
Stalwart's call to defend future generations
PETALING JAYA: The fight against tobacco is not just about eliminating a habit; it's about safeguarding our future generations, says NV Subbarow (pic), a stalwart of Malaysia's anti-smoking movement.
As an education officer with the Consumers Association of Penang, Subbarow has spent nearly 35 years championing tobacco control, recently earning the prestigious Tobacco Control Icon Award from the Health Ministry during the 2025 National Tobacco Control Conference and the national-level World No Tobacco Day celebration.
His work, which involves conducting lectures, interactive sessions, and discussions with students to highlight the dangers of smoking and vaping, has had a tangible impact that has seen many young Malaysians abandon these harmful habits.
Subbarow's journey began with a focus on traditional cigarettes, but as the landscape of tobacco use evolved, so did his strategies.
'When I started, it was just cigarettes. Now, the rise of disposable vapes presents a new challenge.
'These devices, often marketed in enticing flavours and easily accessible, have become a simple and inexpensive alternative for many, particularly the youth,' he said, adding that his interactions revealed a concerning trend.
'Children as young as eight or nine have been experimenting with vapes left unattended by family members.
'It's shocking when children say they were encouraged to try these gadgets under the guise of fruit flavours,' he said, highlighting a disturbing trend of rural vapers mixing substances like drugs and stimulants with the vaporiser's liquid.
To achieve both educational and cautionary results, Subbarow said he uses vivid imagery of nicotine's effects and the dangers of e-cigarette or vaping-associated lung injury (Evali) to drive home the risks.
'Seeing these images often frightens students into quitting immediately,' he said, adding that the fear of having erectile dysfunction also works among older male students.
As Subbarow looks to the future, his resolve is unshaken.
Subbarow draws inspiration from figures such as the late SM Mohd Idris, the former president of CAP, and Dr Mary Assunta, an internationally renowned tobacco control researcher, whose legacies fuel his unwavering determination.
'Winning the award doesn't stop my campaign. I've got five more school programmes lined up after the holidays.
'I won't give up until Malaysia is smoke-free,' he said, adding that 20 students are currently seeking his guidance to quit vaping.
So far, he has reached about 30,000 individuals, including students, undergraduates, and youths from various backgrounds.
Teachers and parents have called him to convey their gratitude, sharing stories of how their children have abandoned the smoking culture.
Subbarow also called for stronger policies, including the Generational Endgame Bill aimed at a tobacco-free society by 2040.
'Without action, the vape culture will lead to more drug addicts in our country.
'The Malaysian government cannot wait further to implement a total ban on smoking and vaping products, whether they come with flavours or otherwise.
'State governments that delay action are sitting on a ticking time bomb, creating a critical issue,' he said.
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The Star
an hour ago
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Paid less than unskilled labourers, community health workers in India go on strike
BENGALURU: Thousands of community health workers in the south Indian state of Kerala have been on strike for more than 110 days. Their demands? Better pay, reduced workload, social security and dignity. This is not the first time they have protested against work conditions, nor are they the only state's health workers in India to do so. In Kerala's capital, Thiruvananthapuram, female community health workers known as Accredited Social Health Activists (Ashas) have been in a day-and-night protest opposite the state secretariat since Feb 10. Yet four meetings with state Health Ministry officials have been inconclusive. Under the national Asha programme, every village or urban ward has a resident health worker who helps ensure people's access to vaccination, safe childbirth and seasonal epidemic checks. In Kerala, these women were on the front line of the state's famously superb Covid-19 response that earned praise from the World Health Organisation. After the devastating 2018 floods in Kerala, they were also at the forefront of preventing rampant waterborne diseases. The health workers' grievances of poor pay and lack of respect stand at odds with Kerala's highly reputed public health system, which has achieved better disease control and maternal mortality and immunisation rates than most other states. Studies credit these healthcare triumphs to decentralised governance and the community engagement by more than 26,000 grassroots health workers. The Indian government defines Asha work under a national programme as voluntary, and the workers' payment an honorarium, not a wage. The workers are paid largely by the local state governments, with each state setting its own honorarium. When the Asha programme was launched in 2005, the honorarium nationwide was 500 rupees (US$5.83) a month. In Kerala, it has been gradually increased in response to protests every few years, up to 7,000 rupees a month since 2024. This still amounts to around 230 rupees a day, only a third of Kerala's legal minimum wage for unskilled labourers, which is 700 rupees. Ashas are also eligible for up to 3,000 rupees a month in performance-based incentives – this is paid by the state and national governments in a 60:40 ratio. 'I was shocked to discover how little the front-line workers of Kerala's proactive health system are paid. It's insulting,' said Dr Gopika Swarna Bai, a community health physician from Kerala who is now doing her residency in Mumbai, where Ashas are paid 13,000 rupees a month. 'Ashas know every household. For example, they spread awareness of a mass drug administration for filariasis for weeks, bring the 100 people, find chairs and shelter for them on a fixed date for doctors like me to just go and administer injections,' Dr Gopika added, noting that government nurses and doctors could be transferred, but Ashas have 'backyard knowledge' as they stay put in a region for decades. All states have raised the honorariums over the years in response to demands and protests. Neighbouring Karnataka increased the fixed honorarium from 5,000 to 10,000 rupees in January after an eight-year campaign by health workers. The north-eastern state of Sikkim has paid Ashas 10,000 rupees a month since 2022; Puducherry in the south pays them 18,000 rupees. In West Bengal, health workers retiring at 65 years old get a one-time payout of 500,000 rupees – the same amount Kerala's Ashas want. Striking health workers in Kerala are demanding minimum wages, which would amount to 21,000 rupees a month. Bindu B., a community health worker in the Kannammoola ward of Thiruvananthapuram city, points to 'the hypocrisy of the communist-led state government that enjoys the plaudits of being people- and worker-centric leaders, but treats women workers almost like slaves'. The 51-year-old, who has been an Asha for 18 years, spoke to The Straits Times on May 30 as she was headed to the protest site, even though there was an orange alert for rainstorms that week. At least 12,000 Ashas like her have endured extreme rain and heat for over 110 days, and held dramatic protests, including a 41-day hunger strike and cutting their hair off. Some of them are now on a statewide march, spending the night under bus shelters or on school verandas as they reach out to Ashas who may not have been able to travel to the Thiruvananthapuram protest site. 