OBG talks to Dr Kenneth Y Y Kok, Medical Director, Brunei Cancer Centre

Interview: Dr Kenneth Y Y Kok

How can Brunei Darussalam cope with the rising cost of health care provision while maintaining a high quality of service?

KEENNETH Y Y KOK: The cost of health care is indeed increasing in most parts of the world. However, if you look at the provision of cancer treatment in Brunei Darussalam, the nation currently does not have radiotherapy services available. This means that a Bruneian citizen will need to be sent overseas for this treatment, most frequently to Singapore or Malaysia. Imagine the amount spent on sending these patients overseas, which includes not only the procedure itself but also travel and accommodations for both the patient and their loved ones, and take into account that the average time for such treatment is four to six weeks. In terms of calculable costs, having facilities such as those required for radiotherapy in Brunei Darussalam will result in significant savings. Thus, while the government must spend, savings will undoubtedly result in the long run.

It is important to note that modern-day cancer treatment is very specific and technology-centric, so such investments are necessary to providing the required treatment, especially with regard to rare diagnoses and inaccessible cancers. We have already allocated the budget necessary to purchase the latest radiotherapy machines, and the government is very willing to make investments that will ensure its people have access to the best treatment possible.

Other technology expenditures include the purchase of the latest oncological drugs, as well as nuclear medicine whereby radioisotopes are used to tell if a cancer has spread to and is targeting specific cells.

What role do the various centres for excellence play in establishing the Sultanate as a regional leader in health care provision?

KOK: Brunei Darussalam has made great strides in establishing itself as a regional health care provider, thanks in large part to the excellence centres available. These include the Cardiac Centre, the Neuroscience and Stroke Rehabilitation Centre, the Brunei Cancer Centre and the Jerudong Park Medical Centre, which is a private hospital. Furthermore, these four centres are all situated on one campus in Jerudong, forming a true regional focal point for health care services.

What investments in local capacity is the Sultanate making to ensure the sustainability of the sector?

KOK: Other than the necessary technology and equipment, human resources are key to the future well-being of the sector. We are actively recruiting from both within the region and the US and Europe, casting our nets to attract truly world-class expertise. However, in order to ensure a sustainable health care sector we must train our own people from our own universities. We also routinely send doctors and technical staff overseas to provide the best training possible, usually to the UK, Singapore, Malaysia and other nations depending on the nature of the courses involved. This build-up of our local human capital is one of our foremost areas of focus.

What measures is the government taking to increase public awareness regarding non-communicable diseases, such as cancer?

KOK: All governments, Brunei Darussalam included, are concentrating on increasing public awareness when it comes to health care. Responsibility does not start and end with treating a patient, but encompasses the whole spectrum. Everything starts with public awareness and the encouragement of screenings. The Ministry of Health is leading a campaign through its Health Promotion Centre to ensure that the correct information is disseminated and to educate local communities. After this comes screening, as the chances of successful treatment are higher if a cancer is diagnosed at an early stage. While treatment remains our main focus, prevention is certainly better than a cure. It is important to recognise that diseases such as cancer span a spectrum of stages, and Brunei Darussalam is certainly making strides through public awareness campaigns.