Tan Maw Pin: It takes a spark

She wanted an Asian meeting on falls prevention but her passion led to her becoming chairperson to the inaugural World Congress On Falls and Postural Stability

Tan Maw Pin

You had smaller plans initially – to organise an Asian falls prevention meeting in Malaysia. The idea went on to become the first World Congress on Falls and Postural Stability (WCFPS), held in Kuala Lumpur last December. What transpired?
In the first half of 2017, I approached the Malaysia Convention & Exhibition Bureau (MyCEB) to ask if they would consider funding an Asian-based falls prevention meeting.
At the time, other parts of the world were holding such meetings. There was the European Falls Festival and the biennial Australia and New Zealand Falls Prevention Conference, but there was no such platform in Asia.

Malaysia Convention & Exhibition Bureau (MyCEB) did some research on their own and came across the International Conference on Falls and Postural Stability, which had been held successfully in UK by the British Geriatrics Society (BGS) for nearly two decades.
The MyCEB representative in London went to meet the publicity arm of BGS and proposed the idea of bringing the conference to Malaysia.

BGS initially thought it was a good idea and an opportunity to make more connections in Asia. MyCEB then developed a bid proposal and offered to fund my attending the 18th International Conference on Falls and Postural Stability in Birmingham in 2017.

That’s where I met Tash Masud, president elect, BGS and chair of the Falls and Bone Health Special Interest Group (SIG) in 2017. I presented the bid proposal to the Falls and Bone Health SIG committee informally on the eve of the 18th International Conference on Falls and Postural Stability and he explained that the conference will not leave the UK because its members would not receive much funding support to attend the conference if it were to be held overseas.

However, Masud went on to suggest that it would be a good idea to work together to hold a world congress on falls and postural stability and that such a meeting was long overdue. After further negotiations mediated by MyCEB, the meeting materialised.

What were the concerns BGS had before they agreed to come onboard?
We had to convince the BGS that the Malaysian Society of Geriatric Medicine (MSGM) had the capacity to organise the congress. At that time, our society had only 70 members whereas the BGS had over 3,000, comprising professionals specialising in the healthcare of older people across the UK.

It helped that Masud knew me as I had worked under him when I was a young doctor in the UK. He knew and trusted me and that helped make the conversations easier.
We also had to convince BGS that Kuala Lumpur had the facilities and capabilities to hold the congress. MyCEB assisted by funding a BGS delegation for a site inspection. It was only after seeing the facilities at Kuala Lumpur Convention Centre and a few key hotels that they were convinced.

Asia has benefited from the WCFPS.
Yes, there is no doubt about that. The WCFPS attracted 450 delegates, half of which were Malaysians and the rest from Asia. They came mainly from Singapore, Japan and South Korea.

The congress provided a platform for Asians to share their research on falls and postural stability. This meant that the world could also come to know that Asians have researching on these areas.

We have developed advanced technology to prevent falls such as robots to help people rehabilitate and sensors that can detect imminent falls to prevent them from happening. The majority of the non-Asian delegates were from Australia, the UK and the Netherlands.

The congress provided opportunities for early career researchers and early career falls practitioners to meet key opinion leaders from all over the world. When you go to a large congress on geriatrics, it could be difficult to find people interested in the research area of falls, but everyone who came to the WCFPS were interested in falls research.

So, it was very specific group of people the delegates could speak to.

Has the society brought up any issues to the Ministry of Health Malaysia after the congress?
Yes, we have. Issues raised during the WCFPS include not having sufficient geriatricians in government hospitals in Malaysia, retention of staff specialising in geriatric healthcare in the civil service, inadequate remuneration for civil servants in the healthcare sector as well as support in developing age-friendly services.

These issues were submitted to the Ministry of Health earlier this year along with the MSGM’s strategic report. This report is our action plan and recommendation to the ministry on how we can work with all stakeholders to enhance the health of our senior population.

