Pregnancy With Hypertension (High Blood)

BY DR NORAFIDAH AHMAD
CONSULTANT OBSTETRICIAN AND GYNAECOLOGIST
KPJ SABAH SPECIALIST HOSPITAL KOTA KINABALU

Hypertension is also known as high blood pressure. It is a commonest medical problem encountered in pregnancy. Due to this, blood pressure is routinely assessed during each antenatal visit.

Blood pressure readings are recorded as two numbers. Systolic blood pressure is the higher reading. It measures the pressure in the blood vessel wall when the heart contracts. Normal readings of systolic blood pressure are about 120mmHg (millimetres of mercury). Diastolic blood pressure is the lower reading. It measures the pressure in the blood vessels when the heart relaxes between beats. Normal readings of diastolic blood pressure are about 80mmHg. When the blood pressure is consistently 140/90 or higher, hypertension is diagnosed. Severe hypertension occurs when the blood pressure is 160/110 mmHg or higher.

Hypertension complicates 10 to 15% of all pregnancies. Hypertension in pregnancy can be divided into pre-existing hypertension, pregnancy induced hypertension and pre-eclampsia. Pre-eclampsia affects 3 to 5 % of all pregnancies. Eclampsia occurs in approximately 1% of women with pre-eclampsia. It is a serious medical condition which is associated with convulsions and other complications such as stroke, kidney and liver failure.

Pre-existing hypertension is also known as chronic hypertension. In pre-existing hypertension, women are usually diagnosed as hypertensive prior to pregnancy. If hypertension is noted for the first time in the early pregnancy it is also likely that it is a chronic pre-existing problem. In this type of hypertension, the blood pressure will not return to normal after delivery.

Pregnancy induced hypertension is diagnosed when a woman’s blood pressure is normal before pregnancy but consistently rises to more than 140/90 mmHg after about 20 weeks of pregnancy. The blood pressure usually returns to normal after childbirth. However, some women may remain hypertensive following delivery and continue to develop chronic hypertension.

Pre-eclampsia is a condition where the maternal blood pressure is elevated in the second half of pregnancy along with presence of other signs and symptoms such as an abnormal level of protein in the urine and abnormal blood results. It is a potentially serious condition which can threaten the health of mother and baby.

Pre-eclampsia can also occur in women with pre-existing chronic hypertension. This carries a higher risk to mother and baby as compared to chronic hypertension alone. Regular monitoring is required to detect this superimposed pre-eclampsia condition.

In women with pregnancy induced hypertension and pre-existing hypertension, blood pressure must be regularly monitored. Treatment to lower blood pressure is important if blood pressure readings are consistently higher than normal. This is in order to avoid serious complications for mother and baby. However for mild to moderate hypertension, medication may or may not be recommended. Severe hypertension always requires prompt treatment to lower the blood pressure. There are a few types of anti-hypertensive medications which are available and safe to be used in pregnancy. Although some may cause side effects, they are usually well tolerated by most women. In some women, a combination of medications may be necessary to achieve good blood pressure control.

Pre-eclampsia affects one in every 10 pregnancies. Its severity varies from mild to severe. Pre-eclampsia can progress to eclampsia if left untreated or does not respond to treatment. Eclampsia
is a medical emergency and requires urgent multidisciplinary treatment to ensure safety of mother and baby.

The exact cause of pre-eclampsia remains unclear. It is most likely due to problems with the development of the placenta during the early stages of the pregnancy. Placenta is a tissue which carries oxygen and nutrients from the mother to the baby. Failure of implantation of placenta to the wall of the uterus causes baby at risk of not receiving oxygen and nutrients.

Although it is not possible to accurately predict the women who will develop pre-eclampsia, several risk factors such as general, genetic and medical factors are found to be associated with this condition. The risk factors includes teenage or advance maternal age, obesity, history of previous pregnancy with pre-eclampsia, women with a mother or sister with a history of pre-eclampsia, first pregnancy, twin or multiple pregnancy, long birth interval and some fetal chromosomal disorders. Woman with pre-existing medical conditions such as diabetes, kidney disease, chronic hypertension, autoimmune disorders and blood clotting disorders are also at risk of developing pre-eclampsia.

