considering the profit, return on investment or sales as in any other commercial industries should be changed to be more customer-oriented rather than organizationaloriented. Building he strategies can be done by â€Å"developing, communicating and delivering the right emotional benefits to the targeted customers† (Stuart-Kregor, 2005, pp. 117). The right emotional benefit here is viewed as brand by Stuart-Kregor (2005). This paper is in agreement with the argument, which is to develop the marketing strategies by focusing on the emotional benefits (brands), and assess the effectiveness of the strategies by measuring the satisfactions of the customer. Further discussion on this is available in the next section. 171 The science of excellent marketing strategies would be wasted without a good delivery system.The state of local expertise, technologies and facilities must be attended to in order to assess t he quality of the service offered against the global level. This is where the industry should strive to be as similar as other excellent providers. The commodification of medical tourism (Chee, 2007) is an evident of this occurrence. Dunn (2007) argued that patients are making choices on medical tourism destinations based on how similar is the service delivered, especially concerning patients from industrialized nations, and the service is expected to come with much lower price.Consequently, it is observed that patients are not looking for low cost products at the expense of the quality in the industry. Successful players realize this and capitalize on the factors well. This explains the rapid movement of workforce and technologies across the four corners of the world. India as an example has been successful in luring its medical doctors who have been trained and worked abroad to return with their internationally recognized expertise and work in the country.Thailand and United Arab Emirates have been successful in rearranging for international collaboration in the industry (Schroth and Khawaja, 2007). Through these strategies, the countries have been able to keep their expertise, technologies and facilities up with the global standard. Proposed Strategies of Reviving and Sustaining Medical Tourism: The Case of IJN With the national governments’ involvement recently (Chee, 2007; Noor Hazilah, Roslan Johari and Kadar, 2010; PEMANDU, 2010), the industry has been attracting the interest of many concerned parties.Since the medical tourism is fast becoming a commodity (Chee, 2007), its marketing strategies should be focusing more on brands and less on products to be distinctive than other providers. As in Malaysia, the country is capable of offering similar products with the rest of other players in the world. While Malaysia has been focusing on cost all this while, it is suggested then for the country to deliver a unique brand which is capable of attracting the interest of potential medical tourists, without desecrating the cost advantage.In order to do so, it is particularly important for the players to implement the export market orientation behaviours within their organization, which are generating, disseminating and responding to the export market intelligence (Cadogan, Diamantopoulos and de Mortanges, 1999). Consequently, Malaysia is expected to be able to woo medical tourism patients even more. Hazilah et al. (2010) reported that a medical tourist spends double than a regular tourist while they are in the country. This high buying power therefore is capable of generating more economic opportunities.The medical tourist needs are also offering a lot of opportunities for Malaysian. Apart from medical attention, they need to have accommodation for their accompanying family members. New jobs have been underway to better serve the medical tourists, such as the healthcare broker. A healthcare broker assists the patient to choose a medic al institute and arrange for the patient’s needs while in here, including visa, accommodation and holiday arrangement. Thanks to the internet, these can be arranged prior to the patient’s arrival in the country.To describe more of these strategies and opportunities, this paper choose to present the IJN as a case study merit the discussion. The National Heart Institute or Institut Jantung Negara (IJN) has been established in 1992. The privatization of the institute was done on many premises, especially concerning the potential it has to expand its expertise and to liberalize the 172 financial capabilities of the institute. IJN did not take long to materialize that. A year after its privatization the institute has been able to be financially liberalized and hence reduce the government intervention in its administration.By now, IJN has accomplished a great number of medical milestones recognized not only in the country and the region, but also internationally. To further advance ahead in medical industry, IJN is joining its local peer private institutions to take part in the global medical tourism industry. The previous mentioned factors of global medical tourism industry’s progressive development served as the basis for IJN to be a part of the industry. Besides, like Singapore, the medical tourism industry in Malaysia is receiving a lot of government’s assistants.Being a nationally structured industry, medical tourism therefore is regarded as a potential industry in which would be able to position IJN better. The Malaysian government has been playing an active role in developing the industry in Malaysia since 