'The government's response is that they don't have funds, that the central government has not transferred the budget,' said S. Mini, state vice-president of the Kerala Asha Health Workers Association, which is helming the ongoing strike. Kerala is among several states, such as Tamil Nadu and Telangana, led by opposition parties demanding a greater share of taxes from Indian Prime Minister Narendra Modi's Bharatiya Janata Party government at the centre. India spends a mere 1.14 per cent of its budget on public health. 'Understanding Kerala's financial situation, we asked the (Kerala) Health Minister to increase the pay for now by 100 rupees a day, so that we can get 10,000 rupees a month at least,' said Rosy Mardra, 51, an Asha who was part of the delegation that met officials, of the last meeting. 'They refused even that.' Kerala's Health Ministry has yet to respond to ST's queries. A state official, who requested anonymity, pointed ST to a recent central government study that found the state's financial health poor, ranking 15th among 28 states owing to high social welfare spending and limited revenue growth. He also argued that Kerala paid the honorariums more regularly than other states that promised more, but Ashas have refuted this claim, saying they sometimes do not get paid for over three months. Rosy, struggling to repay loans she took to send her two daughters to college, was enraged by what she called 'the government's cruel excuses'. 'Amid this financial crunch, how come the Kerala government has 100 crore (one billion) rupees to celebrate its fourth anniversary, but does not give us 100 rupees more?' she asked. The cost of living in Kerala is higher than the national average. Some estimates put average monthly expenses excluding rent at more than 27,000 rupees per month. Almost all Ashas in Kerala are from low-income families, and three-quarters are sole breadwinners while a quarter are Dalits, who are at the bottom of India's caste hierarchy, said feminist scholar J. Devika, who conducted spot surveys of striking health workers. 'Families in Kerala are kept safe by these women's cheap labour. They've clearly had enough. Without committed, financially secure Ashas, the state's health indices and disease control will collapse,' she added. Since joining the service at the age of 32, Bindu's work hours have ballooned from two hours a day, per government guidelines, to at least 12 hours a day of fieldwork and report writing. She is responsible for 950 households, and performs 100 tasks each month assigned by the national health programme. These include registering pregnancies, ensuring child immunisations, doing leprosy checks, detecting sources of waterborne diseases, and monitoring fevers or other symptoms in vulnerable populations during epidemics. Kerala has assigned her ten other responsibilities, such as conducting surveys for the local government and digitising a lot of health data. Some days, she is chlorinating wells, and other days, she is collecting diabetes data from every household. The latest task, which many Ashas told ST was a trigger for the ongoing strike, was the Kerala government's app-based statewide screening for non-communicable diseases. Launched in 2023 to detect and prevent lifestyle diseases, the Shaili app's initial phases have shown 45 per cent of the population at risk for diabetes, cancer, tuberculosis and hypertension. But Ashas alleged that having to ask 60 questions a household within tight deadlines over a glitchy app, which does not work in areas with poor data networks, made the job so onerous that it affected other tasks. 'Even as the workload grew and took on a compulsory nature, the pay remains an honorarium fit for volunteers,' social activist Shradha S. said, also a co-founder of a menstruation awareness collective in Kerala. 'The current pay is too little and too erratic, and I keep having to take loans to get by,' said Bindu, who recently took on a second job to make ends meet. After dusk, she delivers medicine for a neighbourhood pharmacy. It pays her 10,000 rupees a month. 'After my husband died a decade ago, my son had to drop out of college to work, and I married my daughter off early at 20 years to have one less mouth to feed,' she told ST. To Bindu, the strike was 'the only step left to save me from dying of exhaustion'. The strike has had a few wins, with Kerala's Health Minister, Veena George, announcing that the Ashas' monthly pay is no longer tied to the fulfilment of ten state tasks, although the fine print reveals that it is still tied to the incentives. The state has also formed a committee to investigate the need for a pay hike. But Chief Minister Pinarayi Vijayan has stated that the government will not engage in further negotiations. As the monsoon sets in, the health workers will also have to begin awareness campaigns to prevent waterborne and mosquito-related diseases like dengue, filariasis and malaria. Cognisant of the impact of their absence on the community, and struggling without any income for three months, most Ashas have gone back to work now. But many are still making time to spend a few hours at the protest site. 'What began as a simple protest seeking fair compensation and lower workload has now turned into a cry for respect and parity,' said Rosy. Bindu has been going to the protest site and conducting her fieldwork despite requiring rest for a ligament tear. 'In my area, there is one palliative care patient with cancer; 13 senior citizens, of whom eight are on (intravenous drips); 150 children are under five years old; 14 kids are under one year (old). I know where mosquitoes breed regularly. This week, four people had a fever – I took them for testing, and two turned out positive for Covid-19.' She asked: 'Who will know people in this detail if I don't go to work? 'Why doesn't the government see us?' - The Straits Times/ANN


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The Star
4 hours ago
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Act now or face vaping fallout, say health experts
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