Photo source: Organic Fact

Pre-eclampsia usually occurs in the third trimester of pregnancy (28 weeks onwards) although in some women it may occur earlier. Women with pre-eclampsia are usually asymptomatic when the disease first occurs. They commonly present with elevated blood pressure and abnormal level of protein in the urine. Apart from that, they can also develop significant symptoms such as rapidly progressive swelling over hand, face and feet; visual disturbance; pain over upper abdomen; vomiting and headache.

If pre-eclampsia is diagnosed, admission to hospital is usually required. Blood pressure is monitored closely. High blood pressure may require oral or intravenous anti-hypertensive medications. Blood and urine tests are performed. Urine test will be able to quantify the level of protein in the urine. Blood tests are carried out to look for altered blood clotting, abnormal liver and kidney function. Monitoring of the baby’s well being can be done by assessing baby’s heart rate tracing, growth, blood flow in the umbilical cord and the amount of amniotic fluid.

The only cure for pre-eclampsia is delivery. However, if the pregnancy is less than 36 weeks, the decision to deliver will be based on the severity of the pre-eclampsia and the risk of prematurity. A major consideration in treating women with pre-eclampsia is to promote the baby’s growth for as long as possible in the uterus whilst keeping the mother’s risk under control. The delivery is however indicated if there is presence of any of the following conditions which are the inability to control maternal blood pressure; worsening general health and well being of the woman such as deterioration of kidney or liver function and reduction in blood platelet level which is important for proper blood clotting; presence of maternal symptoms such as severe headache, vomiting, visual disturbance and upper abdominal pain; baby not growing or showing signs of compromise; placental abruption (separation of placenta from the wall of the uterus) and if woman develop eclampsia.

If delivery is indicated in woman with pre-eclampsia, labour can be induced with medication to stimulate uterine contraction. The woman’s blood pressure is closely monitored throughout labour. High blood pressure will be given medication. If blood clotting is normal, epidural anaesthesia may be recommended. This is in order to relieve pain, lowers blood pressure and improve blood flow to the placenta. Baby’s well being is continuously assessed. If the baby is showing signs of distress, immediate delivery is necessary such as caesarean section.

If the pregnancy is less than 34 weeks, caesarean section is often recommended. This is because inducing labour can be difficult at early gestation and caesarean section is considered in the best interest of both mother and baby. In such cases, woman will usually receive steroid injections before delivery. This is to reduce risk of infant developing respiratory distress, bleeding into the brain and death after delivery.

After delivery, the mother needs to be closely monitored for at least the first 24 to 48 hours. The high blood pressure usually does not settle within first few days after delivery, so anti-hypertensive medication may need to be continued until blood pressure is stabilised. Blood pressure may take up to 3 months to return to normal. Woman should discuss with the doctor regarding risk or pre-eclampsia recurring in her next pregnancy and preventive measures.

Clinical studies have shown that a low dose of aspirin supplementation in early pregnancy may be able to reduce the risk of developing pre-eclampsia by about 15%. It should be started before 12 weeks gestation and continued throughout pregnancy. Apart from that, for women with a low calcium intake, supplementation with calcium during pregnancy may be able to reduce risk of pre-eclampsia.

If you have any enquiries relating to this topic, please do not hesitate to contact Dr. Norafidah Ahmad, Consultant Obstetrician and Gynaecologist at KPJ Sabah Specialist Hospital.

AJFC Malaysia 2018 crowns Sabah Region champions

Kota Kinabalu, 12 May 2018 – Eighteen young Sabahan footballers are one step closer to earning a golden ticket to be part of the Allianz Junior Football Camp (AJFC) in Munich and the chance to train with FC Bayern Munich’s youth coaches this August.

 The players thoroughly impressed selectors at the Regional Finals today and will now represent the Sabah in the Grand Finals of the AJFC Malaysia League 2018 from 5 to 7 July 2018.

 In the final, JJFC Tenom were crowned Sabah champions after beating Safa Kota Belud 3-0 at Stadium Likas, Kota Kinabalu today. In the third and fourth placing match, Tabs Safa Bandaraya beat Menggatal Town Academy 1-0.

 “We are very proud to crown the Sabah champions today. All the players showed a lot of heart and played tremendously. With AJFC, Allianz is very proud to be able to give these inspiring, and gifted young footballers a dream experience of what it is like to play football professionally. We congratulate all 18 players for making the team and we wish them the very best in the Grand Finals,” said Johnny Chung, Marketing Manager, Kota Kinabalu branch for Allianz General Insurance Company (Malaysia) Berhad.