1998. The main driver of this is to revive the private medical industry after the 1997 Asian economic downturn which has affected the industry very badly. The success story of Thailand which managed to get the industry out of the crisis by focusing on delivering the service to foreign patients has prompt the government to encoura ge private players to do the same.Consequently, while Thailand has been restructuring the industry without much government involvement, Malaysia and Singapore has been leveraging the industry well with cooperation between the public and the private sectors. IJN has been viewing this very positively and has since become a significant player in the region. While being rapidly developing the industry, the players recognized several major constraints which are able to slow down the progress. Coordination is a key constraint. To increase coordination, the Association of Private Hospitals of Malaysia (APHM) was formed to increase coordination between the private players.The steadily increasing number of foreign patients and revenues generated since 1998 as shown in Table 1 is an evident of the successful strategies implemented. However the industry, weighted against the global development, was still considered as insignificant. Resulting from the government’s enthusiasm towards med ical tourism as a prospective economic driver industry, and the intensity and potentials portrayed by private sectors, the Malaysia Healthcare Travel Council (MHTC) was established in July 2009.The main purpose of the council is to coordinate promotional activities of medical and healthcare tourism industry in the country. As a part of the economic transformation program, the industry is expected to shift their attention to generate higher patients’ volume, expand the target market beyond Indonesia which is currently the main market of the industry, create alliance across border, and enhance customer experience in the first phase of the strategy. In the following phase, more attention is given on mproving the infrastructure and specialists capacity to attract the more profitable in-patient segment (PEMANDU, 2010). 173 Table 1. The Volume of Foreign Patients and Revenue Generated by Medical Tourism Industry in Malaysia Year 1998 2001 2002 2003 2004 2005 2006 2007 2008 Medical Tourists/Foreign Patients 39,114 75,210 84,585 102,946 174,189 232,161 296,687 341,288 374,063 Revenue (RM million) 14. 1 n/a 35. 9 58. 9 105. 0 150. 9 203. 66 253. 84 299. 1 Another strategy to improve the medical tourism performance is through focusing on specific players.There are approximately 223 private hospitals operating in the country in 2008 (Frost & Sullivan, 2009). Of this number, the government has decided to focus on 35 private hospitals to capitalize on the industry with several characteristics outlined. The characteristics include being a member of APHM, has obtained the Malaysian Society for Quality in Health (MSQH), ISO or other international accreditations, offers major specialties and/or some sub-specialties, provides for a minimum 50 beds, and has its own websites.IJN has been one of the selected 35. The commitment demonstrated by IJN towards the industry is paramount. In order to be internationally recognized, the institute has been striving hard to be in the s ame par with the other international organizations. IJN has been accredited by JCI in 2009, which is a recognition of the strong culture of safety and quality within the organization. The internationally recognized accreditation is expected to improve IJN’s international positioning in the future.IJN realizes that in order to make the most of the industry, it needs to build a customer-oriented system. Beginning in 2006, the institute has been conducting the Customer Focused Program. The program was aimed at transforming IJN into a global centre of excellence by ensuring customers’ satisfaction. In 2008, the institute launched what was designed as the second phase of the program, called Customer Focused Culture. While the CFP was initiated to increase awareness of ensuring customers’ satisfaction, the CFC aimed at internalizing the institute’s shared values across the rganization. IJN also comprehend its capacity constraint which is becoming the largest hi ndrance from going big in the global medical tourism industry. Apart from improving on its culture system, the institute has been adamant in enhancing its infrastructure capabilities. A major extension work has been carried out at IJN to expand its capacities from 270 beds to 432, eight wards to 13, 23 outpatient clinic rooms to 59, and an international patient centre, to improve its service for customers.This is in line with numerous governments’ incentives offered to the private hospitals embarking on medical tourism industry to expand their infrastructure capacities. In August 2009, IJN has its new wing officiated by the Malaysian Prime Minister, who acknowledged that the institute has undergone RM230 million expansion program since 2005. In the same ceremony, the Prime Minister has also announced the proposal for IJN to become a research and development institute, measuring itself against the international best heart institute such as the Cleveland Clinic Heart Centre in the US.These are all evidences of how IJN has been greatly employing the export market orientation behaviors within its organization. In commenting the current development of the industry, IJN has expressed its concern for the country to be more progressive towards promoting medical tourism. 