What is the future like for the WCFPS?
It has been decided there will be a world congress every three years. Interested parties will have to bid for it. At its first run, it was provisionally decided that the 2nd WCFPS will be hosted by the Australia and New Zealand Falls Prevention Society, and held together with their regular meeting in Perth in 2022.

The (Malaysian) organising committee intends to set up a steering committee and are in the process of developing guidelines for future WCFPS. This is important to ensure that our efforts to initiate such a meeting are not wasted.

The MSGM will therefore take on the responsibility as inaugural hosts of ensuring the continuity and longevity of this event. We have plans now to initiate an Asian Falls Network and we hope that an Asian Falls and Postural Stability Meeting can be held in 2021.

What new projects are you busy with now?
I am involved in the AGELESS Project where I am the overall programme lead. AGELESS is an acronym for Transforming Cognitive Frailty to Later Life Self-Sufficiency. This project also involves researchers from seven other local universities. We received a RM6 million (US$1.4 million) grant from the Ministry of Education Malaysia for this five-year project, which is a study aimed at addressing cognitive frailty in older persons.

Currently, medical professionals deal with dementia and frailty in older people separately. What we want to do is to develop early detection of cognitive frailty and to develop strategies to address these two conditions together.

What events in your life led you to the area of geriatric medicine and research?
When I was training in the UK, I worked for two months as a house officer on the geriatric ward. I noticed that older people were treated as second class citizens, to put it simply. On ward rounds, doctors walked past them and older people were denied treatment simply on the basis of age. What’s worse was that they were denied what everybody deserves – a good death at home, surrounded by family and friends. Like most young people, I wanted to save the world.

As I delved deeper into geriatric medicine, I realised that saving the world in the 21st century means preparing for an ageing population. I made a conscious effort to fully immerse myself in this area to make life better for older people.

You are the founding secretary of the MSGM, which was set up in 2012. What would you say is the society’s biggest challenge?
The main issue is getting people from various sectors in geriatrics – such as geriatricians, allied health professionals and people interested in developing healthcare services for older people – to work together on a common agenda.

Why is it so hard?
Doctors are very independently-minded people. However, we are fortunate that geriatricians are natural team players. We may have arguments, but at the end of the day, everyone still pulls together. Events like the WCFPS and organising annual conferences will always pull people together. You know the saying – united we stand, divided we fall.

Speaking of pulling people together, has the congress helped to attract new members?
Yes, we have many more who have signed up as members and it has certainly created more awareness of the work we do.

Prior to the congress, we hired a publicity personnel to generate media awareness on the event and its importance. For people to join our society, they must first recognise the benefits of becoming a member.

We hold an annual national conference which provides members with knowledge sharing sessions and networking opportunities. There is also a WhatsApp forum for members to post queries about the administration of the society, exchange ideas, ask advice from fellow members and address issues raised by members.

For example, if my patient wants to move to another healthcare facility in the country, I can post a query and quickly get information on what is available.

How does the MSGM raise funds for outreach programmes that promote awareness of health issues among older people?
It sounds strange, but money it is not the most important thing. The most crucial part in running programmes is the human capital.

As the society’s main role is to raise awareness on geriatic medicine and provide relevant education, our events involve conferences and workshops. Attendees are mainly healthcare professionals keen to learn about how to improve the way they provide healthcare to older persons.

Our job is to make these events affordable for them, and they will willingly pay registration fees to attend our events if they see the value they get for their money.

What are the MSGM’s plans for the future?
We are going to place our attention on Malaysia’s response to an ageing population as well as the ageing agenda in developing nations.

Malaysia is unique in that we have repeatedly been named a leading retirement destination globally. We are therefore confident, that if we plan carefully and learn from other countries’ experience in policy for population ageing, we will be able to ensure our country benefits and reaps its dividends from an ageing population.

The MSGM feels that we are well placed in moving forward the population ageing agenda for Malaysia with our critical mass of highly motivated and passionate members.

In addition, we would like to bring to light that most older people now live in developing countries, while nearly all the research and development have occurred in developed countries. We are determined to shout as loud as possible that developing countries matter just as much and no one should be left behind.