 AJFC Malaysia League kicked-off in Central region at Universiti Kebangsaan Malaysia, Bangi on 24 March 2018, followed by Southern region at Kompleks Sukan Hang Jebat, Malacca and Northern region at Universiti Sains Malaysia, Penang (7 April); and East Coast region at Padang Majlis Perbandaran Kuantan 1and Kolej Universiti Islam Pahang Sultan Ahmad Shah in Kuantan, Pahang and Sabah at Padang Sukma Kota Kinabalu (14 April). The format for the Malaysia League remains an 11-a-side affair played for 70 minutes.

Upon the culmination of the Malaysia League, the regional selection panel will then select the top 18 players from each region to form six regional teams that will compete in the Finals. Following three days of centralised training, the six teams will go head to head to determine the winner at the Grand Final on 7 July. At the end of the Grand Finals, 10 players will be selected to attend the AJFC Asia in Bangkok, Thailand, where the best two Malaysian players will be selected to attend AJFC in Munich, Germany.

Keep up to date on AJFC via Allianz Malaysia’s Facebook and Instagram page: facebook.com/AllianzMalaysia and instagram.com/allianzmalaysia.

The Importance of Educating the Whole Child

By Nicky Russell | Head of Primary

Kinabalu International School www.kis.edu.my

We live in a global economy that requires our students to be prepared to think both critically and creatively, evaluate huge amounts of information, solve complex problems, and communicate effectively. A strong foundation in reading, writing, mathematics, and other core subjects is still as important as ever, yet by itself is insufficient for lifelong success.

For too long, we have been committed to time structures, coursework, instructional methods and assessments designed more than a century ago. Our current definition of student success is too narrow. At Kinabalu International School, we put students first, align resources to students’ multiple needs, and advocate for a more balanced approach to education.

What works best for children? What must we all—educators, families, and community members—do to ensure their success? Answering those questions pushes us to redefine what a successful learner is and how we measure success. A student who enters school happily and feels safe is ready to learn, while a student who feels connected to their learning environment is more likely to thrive in school

All students who have access to challenging and engaging academic programmes are better prepared for continuing their educational journey as long as possible. These components must work together, not in isolation.

The demands of the 21st century require a new approach to education— a whole child approach to learning, teaching, and community engagement. Measuring academic achievement is important and necessary; no one is arguing otherwise. But if we fail to move beyond a narrow curriculum and accountability system, we will have failed to adequately prepare our children for their futures.

The broad and balanced curriculum offered at Kinabalu International School inspires students to learn. The range of subjects helps students acquire knowledge, understanding and skills in all aspects of their education, including the humanities and linguistic, mathematical, scientific, technical, social, physical and artistic domains. We ensure that, as well as educating your child in these academic subjects, we are also looking after your child’s emotional and social education.

According to numerous studies, feeling safe at school translates into higher academic achievement, increased student well-being, and greater engagement. Children who don’t feel safe have difficulty concentrating on their studies, don’t connect with their classmates, or don’t go to school at all. It is imperative that a child happily travels through their educational journey, being safe in the knowledge that they will come to no harm while under the care of their teachers and the school staff.

To learn at their best, students must be engaged and motivated. Substantial research shows that students who feel both valued by adults and a part of their school perform better academically and also have more positive social attitudes, values, and behaviours. After-school programmes can promote academic achievement, but their success requires targeted investment, stakeholder commitment, focused academic support, quality programming, and a process of continual improvement. At Kinabalu International School an enhanced Extra Curricular Programme helps support this. Children need to be given the opportunity to further their skills in sport, the arts, debating, adventurous activities or more academic areas outside of the mainstream.

In addition to improving students’ academic performance, research shows that supportive schools also help prevent a host of negative consequences, including isolation and feelings of unhappiness. Central to a supportive school are teachers, administrators, and other caring adults who take a personal interest in the welfare of each student. At Kinabalu International School, each child is treated as an individual and has a learning programme which caters to their strengths, needs, aspirations and goals. We are a school that prides ourselves on our family atmosphere.

To succeed in their secondary and tertiary education, and the workplace, students need higher-level thinking, communication, and problem-solving skills, as well as knowledge of the world and its people. These are all products of a curriculum that challenges students to work hard as they investigate a wide range of real-world subjects. What’s more, secondary school graduates who pursue college and university places must be adequately prepared.