174 The IJN Holdings Group Managing Director, Datuk Mohd. Radzif Mohd. Yunus mentioned that the failure for Malaysia to capitalize on its capabilities in the industry would result to the loss of human capital as they will migrate to other countries with better offers.This is also reiterated by Datuk Syed Hussien Al-Habshee, the Secretary General of National Chambers of Commerce and Industry Malaysia (NCCIM) who said that the country need to step up its marketing efforts of medical tourism if it wants to catch up with Thailand and Singapore. PEMANDU (2010) has confirmed the assertion by reporting on the stronger growth of the industry by neighboring Thailand and Singapore. The set up of MHTC and several other initiatives are therefore deemed as timely to help Malaysia to rise in the industry at the global stage.Conclusion and Recommendation As exemplified in the discussion, medical tourism offers a lot of economic opportunities and hence is indeed a potential contributor to economic growth. However, Malaysia, while has been enjoying the growth of the industry vehemently over the pass few years, has not been capitalizing the industry well compared to the other global players. Therefore, the Malaysian players need to revise their marketing strategies and delivery system, as represented by IJN.The cooperative efforts between the public (government) and the private sectors too must be further carried on, especially for the sake of protecting the interests of the local society and the survival of the medical tourism players. It is strongly suggested for medical tourism players in the country to leverage on their expertise by focusing the marketing strategies on brands rather tha n on products, as well as enhancing on their infrastructure and culture systems to be more export market-oriented. In doing so, however, the players must not disregard the country’s current edge, which is the competitive cost.In terms of theoretical development, this paper is believed to be able to expose the medical tourism niche and its economic opportunities, as well as the marketing strategies fitting the industry. Quite a number of studies involving Malaysian medical tourism industry have been conducted. Nonetheless, this paper presents the scenario from the view of a single case study. It is highly suggested for similar studies to be conducted with the presence of empirical data to see the quantifiable aspects of the industry in the future.With such studies, it is expected that further theoretical contributions can be made, and hence the progress of the industry can then be expedited even more. Reference Ang, Elaine. Malaysian Medical Tourism Growing. The Star, February 14, 2009. Cadogan, J. W. , Diamantopoulos, A. , & de Mortanges, C. P. (1999). A measure of export market orientation: Scale development and cross-cultural validation. Journal of International Business Studies, 30(4), 689-707. Chee, H. L. (2007, January). Medical tourism in Malaysia: International movement of healthcare consumers and the commodification of healthcare. ARI Working Paper, No. 3. Retrieved from www. ari. nus. edu. sg/pub/wps. htm Choy, L. B. (2010, April 13). Medical tourism good for Malaysia’s health. News Straits Times. Retrieved from http://findarticles. com/p/news-articles/newstraits-times/mi_8016/is_20100413/ medical-tourism-malaysias health/ai_n53130944/ 175 Connell, J. (2006). Medical Tourism: Sea, sun, sand and †¦ surgery. Tourism Management, 27. 1093-1100. Dunn, P. 2007. Medical Tourism Takes Flight. Hospitals and Health Networks, 81(11): 40-44. Frost & Sullivan (2009, October 28). Frost & Sullivan: Growing healthcare tourism in Malaysia. Retrieved from http://www. alaysiahealthcare. com/ Garcia-Altes, A. (2005). The development of health tourism services. Annals of Tourism Research, 32 (1): 262-266. Hansen, F. (2008). A revolution in healthcare. Review-Institute of Public Affairs, 59(4), 43-45. Health and medical tourism will boost growth: Datuk Liow Tiong Lai. The Star, November 08, 2008. Retrieved from http://www. wellnessvisit. com/liowhealth-and-medical-tourism-will-boost-growth. php Herrick, D. M. (2007, November). Medical tourism: Global competition in health care. NCPA Policy Report, No. 304. Retrieved from www. ncpa. org/pub/st/st304 Horowitz, M. D. Rosensweig, J. A. , & Jones, C. A. (2007). Medical tourism: Globalization of healthcare marketplace. Medscape General Medicine, 9(4), 33. Leonard, T. (2009, October 28). Medical tourists to bring in RM540mil by 2020. Retrieved from http://www. malaysiahealthcare. com/ Marlowe, J. , & Sullivan, P. (2007). Medical tourism: The ultimate outsourcing. HR. Human Resource Planni ng, 30(2), 8-10. Noor Hazilah Abd Manaf, Roslan Johari Dato’ Mohd Ghazali, & Kadar Marikar. (2010). â€Å"Positioning Malaysia in Medical Tourism†. Paper presented at the International Conference on Marketing (ICMAR), June 2010, in Kuala Lumpur.Panjanadan, S. (2009, August 9). GE looking into enhancing presence in tourism Retrieved from healthcare. http://bernama. com/bernama/v5/newsbusiness. php? id=519842 PEMANDU (2010, September 21). Healthcare-EPP Panels. Retrieved from http://www. pemandu. gov. my/index. php? option=com_content&view=article&i d=619&Itemid=139&lang=en Schroth, L. , & Khawaja, R. (2007). Globalization of healthcare. Frontiers of Health Services Management, 24(2), 19-30. Speech by YB Dato’ Sri Liow Tiong Lai, Minister of Health Malaysia, at the APHM International Healthcare Conference and Exhibition at KLCC,