To conclude, in order for a student to achieve their full potential at school, every child needs to:

• Learn in an environment that is physically and emotionally safe for them.

• Be actively engaged in learning and be connected to the school they belong to and its broader community.

• Have access to a personalised learning journey and be supported by qualified, caring adults.

• Be challenged academically and prepared for success in their further studies, and for employment and participation in a global environment.

If you would like to find out more about our school, please contact our Admissions Officer, Tina Koroh, to arrange a tour and explore the opportunities available for your child or contact me, Nicky Russell, Head of Primary, at nickyrussell@kis.edu.my

WHEN IS A SPRAIN A STRAIN, AND IS THERE ANYTHING I CAN DO ABOUT IT?

By Chan Yin Keen | Principal Chiropractor
One Spine Chiropractic, D27, 3rd Floor, Centre Point Sabah.


Have you ever noticed these two words being thrown about, and ever wondered whether they’re two words that mean the same thing or whether it is two completely different things? They are often used to describe injuries where you have overstretched or torn soft tissue structures around your joints. The reality is they refer to different types of soft tissue structures being injured, even if the mechanism of injury is the same!

A joint sprain refers to the overstretching or even tearing of ligaments in a joint. Ligaments, are bands of flexible, fibrous connective tissue that holds two bones or cartilage together to form a joint. The most common location you will see a joint sprain is the ankle. Other locations we typically see joint sprains are knees and wrists.

A joint strain refers to the overstretching or tearing of muscles or even tendons.

Tendons are tough, fibrous bands connective tissue that holds your muscles to your bones. The most common location we see joint or muscle strains in our office is definitely the lower back. Other common locations are your hamstrings, your quads, even the biceps.

If a joint sprain and joint strain still sounds the same, it is because tendons are ligaments are actually quite similar. Both are fibrous bands of connective tissue, and both are made of collagen. The only difference is ligaments connect two bones together, while tendons connect muscle to bone.

The commonality does not stop there, as even the symptoms are almost alike. You are going to find in both cases there is pain, swelling, and limited ability to move or flex the joint. You might see some bruising when it is a sprain, or muscle spasms when it comes to a strain.

Some of you may be well acquainted with how one gets a sprain or strain. It is not uncommon, and for those of us who are clumsy, it is a fairly regular occurrence. Activities like running, jogging, futsal, Crossfit, even golf, can lead to a sprain or strain. Slips and falls, even those where you catch yourself before you hit the ground, can be a mildly painful experience. Lifting heavy objects, lifting incorrectly, are common reasons people get back strains.

Understand that while anyone can get a sprain or a strain, there are certain factors that predisposes you to overstretching your joint. Being out of shape and in poor condition leaves your muscles weak and susceptible to injury. Not warming up before any exercise or athletic endeavour is another factor to consider. Warm ups help stretch out your muscles, gets the blood flowing and ensures you have as much range of motion as possible in your joint to prevent injury to yourself.

Know when your body is fatigued. Tired muscles lead to bad form, and bad form can lead to injury. Heavy lifting when your muscles are fatigued means they may not be able to provide sufficient support. Fatigue when running might mean a misstep and a rolled ankle. Know when your body is fatigued, exercise caution, and save yourself from potential pain.

Let’s just assume you did yourself in with a mild sprain or mild strain. What now? Let me introduce you to your new best friend. RICE. RICE stands for Rest, Ice, Compression and Elevate.

R.I.C.E: 

Rest: Take the weight off the affected joint, avoiding any activities that may cause pain and discomfort. This is to give the joint and soft tissue structures time to heal.

Ice: Ice helps with reduce the swelling and inflammation around the area. It also has a mild numbing
effect, reducing the pain. Always be sure to put a barrier between ice and skin, like clothing or a towel. Leaving it on for 10-20 minutes, then taking it off for 20 minutes, and repeating several more times is a common method of using ice. To clarify, the ice goes on the area that is pain, not anywhere else. Putting the ice on our head when the sprain is in the ankle will not do our ankle any favours sadly.

Compression: Compressing the area affected can help reduce the swelling. Using a bandage or some

compression tape to wrap the joint will keep it from swelling too much as well as reducing movement and the possibility of more damage to the joint. It is important not to wrap too tightly and cut off circulation, as well as to loosen it should pain increase.

Elevate: Elevating the affected joint above the level of your heart is another step in reducing swelling. Fairly easy if the affected joint is your wrist; if it is the knee or ankle, you will need to be lying down on a bed or couch with your leg up to let gravity do its thing.


The RICE protocol will get you through mild sprains and strains, easing the pain and discomfort of the first 48 hours. Once the acute phase is over, rehab based management to maximise stability and strength while reducing the length of time the joint stays injured is paramount, as it can even take months to get over an ankle sprain if not careful.

It is also important to recognize when it’s time to throw in the towel and get professional help. Signs like being unable to stand or walk without significant pain, being unable to move the joint, or if you’re having numbness and tingling at the injured area, indicate a need to see your doctor about that sprain or strain you are having in case it is something a little more serious. Likewise if you are experiencing pain and difficulty moving your joint weeks after your incident, consult your doctor to find out what might be the problem.

Typical mild sprains and strains should ease off enough that you can get back to work or light activity within a few days to a week. It is usually advisable to protect the joint for at least a week or two with tape or a brace so the soft tissue has time to heal. Severe sprains and strains can be to the point where surgery is indicated, should there be a torn ligament or ruptured muscle. Sometimes, an X-ray may be requested to rule out fractures as well.

An interesting fact regarding sprains and strains in young children is that it is rather uncommon to see them with either as they are instead prone to fractures. This is due to the fact that the growth plates (areas where bone grows) on their bones are weaker than their muscles or tendons.

Accidents happen. Sometimes an injury can happen even though we are well prepared. Even so, it helps to take preventative measures to reduce the risk of sprains and strains. Stretches to warm up the joints before any strenuous activities, regular exercise to keep the body active and healthy, knowing our limits and not pushing ourselves over the point of pain, all play a part in reducing the risk of sprains and strains to our joints. Lastly if you do end up with an injury, remember to RICE, and if it looks and feels dire, seek professional help immediately.

A Chosen Child

REAL PEOPLE, REAL STORY: 
THIS IS LETICIA SUNDUVANZA

Written by Caroline Charles-Ting

We would probably had gotten full preparation for new adventures as new parents;

One, if the consent for us to be the parents was finalised as early as the pregnancy was known. Instead, it was already into 7 months.

Two, if baby stayed warm and cosy in mommy’s womb until full term. Instead, she decided that at 31 weeks, was already restless being confined inside. Pre-cautions were taken and for the safety of baby and mom, scheduled C-Section was conducted when baby was 35 weeks on January 8th, 2016.

Basically, only two months’ notice for the stork to deliver the baby.

God has better plans.

And indeed.

That day onwards, we became parents. After 11 years of waiting and several ordeals dealing with infertility.

Leticia Sunduvanza; Leticia means Joy while Sunduvanza picked by her beloved Aki (paternal grandfather) an hour before she was born (!) loosely translated as ‘our spirit/strength’ in Kadazan. She was born with cleft lip and palate. A condition that is one of every 700 pregnancies based on Statistic. It stunned us the minute we saw her ‘differences’ cos we did not expect this during the regular check-ups.

I was telling Him, “Please, no more that I can’t handle Lord,” and at that instant, my husband rubbed his hand on my back. As if sending His message in the form of my husband, a sense of assurance touched me that I have been promised by the Lord that everything will fall in place.

It was hay-wired in the beginning. We were only prepared for a baby in a matter of two months and we certainly did not prepare for baby with special needs. We thought it would be like any other deliveries; baby is born, baby is brought home a few days after. However, things are different with this little one. In short, we did not anticipate the long winding process that we will have to go through just so we can bring a child to our home and live a happy, family life.

How’s life after baby?

Honestly, just like any other new parents would answer, a 360˚ turn in life.

Of course, her arrival has been nothing but a joy. But all the late nights, the panda eyes, the stress...they have all been the same as what other new parents would experience. During those times we had to deal with a colic baby, I remember feeling disappointed at how other parents did not properly explain how this situation would be. At least, I think the experience was not correctly expressed.

Yes, they said something about having to stay up late attending to crying baby that feels like an endless night. Or when you can’t but cry together when baby does not seem to stop crying and you don’t know how else to calm her down. Or the emotional build up you have to keep cos you can’t just burst it out to the husband or family cos they too are in the same boat. But in the end, they (the parents) will all covered up those experiences with “But that’s life.

If given a chance, I would go for it again.” Like, why? And then, after the difficult time phased out-...I realized that if a new parent asks me how it’s like having a new baby, I’ll say the same thing, “It’s difficult. It’s not easy. But that’s life. I would go for it if God let me have another one.” And why is that remark? All cause of that one little coo that melts your heart. Or that adorable giggle that can’t seem to dissipate from your ear. Or the sparkle in baby’s eyes when she stared at you intensely while feeding her that blinds you from all the difficulties you were having. Those moment, they are priceless.

Being a cleft lip and palate baby, embarking into her journey surely adds more variety to our title as new parents. The first one year was all filled up with hospital visits and gathering up strength to face up with her surgery process. It definitely was not easy to find courage in facing days when she was in pain. But we did it! That experience taught us that, in whatever situation life throws at us, with enough love and support from people that matters as well as faith in the Lord, no one will come out defeated. Sure, at times we do feel like we have lost the battle but hey, we did not and we are still fighting. Leticia’s cleft journey is still a long way to go as she might face bullies growing up but we will be there to guide her in understanding what she is and the reason of her existence while at the same time praying she will grow up to become a beautiful woman inside and out.

On a more personal level, being a mom also allows me to discover more of my hidden traits. Such as the need to be organized and to keep things in order. I love planning but I am also a go-with-theflow kind of person. But when baby comes in the picture, the planning part gets more serious. We have no maid to help us look after the baby while we are at work. I am fortunate to have my mother in-law to help us around though. 

However, having a baby means having to add extra house chores and well planned itinerary for the day; laundry several times a week (when we would actually do it once a week pre-baby time), making sure the house is clean and neat to allow the little one to roam around safely, meals are ready in time for the child to eat (when we used to just have sunny side up and rice kicap when we were too lazy to cook), no over-time at work unnecessarily, etc. I must say, motherhood and parenthood really help me fine-tuning this trait. I become more aware of keeping a plan and sticking to it, thrive to make things clear and simple so I will be able to run my role as wife and mother smoothly while avoiding unnecessary stress on my shoulders. So far, I am enjoying this inner 

discovery!

So, a baby in life as a whole? Indescribable.

It’s a mix of every feeling you would ever think of. And you think a child can do that to your life?

Well, welcome to parenthood. Living and loving it!

Meet Emily Chew on ESPACE at Grand Merdeka Mall

Exclusive Interview with Emily Chew
Up close & personal with the creator of ESPACE in Grand Merdeka
Mall and why ESPACE will be your kid’s next favourite place to go!

Interview by Stella Matilda | Image by Hannah William Photography

Tell us a little bit about yourself. 
Born and raised in Kota Kinabalu. I come from a humble family background, and growing up in a property developer family with strong work ethic and strict discipline. I am an Australian National University (ANU) graduate with Bachelor of Commerce (Major in Accounting & Management), and a certified chartered accountant with MIA and CPA Australia accreditation. I am drawn to music, dance, arts and design at a young age. Started ballet training at the age of 5,and pursued ballet for 15 years. I further honed my entrepreneurship and creativity skills by joining my family property development company. Noticing the need for change of landscape and supporting the economy drive in the northern corridor of Kota Kinabalu, i.e. Menggatal, my family decided to start Grand Merdeka Mall and the subsequent future development on this 19 acre land.




How did the idea for ESPACE come about?
After 10 months of operation of the Grand Merdeka Mall, I had an epiphany to change the course of the mall. Thinking to myself how do we differentiate the mall from the malls in the city and our nearby competitors? We can’t just copy and paste the same format in GM Mall. There is no competitive edge for GM Mall if we just put in similar tenant mix as the malls in the region. So I have decided to put more than 50% of the net lettable area (NLA = 300,000 sq ft in total) as family recreation and entertainment outlets, 20-25% as F&B and the rest are for other tenant mix.

It was by chance that my dad and I met up with Kay Yi who then introduced Issac of Escape. We then pursue and venture into this approximately 7,000 sq ft area in the GM Mall as Entertainment Arena, that house a family karaoke centre (KMIX), ESPACE (family and group recreation space with games ranging from synthetic ice skating, archery battle, bubble soccer, soccer darts and many more, 10 lanes of conventional archery arena, and the ESCAPE that promises their newest and more challenging games in town. ESPACE is also known as “Entertainment Space”.



I love that ESPACE offers the first Ice Skating Rink in Sabah. Do you mind to tell me what give you this brilliant idea and how does it work?
It was a group effort to come out with Sabah first ever synthetic ice skating rink. It is about 3000 sq ft rink at the second floor of the mall. Due to the extremely high cost of CAPEX and maintenance cost to maintain a real ice skating rink, and yet at the same time bringing in a new, fresh and most importantly affordable ice skating arena for family, children and corporate companies to have team building activities. Hence a synthetic version came into mind. Synthetic ice skating rink is not relatively new in other parts of the world, or even west Malaysia. There are a few malls that have also installed synthetic Ice Skating, such as Sunway Velocity Mall. Our skaters will wear the normal ice skating shoes and gears to skate on the rink as per the real ice.

Why should families choose to come all the way to ESPACE in Grand Merdeka Mall?
ESPACE in Grand Merdeka Mall is a place for you and your family to spend quality time together and strengthen bonds amongst family members. The games that we offer will make family members of all ages to enjoy and to bond at an affordable price.

How can school integrate their sports activities with ESPACE?
We have also planned to integrate school extra curriculum activities with ESPACE sports/games such as providing the ice skating rink to be the official skating rink for schools. We will organised workshops for school students and also sponsored a few students from each school or institutions to be trained by qualified trainers. Workshops would also encompassed ice skating and archery sports. With these workshops, we are able to help schools to cultivate, nurture and train potential ice skating and archery athletes.

To learn more about what ESPACE is offering, kindly visit them at Grand Merdeka Mall or call 088 357 977. Special bookings are available for birthday parties, team building and many more.

The Life Changing Story of Charlie

On Your Side | Real Life Story: Often times, we hear stories of people with health-related problem and their successful journey of healing. This time, Parents Avenue brings you the life-changing story of Charlie from Kota Marudu, Sabah.

Written by Sylviannie Jreneus 
Parents Avenue Magazine Issue No.11 April to June 2018

Charlie with his parents in the ward on the day of discharge.

Charlie bin Magawa is a 9-year-old boy from Kampung Mantus, Kota Marudu. He is the fifth and the youngest child of Magawa bin Malugot, 55 and Roining binti Kulamau, 49. Charlie has two older brothers and two older sisters. The first two siblings, aged 28 and 25, are currently working with a private agricultural company in Australia. The third sibling, aged 21, is currently unemployed, whilst the fourth sibling is studying in Form One in SMK Tandek, Kota Marudu. As for Charlie, he goes to SK Tanjung Batu, Kota Marudu as a Year 3 student. With a big passion for badminton and art, Charlie leads a normal life just like every other boy at his age. But, little do we know, that Charlie was previously diagnosed with a serious health condition that, had he been left untreated, could have cost him his life.

It all started when Charlie, who was then only 5 years old, was down with fever and later begun to experience breathing difficulties. As every concerned parent would do, his parents brought him to a Kota Marudu Hospital to seek for further help. The doctor on duty did an X-ray on the little boy, which led to the first diagnosis – Charlie had heart issues. The same day that he was diagnosed, Charlie was sent into emergency and was straightaway transferred to Sabah Women and Children Hospital, Likas, Kota Kinabalu.

He received more detailed tests in Sabah Women and Children Hospital. A blood test was performed and the results came in positive that he was suffering from Rheumatic Heart Disease (RHD). A paediatric cardiologist from Sabah Women and Children Hospital, Likas did an X-ray on Charlie. He had found that one of Charlie’s four heart valves was infected.

After detection, Charlie was given antibiotics to fight off against his valve infection, and that treatment lasted for a year. Unfortunately, the valve was still infected, so Charlie had no other choice than to receive a monthly injection during the second year until proper treatment could be done; which is to undergo a heart surgery.

Charlie’s scar 3 months after the surgery.

Rheumatic Heart Disease (RHD) suffered by Charlie is a condition of permanent damage to one or more heart valves. It is caused by rheumatic fever, which is a complication of an untreated bacterial infection with Streptococcus, or “strep”. Like in Charlie’s case, it is all started when he was down with fever but at the same time, he experienced breathing difficulties. Rheumatic fever, which symptoms are shown by Charlie during the early detection, is an inflammatory disease that follows a strep infection. If it is left untreated, it can affect many tissues, especially the heart, joints, skin, or brain. The infection may cause heart damage, particularly scarring of the heart valves. This forces the heart to work harder than usual to pump blood. In some cases, the damage may resolve on its own. However, there are also cases where the damage is permanent, which eventually causes heart failure. Heart-related complications of rheumatic fever may develop months or even years after the initial strep infection.

The doctor who handled Charlie’s case in Sabah Women and Children Hospital, Likas made an effort to ease out the family’s application to get funds from Sabah Council of Social Service (SCSS) as little Charlie needed to undergo a heart surgery as soon as possible. They waited for less than a year before the application was finally approved by YB Datuk Hajjah Jainab DSP Hj Ahmad Ayid, the Ministry of Community Development and Consumer Affairs. That was the first good news received by the family for Charlie’s case. In the meantime, Charlie still depended on the monthly injection until he turned 8.

At first, Charlie’s parents were informed about their available options on where the surgery can be performed, which was at a hospital in India, or Gleneagles Kota Kinabalu Hospital. Due to distance, going to India was not the family’s first option, so they opted for Gleneagles Kota Kinabalu Hospital as they were able to perform the heart surgery for Charlie there. That was indeed the second good news for the family.

Dr. Abu checking Charlie’s heart.

Dr. Abu Bakar, Cardiothoracic Surgeon of Gleneagles Kota Kinabalu Hospital finally handled Charlie’s case. Before surgery, Charlie’s condition worsened up until the point where he turned terribly weak. His skin turned pale, he lost a lot of weight and he was down with swollen chest. He also experienced abdominal and chest pain which made his condition even worse. He was still facing difficulties in breathing due to the worsening of his heart condition. His parents were very heartbroken to see their youngest child being in that condition and have been praying hard to be able to see Charlie’s health back on track again. The strong parents refused to give up on their son.

So the heart surgery was done and there comes the third good news and the biggest blessings for the family. Charlie’s heart surgery was a success! Thanks to all doctors who did their parts throughout his journey as a Rheumatic Heart Disease patient, from a very weak and thin little boy, Charlie is now an active boy and he gained weight as his appetite increased. His parents’ prayers have been answered. Just like typical adventurous boys of his age, he is always with his outdoor activities, especially cycling and playing badminton. The surgery done by Dr. Abu Bakar from Gleneagles Kota Kinabalu Hospital is indeed life changing. Charlie’s case is a living proof of that.

The operation cost is approximately RM60,000 to RM80,000 and was fully funded by Sabah Council of Social Service (SCSS). SCSS, or also known as Majlis Perkhidmatan Masyarakat Sabah (MPMS) is established under the Chairmanship of the Commissioner Labour and Welfare with the main purpose of assisting voluntary welfare work and it includes for health-related cases like Charlie’s. SCSS is later became the constituent partner of The National Council of Social Welfare, Malaysia alongside with the Sarawak Social Welfare Council.

Charlie with his parents at Gleneagles Kota Kinabalu Hospital

As parents, Magawa and Roining were over the moon and were very thankful to be able to receive full funding from SCSS to cover Charlie’s heart surgery cost at Gleneagles Kota Kinabalu Hospital. It was a blessing for the family who are desperate to see their beloved child to live a normal life again. And Charlie just did!

As a father, Magawa has a message for every family who are facing similar situation like theirs. To him, patience is the key. There must be a cure for all diseases, as long as we follow what the doctor’s advice. Doctors are specialised in their own fields and of course the suggestions made by them are the best. As for Charlie’s mother, Roining, she said that it is important for us to act fast for treatments and don’t be afraid to do the surgery because it does change our life. Like her husband, she also encourages each of us to listen to the doctor’s advice.

Gleneagles Kota Kinabalu Hospital, where Charlie’s life-changing heart surgery was performed, is a tertiary level hospital bringing Sabah a Healthcare facility of International standards that shall work towards enhancing care in the state of Sabah. It is assimilated with regionally well-established premium Gleneagles brand inculcating a facility with high quality amenities / comforts, service levels to match, infused with cutting edge technology and have a highly trained team of consultants and staffs.

Gleneagles Kota Kinabalu Cardiac Centre is bolstered by prevention program, diagnosis and treatment directly to the patients, both adults and children. The cardiac team consists of Interventional Cardiologist, Cardiothoracic Surgeon, Cardiac Anaesthetist, Perfusionist, Peadiatric Cardiologist & Cardiac Technicians. They have a standby cardiac catheterization laboratory that would operate for 24 hours. Thanks to the professionalism of the Gleneagles Kota Kinabalu Hospital, many lives were saved, that including Charlie’s.